Summer - United States Special Operations Command

Editorial Comment on “Psychological Resilience and Postdeployment Social SupportProtect Against Traumatic Stress and Depressive Symptoms in Soldiers Returning fromOperations Enduring Freedom and Iraqi Freedom”Depression and Anxiety (Pietrzak et al., 2009a).LTC Craig A. Myatt, PhD; Douglas C. Johnson, PhD(The referred article can be read in this edition’s Previously Published section.)Pietrzak et al. (2009a) used a cross-sectional methodologicalapproach to support the premise that increased resilienceand adequate social support protect against thepotentially deleterious effects of traumatic stress. The emergingconcern about behavioral health in servicemembers servingin Operations Enduring Freedom and Iraqi Freedom(OEF/OIF) has prompted a wave of research that is now almosta 10 years in the making. Several studies introduced inthe literature during that time examined post-traumatic stressdisorder (PTSD), depression, and related psychopathologicalproblems. However, prior to the Pietrzak et al. (2009a) study,no known research in OEF/OIF veterans examined variablesthat may confer protection against traumatic stress and depressivesymptoms. Their study demonstrated that two keyvariables which appear to confer protection are psychologicalresilience and perceived social support.Pietrzak et al. (2009a) hypothesized that OEF/OIFveterans with PTSD would score lower on measures of resilienceand social support than veterans without PTSD.Their hypothesis also stated that increased resilience and socialsupport would be negatively associated with severity oftraumatic stress and depressive symptoms. They used thePost-traumatic Stress Disorder Checklist – Military Version(PCL-M) to measure PTSD and the Connor-Davidson ResilienceScale (CD-RISC) to measure psychological resiliencein a battery of self-report assessments that alsoexamined combat experiences, depressive symptoms, unitsupport, and post-deployment social support. The researchersestablished a cut-off score on the PCL-M to identify veteranswith PTSD. Among the 272 Active and Reserve componentveterans from all services who participated in the study asvolunteer respondents from the state of Connecticut, those inthe PTSD group scored lower on the CD-RISC (less resilience)than those in the no-PTSD group. In addition, regressionanalysis techniques suggested that scores measuringpsychological resilience on the CD-RISC and post deploymentsocial support were negatively associated with PTSDand depressive symptoms.The authors of the study adequately addressed thelimitations in their study, one of which involved the crosssectionalnature of the study. The cross-sectional study provideda “snap-shot” in time on the behavioral health ofOEF/OIF veterans. They addressed this limitation by emphasizingthe need for longitudinal studies that examine therole of resilience and support factors over time. Pietrzak etal., (2009a) convincingly conclude that resilience and socialsupport may be protective against traumatic stress and depressivesymptoms by a host of mechanisms. Those mechanismsinclude: decreased hypothalamic-pituitary-adrenal axisreactivity, decreased stress related physiological arousal, decreasedfear-related appraisals and cognitions, improvedemotional regulation, and enhanced self-efficacy and control.Several of those mechanisms shed light on the importance ofadopting a biopsychosocial perspective in the considerationof future research and applications.Editorial 79