Impact of Combat Stress on Mental Health Outcomes: BRFSS Survey Data 2006

Abstract

Objectives: This study sought to determine the relationship between combat experience and mental health outcomes. The study sought to determine whether age was a significant factor in poor mental health outcomes. Methods: Multiple logistic regression (n = 195,048) and multiple linear regression (n = 264,154) were performed on the 2006 Behavioral Risk Factor Surveillance System (BRFSS) survey. Veteran status and a host of demographic and health status questions were analyzed in relation to diagnosis of anxiety or depressive disorder (multiple logistic regression) and to number of days poor mental health (multiple linear regression). Results: Diagnosis of anxiety or depression was not found to be associated with veteran status. Among both veterans and nonveterans, diagnosis was associated with age <35 years, female gender, white race, unemployment, poor general health, poor physical health, and low levels of emotional support and life satisfaction. In veterans, diagnosis of anxiety or depression was associated with use of disability equipment. In non-veterans, diagnosis of anxiety or depression was associated with heavy drinkers. Greater days of poor mental health was found to be associated with non-veteran status (B = 0.323). Among both veterans and non-veterans, greater number of poor mental health days was associated with younger age, female gender, white race, unemployment, poor general health, poor physical health, low levels of emotional support or life satisfaction, and heavy drinkers. In veterans, greater days of poor mental health was associated with use of disability equipment. In non-veterans, greater days of poor mental health days associated with divorced, separated, or widowed marital status. Conclusions: Contrary to expectations, veteran status was found to be a protective factor for poor mental health outcomes in this analysis. Younger age was found to be associated with poor mental health outcomes, but was an equal association in both veterans and non-veterans, suggesting that mental health outcomes have not been worsened by recent changes in combat characteristics. Denial of mental health status, stoicism within the military community, and limitations of the survey are proposed to explain the unexpected outcome of this analysis.