Optimism, Deployment Intensity and Incident Psychological Disorders in Young U.S. Army Active Duty Soldiers

Introduction: The mental health of our Soldiers is of critical importance to Army leadership. Understanding the effects of combat exposure on mental health and what psychological factors can buffer against mental health issues in young Soldiers is an area of ongoing study. This project investigated the association between Optimism, deployment intensity, and the onset of psychological disorders following deployment in a sample of young U.S. Army active duty Soldiers.

Methods: We used the Person-Event Data Environment (PDE), a secure Army data repository and analysis environment, to integrate existing Global Assessment Tool (GAT), Defense Manpower Data Center (DMDC), Deployment Health Assessment (DHA), and Military Health Systems Data Repository (MDR) data. For this study, we examined a sample of 18,741 young (17 – 25 years of age) U.S. Army active duty Soldiers who deployed for the first time between April 2009 and March 2013 and who were free from psychological disorders prior to deployment. We limited the scope of the study to four psychological disorders: adjustment reaction disorder, anxiety disorder, major depressive disorder, and post-traumatic stress disorder (PTSD). Psychological disorders were identified using diagnostic code data from electronic medical records in the MDR. We applied survival analysis techniques to investigate the relationship between baseline Optimism and psychological disorder incidence over a three-year follow up period. Each outcome was modelled separately, and all models adjusted for relevant demographic (e.g., age, gender, race, education, and marital status) and military (e.g., rank, deployment history) characteristics.

Results: We found that greater baseline Optimism was associated with a decreased risk of developing incident depression, anxiety disorder, PTSD, and adjustment disorder (modelled separately). As expected, greater deployment intensity was associated with a greater risk of developing one of the psychological disorders under examination. Additionally, the protective effects of Optimism were attenuated at high levels of combat intensity (i.e., in extremely tough situations).

Conclusions: It is critical that we monitor and promote Soldiers’ mental health in order to maintain the health and readiness of our troops. Future research should examine the extent to which modifying Soldiers’ Optimism through Army resilience-building programs affords greater protection against the onset of psychological disorders following deployment.