The experience of serving in wartime and being a combatant at war or exposed to an active theater of war is highly stressful. Studies have repeatedly found that military personnel that engage in direct combat are at increased risk for experiencing elevation of Post Traumatic Stress (PTS) symptoms, also known as Combat Stress Reactions (CSR). The PTS symptoms are predictive of diagnosed Post Traumatic Stress Disorder (PTSD). PTSD is a painfully experienced disorder that is often long-term. It is characterized by re-experiencing traumatic thoughts or feelings, avoidance of stimuli related to the original trauma, and hyper-arousal, following exposure to life threatening events. Estimates of psychological casualties, most typically measured in the form of PTSD are estimated to be as high as 30 percent of American troops serving in Iraq and Afghanistan (Lapierre, Schwegler, & LaBauve, 2007
). These outcomes, PTS symptoms and PTSD, have been the predominant focus of post-war studies (Friedman, Schnurr, & McDonagh-Coyle, 1994
; Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995
; Koenen, Stellman, Stellman & Sommer, 2003
; Simms, Watson & Doebbeling, 2002
Persons with PTSD or high levels of PTS symptoms often display impaired role and emotional functioning compared to others who have experienced traumatic events but who do not have PTSD or high symptom levels, and also as compared to the general population (Kessler, 2000
; Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995
; Zatzick et al., 1997
). In turn, this reduced functioning is likely to affect many life domains such as social, emotional, and physical health (Orsillo et al., 1996
; Gimbel & Booth, 1994
; Prigerson, Maciejewski & Rosenheck, 2001
) resulting in a downward spiral that can further exacerbate PTS symptoms. In addition, this negative spiral has the potential to also affect job related outcomes such as job burnout and job retention that are relevant to organizational effectiveness.
In addition to being exposed to the traumatic events of war, military forces also experience other stressful events and conditions as they serve in far away countries. These stressful events include separation from families and communities in a process called deployment. Thus, leaving one’s familiar surroundings and stable social networks is fraught with psychological, relationship, economic, and social consequences that must be put aside to deal with the mission of the war. In short, warfare puts soldiers face to face with traumatic events and extraordinary demands that may deplete their adaptive resources and result in poor mental health and deteriorating personal and organizational functioning. At the same time, involvement in the military and the experience of war is often also reported as rewarding, providing enhanced self esteem, a sense of comradery, mastery, courage, and altruism (Aldwin, Levenson, & Spiro, 1994
The human toll of the wars in Iraq and Afghanistan provides an important context for examining the relationships among stressors, which refer to conditions that undermine the capacity for adaptive responses, and their effects on perceived health, psychological well being and role and emotional functioning. To explore the effects of the causal sequence from deployment to war through exposure to trauma and their effects on mental health and functioning, we longitudinally surveyed Air Force personnel who were either deployed to the theaters of the war such as in Iraq or Afghanistan, or to non-theater regions such as in Europe or Southeast Asia. We employed Conservation of Resources (COR) theory (Hobfoll, 1989
) in framing our study and study instruments. We believe that our study is novel in that it integrates research and theory that has been applied to PTS processes and to burnout and organizational processes, whereas these two have typically been explored separately. Our overall goal was to examine the adverse effects of a stress cycle for soldiers serving at times of war on two distinct types of outcomes. One type of outcome consists of health and functioning (e.g., perceived health, role functioning). The other type consists of personal but relevant organizational variables (e.g., job burnout, organizational commitment).
This stress cycle begins with deployment to the theaters of the war and the exposure to various war traumas in the theater, which in turn, potentially contribute to PTS symptoms, and, in turn, may contribute to further loss of resources. This combination of PTS symptoms and ongoing resource loss, in turn, contributes to compromised role functioning and poor health. As noted, we also examine the possible adverse effects of this cycle on major organizational-relevant outcomes such as job burnout, organizational commitment, deployment readiness, and intention to reenlist. Although these are personal outcomes, they are deemed to have an impact on the effective functioning and readiness of the Air Force as an organization.
In the past 20 years, Conservation of Resource (COR) theory has provided an organizing set of principles that tie together the experiences of stress and coping (Hobfoll, 1989
). According to COR theory, the major cause of stress is actual loss or a threat of loss of resources. Resources are defined as "… those objects, personal characteristics, conditions, or energies that are valued by the individual or that serve as means for [their] attainment …” (Hobfoll, 1989
, p. 516). Loss and threat of loss are seen by COR theory as precursors to distress and are also hypothesized to activate coping efforts aimed at averting further losses or replenish lost resources. The failure to cope successfully with losses is then manifested in various symptoms of general or specific types of psychological distress (e.g., general anxiety, job strain), difficulties functioning in critical life domains, and diminished physical health. At the same time, COR theory suggests that people are engaged in life and work tasks, in part, to gain and conserve personal, social and material resources, ranging from love and trust on the personal, abstract level, to job security, career advancement and monetary gain on the concrete level. In the current study, we focus on trauma and stressful conditions, but it is important to note that these occur in the context of the study of a healthy, selective and screened population who are actively investing resources not only to offset loss, but to make life gains for themselves, their family, and the nation. Nevertheless, a population deployed to war is at risk of losing important resources due to the deployment that entails separation from family and friends and, for members of the Reserve force, from the civilian job, and other losses of resources such as physical health due to physical injury, and stressful experiences of the engagement in the war itself. Thus the deployment to war endangers not only such vital resources as physical health and well being but also social and family relationships, career and financial resources.
In research on COR theory, loss of resources has been shown to contribute to elevated PTS symptoms (Hobfoll, Canetti-Nisim & Johnson, 2006
). However, if the relationship between resource loss and PTS symptomatology is viewed more broadly, it is possible to see the two phenomena as part of a spiraling cycle, where one exacerbates the other with possible reciprocal effects between them (Johnson, Palmieri, Jackson, & Hobfoll, 2007
). This possibility has not been addressed in the existing literature. Hence, rather than examining these relationships only unidirectionally, which is what has been done in most prior research, we also examined the longitudinal reciprocal effects of PTS symptoms and resource loss on each other. COR theory would suggest that resource loss and PTS symptoms have downstream impact on social and emotional functioning, perceived health, and organizational-relevant personal outcomes (e.g., job burnout, deployment readiness, intention to reenlist). Given that the sample of respondents used in this study is comprised of U.S. military personnel, organizational-relevant outcomes are of particular importance to the armed forces as an organization that is dependent on maintaining a healthy, well-trained, and ready workforce. With the exception of studies on the relationship of burnout to resource loss, there is a gap in the literature regarding the unique and joint effects of PTS symptoms and resource loss on other relevant organizational outcomes.
Of the various organizational relevant outcomes investigated in this study, we seek to highlight the effects of exposure to war, PTS symptoms and resource loss associated with deployment, on job burnout because COR theory provides a comprehensive approach to explain both burnout (cf. Hobfoll & Shirom, 1993
) and PTS (Hobfoll, 1991
). Job burnout is often defined as a psychological strain that results from depletion of personal coping resources in the workplace. And according to COR theory, it is most likely to occur in situations or times when there is an actual or perceived resource loss or a threat of loss, such as during deployment or exposure to the hardship of war which characterize the situations experienced by about half of the sample in this study. Further, according to COR theory, military personnel who are exposed to both trauma related loss and work related loss, as well as the losses related to deployment and being away from families, would be at high risk for experiencing major loss cycles.
In the context of service in the military during the time of Operation Enduring Freedom and of Operation Iraqi Freedom, it is important to consider different groups of military personnel such as those serving in the active duty force versus those serving in the Reserve and the National Guard, henceforth referred to together as the Reserve force. Active duty personnel are full-time members of the armed forces, whereas the members of the Reserve force hold jobs primarily in civilian occupations and participate in the military on a part-time basis. When deployed in support of military operations, members of the Reserve force are placed in active duty status. Compared to airmen (the term used in the military, which also includes women) in the Active Duty force, the airmen in the Reserve force often experience more disruptions in their lives and have been called upon to participate in the recent conflicts much more than in previous ones. When called to military service they leave their civilian job and are separated from their family and civilian community (Grissmer, Kirby, Sze, & Adamson, 1995
). These disruptions and separations are fraught with greater risks for incurring various social, career, and financial losses. Despite the multiple disruptions experienced by the members of the Reserve force, it is possible that they may experience deployment as an opportunity to utilize their skills and training in a meaningful and novel way while active duty personnel are more likely to continue to perform their job skills, albeit in a demanding combat environment.
Using a longitudinal data collection from a representative sample of deployed US Air Force personnel that includes members of both Active Duty and Reserve forces we examined the following sets of hypotheses, each preceded by a brief description of the underlying rationale.
First, compared to various deployment locations, the theater of war is where most of the more traumatic events occur. Therefore, it is more likely to expose soldiers to trauma than other locations, and it is more likely to result in various losses including injury and death. Even those in the theater of war who are not exposed directly to trauma may experience high level of PTS symptoms and resource loss due to other more stressful conditions in the theater of war than in other locations (e.g., more stressful work load, longer deployment away from home). However it is possible that all the effects of the theater of war are fully mediated by the degree of exposure to traumatic events.
Hypothesis set 1. Deployment to the theater of war versus other duty stations predicts an increased level of (a) exposure to trauma, (b) PTS symptoms and (c) loss of resources.
Second, as noted earlier, exposure to trauma is a risk factor for exhibiting PTS symptoms and also for the development of PTSD. It is also likely to produce resource loss due to injury and its consequences (e.g., losing the ability to work) and mediate some or all the effects of deployment in the theater of the war on PTS symptoms and loss of resources.
Hypothesis set 2. Exposure to trauma predicts increased level of (a) PTS symptoms and (b) loss of resources, and also predicts (c) to mediate (perhaps fully) the effects of deployment to the theater of war on PTS symptoms and loss of resources.
Third, compared to the members of the Active duty force, members of the Reserve force experience greater disruptions as a result of deployment since they leave their civilian jobs and their communities behind. Thus, for the members of the Reserve force, deployment may be responsible for greater loss of resources than for the members of the Active duty force. In a similar vein, these disruptions may also affect their deployment experience in ways that increase job burnout and job strain and also produce negative attitude toward the Air Force, which could be manifested in such outcomes as lower job satisfaction, organizational commitment and intention to reenlist.
Hypothesis set 3. Compared to service in the Active duty force, service in the Reserve force predicts (a) greater loss of resources, and (b) greater negative impact on organizational relevant outcomes.
Fourth, high level of PTS symptoms and loss of resources are predicted to have a longitudinal adverse effect on each other. Increased PTS symptoms is a risk factor for PTSD, which as noted earlier produces impaired role and emotional functioning that can result in loss of work, and marital or other close relationships. In turn, loss of critical resources (e.g., health due to injury, work, career, marriage) is a risk factor for PTS symptoms.
Hypothesis set 4. (a) Experiencing elevated PTS symptoms predicts loss of resources at a later time, and (b) loss of resources also predicts PTS symptoms at a later time.
Fifth, as noted above, high level of PTS symptoms is associated with impaired mental health and role and emotional functioning. And, in turn, depletion of resources is expected to adversely affect a host of personal but relevant organizational outcomes. The depletion of resources such as health and well being is expected to increase the difficulty in performing one’s job adequately and result in such outcomes as job burnout, job strain and work-family conflict, and decrease in job involvement and deployment readiness. In addition, the depletion of resources due to deployment would make the organization, the military, less attractive for the individuals who, according to COR theory, engage in efforts to gain or at least conserve resources. Thus, it is expected that loss of resources will result in a decrease in job satisfaction, organizational commitment, and intention to reenlist.
Hypothesis set 5. Controlling for baseline levels, experiencing PTS symptoms and loss of resources have adverse effects on (a) functioning and perceived health and on (b) organizational-relevant personal outcomes.