Reintegration Problems among Iraq and Afghanistan Combat Veterans
OBJECTIVE:
The objectives of this study were to describe the prevalence and types of community reintegration problems among Iraq and Afghanistan combat veterans who receive U.S. Department of Veterans Affairs (VA) medical care, identify interests in interventions or information to promote readjustment to community life, and explore associations between probable posttraumatic stress disorder (PTSD) and reintegration problems and treatment interests.
METHODS:
A national, stratified sample of Iraq-Afghanistan combat veterans receiving VA medical care responded to a mailed survey focused on community reintegration. Of 1,226 veterans surveyed, 754 (62%) responded. Prevalence and proportions were adjusted for potential nonresponse bias.
RESULTS: An estimated 25% to 56% of combat veterans who use VA services reported “some” to “extreme” difficulty in social functioning, productivity, community involvement, and self-care domains. At least one-third reported divorce, dangerous driving, increased substance use, and increased anger control problems since deployment. Almost all (96%) expressed interest in services to help readjust to civilian life (95% confidence interval [CI]=93%–99%). The most commonly preferred ways to receive reintegration services or information were at a VA facility, through the mail, and over the Internet. An estimated 41% (95% CI=36%–46%) screened positive for PTSD, and probable PTSD was associated with reporting more readjustment difficulties and expressing interest in more types of services, including traditional mental health services.
CONCLUSIONS: Iraq-Afghanistan combat veterans who already receive VA medical care reported multiple current reintegration problems and wanted services and information to help them readjust to community life. These concerns were particularly prevalent among those with probable PTSD. Research is needed to explore nontraditional modes of service delivery, including the Internet.
AUTHORS
Nina A. Sayer, Ph.D., Siamak Noorbaloochi, Ph.D., Patricia Frazier, Ph.D., Kathleen Carlson, Ph.D., Amy Gravely, M.A. and Maureen Murdoch, M.D., M.P.H.
Dr. Sayer, Dr. Noorbaloochi, Dr. Carlson, Ms. Gravely, and Dr. Murdoch are affiliated with the Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, 1 Veterans Dr., Minneapolis, MN 55417 (e-mail: nina.sayer@med.va.gov). Dr. Frazier is with the Department of Psychology, University of Minneapolis. Portions of these data were presented at the U.S. Department of Veterans Affairs Health Services Research and Development annual meeting, Baltimore, February 11–13, 2009, and the American Psychological Association annual meeting, Toronto, Ontaria, Canada, August 6–9, 2009.
CITATION
Sayer NA, Rettmann NA, Carlson KF, et al. Veterans with history of mild traumatic brain injury andposttraumatic stress disorder: challenges from provider perspective. J RehabilRes Dev. 2009;46(6):703-16. PubMed PMID: 20104400.
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