Reintegration challenges among post-9/11 veterans: The role of mental health symptoms and resilience- and avoidance-based coping strategies

Many returning service members deployed in the wars of Iraq and Afghanistan (Operations Enduring Freedom, Iraqi Freedom and New Dawn) face numerous challenges within post-deployment community reintegration (PDCR), including mild traumatic brain injury, chronic pain, and psychological disorders such as PTSD– a constellation of symptoms referred to as polytrauma. Within a transdiagnostic acceptance and commitment therapy (ACT) framework, optimal PDCR is hindered by excesses in maladaptive avoidance-based coping and deficits in resilience-based coping. The present cross-sectional study examined the relationship between vulnerability (psychological distress, PTSD symptomology, and experiential avoidance) and resilience (values-based living; VBL) factors with PDCR in a sample of 298 Veterans with polytrauma-related concerns (N_male = 244, M_age = 40.6). Results indicated: 1) higher psychological distress, PTSD symptomology, and experiential avoidance, respectively, and low VBL were significantly associated with greater PDCR difficulty; and 2) Veterans high in VBL (versus low) demonstrated a strengthened association between psychological distress and PTSD symptomology, respectively, with PDCR difficulty. These slope differences revealed a lack of differentiation in PDCR at high levels of distress/PTSD: PDCR difficulty was high for all levels of VBL. Conversely, at low-to-moderate levels of distress/PTSD, differences in PDCR difficulty were observed across VBL levels: PDCR difficulty was lower for Veterans high in VBL (versus low), suggesting VBL as a potential catalyst for facilitating optimal PDCR, but only for a limited range of symptom severity. Findings support the use of transdiagnostic ACT to improve outcomes for Veterans with polytrauma-related concerns.