Abstract
Purpose
Low social support and small social network size have been associated with a variety of negative mental health outcomes, while their impact on mental health services use is less clear. To date, few studies have examined these associations in National Guard service members, where frequency of mental health problems is high, social support may come from military as well as other sources, and services use may be suboptimal.
Methods
Surveys were administered to 1448 recently returned National Guard members. Multivariable regression models assessed the associations between social support characteristics, probable mental health conditions, and service utilization.
Results
In bivariate analyses, large social network size, high social network diversity, high perceived social support, and high military unit support were each associated with lower likelihood of having a probable mental health condition (p < .001). In adjusted analyses, high perceived social support (OR .90, CI .88–.92) and high unit support (OR .96, CI .94–.97) continued to be significantly associated with lower likelihood of mental health conditions. Two social support measures were associated with lower likelihood of receiving mental health services in bivariate analyses, but were not significant in adjusted models.
Conclusions
General social support and military-specific support were robustly associated with reduced mental health symptoms in National Guard members. Policy makers, military leaders, and clinicians should attend to service members’ level of support from both the community and their units and continue efforts to bolster these supports. Other strategies, such as focused outreach, may be needed to bring National Guard members with need into mental health care.
Similar content being viewed by others
References
Wallston BS, Alagna SW, DeVellis BM, DeVellis RF (1983) Social support and physical health. Health Psychol 2(4):367–391
Flannery RB (1990) Social support and psychological trauma: a methodological review. J Trauma Stress 3(4):593–611
Uchino BN (2009) What a lifespan approach might tell us about why distinct measures of social support have differential links to physical health. J Soc Pers Relat 26(1):53–62. doi:10.1177/0265407509105521
Cohen S (2004) Social relationships and health. Am Psychol 59(8):676–684. doi:10.1037/0003-066X.59.8.676
House JS, Landis KR, Umberson D (1988) Social relationships and health. Science 241(4865):540–545
Browne T, Hull L, Horn O, Jones M, Murphy D, Fear NT, Greenberg N, French C, Rona RJ, Wessely S, Hotopf M (2007) Explanations for the increase in mental health problems in UK reserve forces who have served in Iraq. Br J Psychiatry J Ment Sci 190:484–489. doi:10.1192/bjp.bp.106.030544
Vogt DS, Samper RE, King DW, King LA, Martin JA (2008) Deployment stressors and posttraumatic stress symptomatology: comparing active duty and National Guard/Reserve personnel from Gulf War I. J Trauma Stress 21(1):66–74. doi:10.1002/jts.20306
Harvey SB, Hatch SL, Jones M, Hull L, Jones N, Greenberg N, Dandeker C, Fear NT, Wessely S (2011) Coming home: social functioning and the mental health of UK Reservists on return from deployment to Iraq or Afghanistan. Ann Epidemiol 21(9):666–672. doi:10.1016/j.annepidem.2011.05.004
Platt J, Keyes KM, Koenen KC (2014) Size of the social network versus quality of social support: which is more protective against PTSD? Soc Psychiatry Psychiatr Epidemiol 49(8):1279–1286. doi:10.1007/s00127-013-0798-4
Smyth N, Siriwardhana C, Hotopf M, Hatch SL (2014) Social networks, social support and psychiatric symptoms: social determinants and associations within a multicultural community population. Soc Psychiatry Psychiatr Epidemiol. doi:10.1007/s00127-014-0943-8
Ullman SE, Brecklin LR (2002) Sexual assault history, PTSD, and mental health service seeking in a national sample of women. J Community Psychol 30(3):261–279. doi:10.1002/jcop.10008
Sautter FJ, Glynn SM, Thompson KE, Franklin L, Han X (2009) A couple-based approach to the reduction of PTSD avoidance symptoms: preliminary findings. J Marital Fam Ther 35(3):343–349. doi:10.1111/j.1752-0606.2009.00125.x
Sherbourne CD (1988) The role of social support and life stress events in use of mental health services. Soc Sci Med 27(12):1393–1400
Mitchell ME (1989) The relationship between social network variables and the utilization of mental health services. J Community Psychol 17(3):258–266. doi:10.1002/1520-6629(198907)17:3<258:aid-jcop2290170308>3.0.co;2-l
Meis LA, Barry RA, Kehle SM, Erbes CR, Polusny MA (2010) Relationship adjustment, PTSD symptoms, and treatment utilization among coupled National Guard soldiers deployed to Iraq. J Fam Psychol 24(5):560–567. doi:10.1037/a0020925
Lin N, Ye X, Ensel WM (1999) Social support and depressed mood: a structural analysis. J Health Soc Behav 40(4):344–359
Kawachi I, Berkman LF (2000) Social cohesion, social capital, and health. In: Berkman LF, Kawachi I (eds) Social epidemiology. Oxford University Press, New York, pp 174–190
Chou KL, Liang K, Sareen J (2011) The association between social isolation and DSM-IV mood, anxiety, and substance use disorders: wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 72(11):1468–1476. doi:10.4088/JCP.10m06019gry
Escobar JI, Randolph ET, Puente G, Spiwak F, Asamen JK, Hill M, Hough RL (1983) Post-traumatic stress disorder in Hispanic Vietnam veterans. Clinical phenomenology and sociocultural characteristics. J Nerv Mental Dis 171(10):585–596
Hatch SL, Harvey SB, Dandeker C, Burdett H, Greenberg N, Fear NT, Wessely S (2013) Life in and after the Armed Forces: social networks and mental health in the UK military. Sociol Health Illn 35(7):1045–1064. doi:10.1111/1467-9566.12022
King LA, King DW, Fairbank JA, Keane TM, Adams GA (1998) Resilience-recovery factors in post-traumatic stress disorder among female and male Vietnam veterans: hardiness, postwar social support, and additional stressful life events. J Pers Soc Psychol 74(2):420–434
Soares A, Biasoli I, Scheliga A, Baptista RL, Brabo EP, Morais JC, Werneck GL, Spector N (2013) Association of social network and social support with health-related quality of life and fatigue in long-term survivors of Hodgkin lymphoma. Support Care Cancer Off J Multinatl Assoc Support Care Cancer 21(8):2153–2159. doi:10.1007/s00520-013-1775-x
Keane TM, Scott WO, Chavoya GA, Lamparski DM, Fairbank JA (1985) Social support in Vietnam veterans with posttraumatic stress disorder: a comparative analysis. J Consult Clin Psychol 53(1):95–102
Cohen S, Wills TA (1985) Stress, social support, and the buffering hypothesis. Psychol Bull 98(2):310–357
Barnett PA, Gotlib IH (1988) Psychosocial functioning and depression: distinguishing among antecedents, concomitants, and consequences. Psychol Bull 104(1):97–126
Schuster TL, Kessler RC, Aseltine RH Jr (1990) Supportive interactions, negative interactions, and depressed mood. Am J Community Psychol 18(3):423–438
Turner RJ (1981) Social support as a contingency in psychological well-being. J Health Soc Behav 22(4):357–367. doi:10.2307/2136677
Fuller-Thomson E, Battiston M, Gadalla TM, Brennenstuhl S (2014) Bouncing back: remission from depression in a 12-year panel study of a representative Canadian community sample. Soc Psychiatry Psychiatr Epidemiol 49(6):903–910. doi:10.1007/s00127-013-0814-8
Salinero-Fort MA, Jimenez-Garcia R, de Burgos-Lunar C, Chico-Moraleja RM, Gomez-Campelo P (2014) Common mental disorders in primary health care: differences between Latin American-born and Spanish-born residents in Madrid. Soc Psychiatry Psychiatr Epidemiol, Spain. doi:10.1007/s00127-014-0962-5
Handley TE, Inder KJ, Kelly BJ, Attia JR, Lewin TJ, Fitzgerald MN, Kay-Lambkin FJ (2012) You’ve got to have friends: the predictive value of social integration and support in suicidal ideation among rural communities. Soc Psychiatry Psychiatr Epidemiol 47(8):1281–1290. doi:10.1007/s00127-011-0436-y
Sundermann O, Onwumere J, Kane F, Morgan C, Kuipers E (2014) Social networks and support in first-episode psychosis: exploring the role of loneliness and anxiety. Soc Psychiatry Psychiatr Epidemiol 49(3):359–366. doi:10.1007/s00127-013-0754-3
Coker AL, Smith PH, Thompson MP, McKeown RE, Bethea L, Davis KE (2002) Social support protects against the negative effects of partner violence on mental health. J Womens Health Gend Based Med 11(5):465–476. doi:10.1089/15246090260137644
Brewin CR, Andrews B, Valentine JD (2000) Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol 68(5):748–766
Ozer EJ, Best SR, Lipsey TL, Weiss DS (2003) Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychol Bull 129(1):52–73
Dinenberg RE, McCaslin SE, Bates MN, Cohen BE (2014) Social support may protect against development of posttraumatic stress disorder: findings from the Heart and Soul Study. Am J Health Promot 28(5):294–297. doi:10.4278/ajhp.121023-QUAN-511
Kadushin C (1983) Mental health and the interpersonal environment: a reexamination of some effects of social structure on mental health. Am Sociol Rev 48(2):188–198
Marchand A, Durand P, Haines V 3rd, Harvey S (2014) The multilevel determinants of workers’ mental health: results from the SALVEO study. Soc Psychiatry Psychiatr Epidemiol. doi:10.1007/s00127-014-0932-y
Myklestad I, Roysamb E, Tambs K (2012) Risk and protective factors for psychological distress among adolescents: a family study in the Nord-Trondelag Health Study. Soc Psychiatry Psychiatr Epidemiol 47(5):771–782. doi:10.1007/s00127-011-0380-x
Modie-Moroka T (2014) Stress, social relationships and health outcomes in low-income Francistown, Botswana. Soc Psychiatry Psychiatr Epidemiol 49(8):1269–1277. doi:10.1007/s00127-013-0806-8
Brewin CR, Andrews B, Valentine JD (2000) Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol 68(5):748–766
Boscarino JA (1995) Post-traumatic stress and associated disorders among Vietnam veterans: the significance of combat exposure and social support. J Trauma Stress 8(2):317–336
Tsai J, Harpaz-Rotem I, Pietrzak RH, Southwick SM (2012) The role of coping, resilience, and social support in mediating the relation between PTSD and social functioning in veterans returning from Iraq and Afghanistan. Psychiatry 75(2):135–149. doi:10.1521/psyc.2012.75.2.135
Pietrzak RH, Goldstein MB, Malley JC, Rivers AJ, Southwick SM (2010) Structure of posttraumatic stress disorder symptoms and psychosocial functioning in Veterans of Operations Enduring Freedom and Iraqi Freedom. Psychiatry Res 178(2):323–329. doi:10.1016/j.psychres.2010.04.039
Pietrzak RH, Johnson DC, Goldstein MB, Malley JC, Rivers AJ, Morgan CA, Southwick SM (2010) Psychosocial buffers of traumatic stress, depressive symptoms, and psychosocial difficulties in veterans of Operations Enduring Freedom and Iraqi Freedom: the role of resilience, unit support, and postdeployment social support. J Affect Disord 120(1–3):188–192. doi:10.1016/j.jad.2009.04.015
Pietrzak RH, Johnson DC, Goldstein MB, Malley JC, Southwick SM (2009) Psychological resilience and postdeployment social support protect against traumatic stress and depressive symptoms in soldiers returning from Operations Enduring Freedom and Iraqi Freedom. Depress Anxiety 26(8):745–751. doi:10.1002/da.20558
King LA, King DW, Vogt DS, Knight J, Samper RE (2006) Deployment risk and resilience inventory: a collection of measures for studying deployment-related experiences of military personnel and veterans. Mil Psychol 18(2):89–120. doi:10.1207/S15327876mp1802_1
Vogt DS, Pless AP, King LA, King DW (2005) Deployment stressors, gender, and mental health outcomes among Gulf War I veterans. J Trauma Stress 18(3):272–284. doi:10.1002/jts.20044
Iversen AC, Fear NT, Ehlers A, Hacker Hughes J, Hull L, Earnshaw M, Greenberg N, Rona R, Wessely S, Hotopf M (2008) Risk factors for post-traumatic stress disorder among UK Armed Forces personnel. Psychol Med 38(4):511–522. doi:10.1017/S0033291708002778
Brailey K, Vasterling JJ, Proctor SP, Constans JI, Friedman MJ (2007) PTSD symptoms, life events, and unit cohesion in US soldiers: baseline findings from the neurocognition deployment health study. J Trauma Stress 20(4):495–503. doi:10.1002/jts.20234
Dickstein BD, McLean CP, Mintz J, Conoscenti LM, Steenkamp MM, Benson TA, Isler WC, Peterson AL, Litz BT (2010) Unit cohesion and PTSD symptom severity in Air Force medical personnel. Mil Med 175(7):482–486
Smith BN, Vaughn RA, Vogt D, King DW, King LA, Shipherd JC (2013) Main and interactive effects of social support in predicting mental health symptoms in men and women following military stressor exposure. Anxiety Stress Coping 26(1):52–69. doi:10.1080/10615806.2011.634001
Harpaz-Rotem I, Rosenheck RA, Pietrzak RH, Southwick SM (2014) Determinants of prospective engagement in mental health treatment among symptomatic Iraq/Afghanistan veterans. J Nerv Ment Dis 202(2):97–104. doi:10.1097/NMD.0000000000000078
Han SC, Castro F, Lee LO, Charney ME, Marx BP, Brailey K, Proctor SP, Vasterling JJ (2014) Military unit support, postdeployment social support, and PTSD symptoms among active duty and National Guard soldiers deployed to Iraq. J Anxiety Disord 28(5):446–453. doi:10.1016/j.janxdis.2014.04.004
Ozbay F, Johnson DC, Dimoulas E, Morgan CA, Charney D, Southwick S (2007) Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry 4(5):35–40
Fleming R, Baum A, Gisriel MM, Gatchel RJ (1982) Mediating influences of social support on stress at Three Mile Island. J Hum Stress 8(3):14–22. doi:10.1080/0097840X.1982.9936110
Ozer EJ, Weinstein RS (2004) Urban adolescents’ exposure to community violence: the role of support, school safety, and social constraints in a school-based sample of boys and girls. J Clin Child Adolesc Psychol 33(3):463–476. doi:10.1207/s15374424jccp3303_4
Eriksson CB, Vande Kemp H, Gorsuch R, Hoke S, Foy DW (2001) Trauma exposure and PTSD symptoms in international relief and development personnel. J Trauma Stress 14(1):205–212. doi:10.1023/A:1007804119319
Teo AR, Choi H, Valenstein M (2013) Social relationships and depression: ten-year follow-up from a nationally representative study. PLoS ONE 8(4):e62396. doi:10.1371/journal.pone.0062396
Cacioppo JT, Hawkley LC, Thisted RA (2010) Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study. Psychol Aging 25(2):453–463. doi:10.1037/a0017216
Golden J, Conroy RM, Bruce I, Denihan A, Greene E, Kirby M, Lawlor BA (2009) Loneliness, social support networks, mood and wellbeing in community-dwelling elderly. Int J Geriatr Psychiatry 24(7):694–700. doi:10.1002/gps.2181
Tempier R, Balbuena L, Lepnurm M, Craig TK (2013) Perceived emotional support in remission: results from an 18-month follow-up of patients with early episode psychosis. Soc Psychiatry Psychiatr Epidemiol 48(12):1897–1904. doi:10.1007/s00127-013-0701-3
Broadhead WE, Gehlbach SH, deGruy FV, Kaplan BH (1989) Functional versus structural social support and health care utilization in a family medicine outpatient practice. Med Care 27(3):221–233
Maulik PK, Eaton WW, Bradshaw CP (2011) The effect of social networks and social support on mental health services use, following a life event, among the Baltimore Epidemiologic Catchment Area cohort. J Behav Health Serv Res 38(1):29–50. doi:10.1007/s11414-009-9205-z
Munoz-Laboy M, Severson N, Perry A, Guilamo-Ramos V (2014) Differential impact of types of social support in the mental health of formerly incarcerated latino men. Am J Mens Health 8(3):226–239. doi:10.1177/1557988313508303
Price M, Davidson TM, Ruggiero KJ, Acierno R, Resnick HS (2014) Predictors of using mental health services after sexual assault. J Trauma Stress 27(3):331–337. doi:10.1002/jts.21915
Spoont MR, Nelson DB, Murdoch M, Rector T, Sayer NA, Nugent S, Westermeyer J (2014) Impact of treatment beliefs and social network encouragement on initiation of care by VA service users with PTSD. Psychiatr Serv 65(5):654–662. doi:10.1176/appi.ps.201200324
Pietrzak RH, Johnson DC, Goldstein MB, Malley JC, Southwick SM (2009) Perceived stigma and barriers to mental health care utilization among OEF-OIF veterans. Psychiatr Serv 60(8):1118–1122. doi:10.1176/appi.ps.60.8.1118
Albert M, Becker T, McCrone P, Thornicroft G (1998) Social networks and mental health service utilisation—a literature review. Int J Soc Psychiatry 44(4):248–266
Fikretoglu D, Brunet A, Guay S, Pedlar D (2007) Mental health treatment seeking by military members with posttraumatic stress disorder: findings on rates, characteristics, and predictors from a nationally representative Canadian military sample. Can J Psychiatry 52(2):103–110
Sayer NA, Friedemann-Sanchez G, Spoont M, Murdoch M, Parker LE, Chiros C, Rosenheck R (2009) A qualitative study of determinants of PTSD treatment initiation in veterans. Psychiatry 72(3):238–255. doi:10.1521/psyc.2009.72.3.238
Sripada RK, Pfeiffer PN, Rauch SA, Bohnert KM (2015) Social support and mental health treatment among persons with PTSD: results of a nationally representative survey. Psychiatr Serv 66(1):65–71. doi:10.1176/appi.ps.201400029
Smith-Osborne A (2009) Mental health risk and social ecological variables associated with educational attainment for gulf war veterans: implications for veterans returning to civilian life. Am J Community Psychol 44(3–4):327–337. doi:10.1007/s10464-009-9278-0
Andersen RM (1995) Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav 36(1):1–10
Interian A, Kline A, Callahan L, Losonczy M (2012) Readjustment stressors and early mental health treatment seeking by returning National Guard soldiers with PTSD. Psychiatr Serv 63(9):855–861. doi:10.1176/appi.ps.201100337
Kehle SM, Polusny MA, Murdoch M, Erbes CR, Arbisi PA, Thuras P, Meis LA (2010) Early mental health treatment-seeking among U.S. National Guard soldiers deployed to Iraq. J Trauma Stress 23(1):33–40. doi:10.1002/jts.20480
Sayer NA, Clothier B, Spoont M, Nelson DB (2007) Use of mental health treatment among veterans filing claims for posttraumatic stress disorder. J Trauma Stress 20(1):15–25. doi:10.1002/jts.20182
Lehavot K, Der-Martirosian C, Simpson TL, Shipherd JC, Washington DL (2013) The role of military social support in understanding the relationship between PTSD, physical health, and healthcare utilization in women veterans. J Trauma Stress 26(6):772–775. doi:10.1002/jts.21859
Gourash N (1978) Help-seeking: a review of the literature. Am J Community Psychol 6(5):413–423
Milliken CS, Auchterlonie JL, Hoge CW (2007) Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war. JAMA 298(18):2141–2148. doi:10.1001/jama.298.18.2141 298/18/2141 [pii]
Thomas JL, Wilk JE, Riviere LA, McGurk D, Castro CA, Hoge CW (2010) Prevalence of mental health problems and functional impairment among active component and National Guard soldiers 3 and 12 months following combat in Iraq. Arch Gen Psychiatry 67(6):614–623. doi:10.1001/archgenpsychiatry.2010.54
Kehle SM, Polusny MA, Murdoch M, Erbes CR, Arbisi PA, Thuras P, Meis LA (2010) Early mental health treatment-seeking among US National Guard soldiers deployed to Iraq. J Trauma Stress 23(1):33–40. doi:10.1002/jts.20480
Dillman D, Smyth J, Christian L (2009) Internet, Mail, and Mixed-Mode Surveys: The Tailored Design Method. Wiley, New York
Valenstein M, Gorman L, Blow AJ, Ganoczy D, Walters H, Kees M, Pfeiffer PN, Kim HM, Lagrou R, Wadsworth SM, Rauch SA, Dalack GW (2014) Reported barriers to mental health care in three samples of U.S. Army National Guard soldiers at three time points. J Trauma Stress 27(4):406–414. doi:10.1002/jts.21942
Bonar EE, Bohnert KM, Walters HM, Ganoczy D, Valenstein M (2014) Student and nonstudent national guard service members/veterans and their use of services for mental health symptoms. J Am Coll Health: 0. doi:10.1080/07448481.2014.975718
Weathers FW, Huska JA, Keane TM (1991) PCL for DSM-IV. In. National Center for PTSD—Behavioral Science Division, Boston
Lowe B, Unutzer J, Callahan CM, Perkins AJ, Kroenke K (2004) Monitoring depression treatment outcomes with the patient health questionnaire-9. Med Care 42(12):1194–1201
Kroenke K, Spitzer RL, Williams JB, Lowe B (2010) The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. Gen Hosp Psychiatry 32(4):345–359. doi:10.1016/j.genhosppsych.2010.03.006
Kroenke K, Spitzer RL, Williams JBW (2001) The PHQ-9. J Gen Intern Med 16(9):606–613. doi:10.1046/j.1525-1497.2001.016009606.x
Spitzer RL, Kroenke K, Williams JB (1999) Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary care evaluation of mental disorders. Patient health questionnaire. J Am Med Assoc 282(18):1737–1744. doi:10.1001/jama.282.18.1737
Wittkampf KA, Naeije L, Schene AH, Huyser J, van Weert HC (2007) Diagnostic accuracy of the mood module of the patient health questionnaire: a systematic review. Gen Hosp Psychiatry 29(5):388–395. doi:10.1016/j.genhosppsych.2007.06.004
Spitzer RL, Kroenke K, Williams JB, Lowe B (2006) A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 166(10):1092–1097. doi:10.1001/archinte.166.10.1092
Osman A, Bagge CL, Gutierrez PM, Konick LC, Kopper BA, Barrios FX (2001) The suicidal behaviors questionnaire-revised (SBQ-R): validation with clinical and nonclinical samples. Assessment 8(4):443–454
Cohen S, Wills TA (1985) Stress, social support, and the buffering hypothesis. Psychol Bull 98(2):310–357
Cohen S, Hoberman HM (1983) Positive events and social supports as buffers of life change stress. J Appl Soc Psychol 13(2):99–125. doi:10.1111/j.1559-1816.1983.tb02325.x
Cohen S, Mermelstein R, Karmarck TW, Hoberman H (1985) Measuring the functional components of social support. In: Sarason IG, Sarason BR (eds) Social support: theory, research and application. Martinus Nijhoff, The Hague
Merz EL, Roesch SC, Malcarne VL, Penedo FJ, Llabre MM, Weitzman OB, Navas-Nacher EL, Perreira KM, Gonzalez F, Ponguta LA, Johnson TP, Gallo LC (2014) Validation of Interpersonal Support Evaluation List-12 (ISEL-12) Scores Among English- and Spanish-Speaking Hispanics/Latinos From the HCHS/SOL Sociocultural Ancillary Study. Psychol Assess 26(2):384–394. doi:10.1037/a0035248
Vogt DS, Proctor SP, King DW, King LA, Vasterling JJ (2008) Validation of scales from the deployment risk and resilience inventory in a sample of operation Iraqi freedom veterans. Assessment 15(4):391–403. doi:10.1177/1073191108316030
Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA (1998) The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol use disorders identification test. Arch Intern Med 158(16):1789–1795
Hoge CW, Auchterlonie JL, Milliken CS (2006) Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. JAMA 295(9):1023–1032. doi:10.1001/jama.295.9.1023
Ware J Jr, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34(3):220–233
Fasoli DR, Glickman ME, Eisen SV (2010) Predisposing characteristics, enabling resources and need as predictors of utilization and clinical outcomes for veterans receiving mental health services. Med Care 48(4):288–295
Suitor J, Keeton S (1997) Once a friend, always a friend? Effects of homophily on women’s support networks across a decade. Soc Netw 19(1):51–62. doi:10.1016/S0378-8733(96)00290-0
Auslander GK, Soskolne V, Ben-Shahar I (2005) Utilization of health social work services by older immigrants and veterans in Israel. Health Soc Work 30(3):241–251
Monson CM, Gradus JL, Young-Xu Y, Schnurr PP, Price JL, Schumm JA (2008) Change in posttraumatic stress disorder symptoms: do clinicians and patients agree? Psychol Assess 20(2):131–138. doi:10.1037/1040-3590.20.2.131
Karstoft KI, Armour C, Elklit A, Solomon Z (2013) Long-term trajectories of posttraumatic stress disorder in veterans: the role of social resources. J Clin Psychiatry 74(12):e1163–e1168. doi:10.4088/JCP.13m08428
Lowe SR, Galea S, Uddin M, Koenen KC (2014) Trajectories of posttraumatic stress among urban residents. Am J Community Psychol 53(1–2):159–172. doi:10.1007/s10464-014-9634-6
Kaniasty K, Norris FH (2008) Longitudinal linkages between perceived social support and posttraumatic stress symptoms: sequential roles of social causation and social selection. J Trauma Stress 21(3):274–281. doi:10.1002/jts.20334
Acknowledgments
This work was supported by the Department of Veterans Affairs Health Services Research and Development Service, RRP 09-420 and SDP 10-047; the Welcome Back Veterans Initiative, the McCormick Foundation, and Families and Communities Together Coalition of Michigan State University. Writing of this manuscript was supported by the Department of Veterans Affairs Office of Academic Affiliations, Advanced Fellowship Program in Mental Illness Research and Treatment, the Veterans Affairs Serious Mental Illness Treatment Resource and Evaluation Center (SMITREC) and the Mental Health Service of the VA Ann Arbor Healthcare System.
Ethical standards
This study was approved by the Institutional Review Board of the Department of Veterans Affairs Ann Arbor Healthcare System and was therefore performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Data were collected under an approved waiver of written informed consent.
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sripada, R.K., Bohnert, A.S.B., Teo, A.R. et al. Social networks, mental health problems, and mental health service utilization in OEF/OIF National Guard veterans. Soc Psychiatry Psychiatr Epidemiol 50, 1367–1378 (2015). https://doi.org/10.1007/s00127-015-1078-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00127-015-1078-2