Effects of War Exposure on Air Force Personnel's Mental Health, Job Burnout and Other Organizational Related Outcomes

Article (PDF Available)inJournal of Occupational Health Psychology 16(1):3-17 · January 2011with46 Reads
DOI: 10.1037/a0021617 · Source: PubMed
Abstract
Longitudinal data from a stratified representative sample of U.S. Air Force personnel (N = 1009) deployed to the wars in Iraq, Afghanistan, and other locations were analyzed in this study. Using structural equation models, we examined the effects of war exposure on traumatic experiences, Post Traumatic Stress (PTS) symptoms, resource loss, and on subsequent functioning, perceived health, and on job and organizationally relevant outcomes. The job and organizational outcomes included job burnout, job involvement, job strain, job satisfaction, work-family conflict, organizational commitment, deployment readiness, and intention to reenlist. We found that deployment to the theater of the war increased risk of exposure to trauma, which in turn, predicted elevated PTS symptoms and resource loss. PTS symptoms predicted later loss of resources and deterioration in perceived health and functioning. In turn, resource loss predicted negative job and organizational outcomes. Exposure to trauma fully mediated the effects of deployment to the theater of war on PTS symptoms and resource loss and had additional significant indirect effects on several job and organizational relevant outcomes. For returning veterans, deployment to the theater of war, exposure to trauma, PTS symptoms, and resource loss represents a "cascading" chain of events that over time results in a decline of health and functioning as well as in adverse job and organizationally relevant outcomes that may affect organizational effectiveness.
Effects of War Exposure on Air Force Personnel’s Mental Health,
Job Burnout and Other Organizational Related Outcomes
Amiram D. Vinokur, Penny F. Pierce,
and Lisa Lewandowski-Romps
University of Michigan
Stevan E. Hobfoll
Rush Medical College
Sandro Galea
University of Michigan
Longitudinal data from a stratified representative sample of U.S. Air Force personnel (N 1009)
deployed to the wars in Iraq, Afghanistan, and other locations were analyzed in this study. Using
structural equation models, we examined the effects of war exposure on traumatic experiences,
Post Traumatic Stress (PTS) symptoms, resource loss, and on subsequent functioning, perceived
health, and on job and organizationally relevant outcomes. The job and organizational outcomes
included job burnout, job involvement, job strain, job satisfaction, work-family conflict, organi-
zational commitment, deployment readiness, and intention to reenlist. We found that deployment
to the theater of the war increased risk of exposure to trauma, which in turn, predicted elevated
PTS symptoms and resource loss. PTS symptoms predicted later loss of resources and deterio-
ration in perceived health and functioning. In turn, resource loss predicted negative job and
organizational outcomes. Exposure to trauma fully mediated the effects of deployment to the
theater of war on PTS symptoms and resource loss and had additional significant indirect effects
on several job and organizational relevant outcomes. For returning veterans, deployment to the
theater of war, exposure to trauma, PTS symptoms, and resource loss represents a “cascading”
chain of events that over time results in a decline of health and functioning as well as in adverse
job and organizationally relevant outcomes that may affect organizational effectiveness.
Keywords: war exposure, PTS symptoms, mental health, functioning, job burnout
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 symp-
toms are predictive of diagnosed Post Traumatic
Stress Disorder (PTSD). PTSD is a painfully experi-
enced disorder that is often long-term. It is charac-
terized by reexperiencing traumatic thoughts or feel-
ings, avoidance of stimuli related to the original
trauma, and hyper-arousal, following exposure to life
threatening events. Estimates of psychological casu-
alties, most typically measured in the form of PTSD,
are estimated to be as high as 30% of American
troops serving in Iraq and Afghanistan (Lapierre,
Schwegler, & LaBauve, 2007). These outcomes, PTS
Amiram D. Vinokur and Lisa Lewandowski-Romps, In-
stitute for Social Research, University of Michigan, Ann
Arbor, Michigan; Penny F. Pierce, Institute for Social Re-
search, School of Nursing, University of Michigan; Stevan
E. Hobfoll, Rush Medical College, Chicago, Illinois; Sandro
Galea, Institute for Social Research, School of Public
Health, Center for Global Health, University of Michigan.
The work submitted conforms to all applicable gov-
ernmental regulations and discipline appropriate profes-
sional ethical standards. The work complied with APA
ethical standards in the treatment of the sample. The
work was approved by the Institutional Review Boards of
the University of Michigan and of the Uniformed Ser-
vices University established to protect the welfare of
human subjects. Participants provided informed consent.
This research (MDA 905-04-1-TS07) was sponsored by
the TriService Nursing Research Program, Uniformed
Services University of the Health Sciences; however, the
information or content and conclusions do not necessarily
represent the official position or policy of, nor should any
official endorsement be inferred by, the TriService Nurs-
ing Research Program, the Uniformed Services Univer-
sity of the Health Sciences, the Department of Defense
(DoD), or the U.S. Government. Dr. Sandro Galea was
supported in part by NIH Grant MH 082729 and DoD
Grant W81XWH-0802-0204.
Correspondence concerning this article should be ad-
dressed to Amiram D. Vinokur, Institute for Social Re-
search, 426 Thompson Street, Ann Arbor, MI 48106-1248.
E-mail: avinokur@umich.edu
Journal of Occupational Health Psychology
2011, Vol. 16, No. 1, 3–17
© 2011 American Psychological Association
1076-8998/11/$12.00 DOI: 10.1037/a0021617
3
symptoms and PTSD, have been the predominant
focus of postwar studies (Friedman, Schnurr, &
McDonagh-Coyle, 1994; Kessler, Sonnega, Bromet,
Hughes, & Nelson, 1995; Koenen, Stellman, Stell-
man, & Sommer, 2003; Simms, Watson & Doebbel-
ing, 2002).
Persons with PTSD or high levels of PTS symp-
toms often display impaired role and emotional func-
tioning 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, et al., 1995; Za-
tzick 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 reten-
tion 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 sepa-
ration from families and communities in a process
called deployment. Thus, leaving one’s familiar sur-
roundings 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 camaraderie, mas-
tery, courage, and altruism (Aldwin, Levenson, &
Spiro, 1994).
The human toll of the wars in Iraq and Afghanistan
provides an important context for examining the re-
lationships among stressors, which refer to condi-
tions that undermine the capacity for adaptive re-
sponses, 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 nonthe-
ater regions such as in Europe or Southeast Asia. We
employed conservation of resources (COR) theory
(Hobfoll, 1989, 1998) 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 function-
ing). The other type consists of personal but relevant
organizational variables (e.g., job burnout, organiza-
tional 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 con-
tribute to PTS symptoms, and, in turn, may contrib-
ute 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, organiza-
tional commitment, deployment readiness, and inten-
tion 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 prin-
ciples that tie together the experiences of stress and
coping (Hobfoll, 1989, 2001, 2002). 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, condi-
tions, or energies that are valued by the individual or
that serve as means for [their] attainment . . .” (Hob-
foll, 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 spe-
cific 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 mon-
etary gain on the concrete level. In the current study,
4 VINOKUR, PIERCE, LEWANDOWSKI-ROMPS, HOBFOLL, AND GALEA
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 popu-
lation who are actively investing resources not only
to offset loss, but to make life gains for themselves,
their family, and the nation. Nevertheless, a popula-
tion deployed to war is at risk of losing important
resources due to the deployment that entails separa-
tion 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 possi-
ble 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 unidi-
rectionally, 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 re-
source loss and PTS symptoms have downstream
impact on social and emotional functioning, per-
ceived health, and organizational-relevant personal
outcomes (e.g., job burnout, deployment readiness,
intention to reenlist). Given that the sample of re-
spondents 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 re-
source loss associated with deployment on job burn-
out because COR theory provides a comprehensive
approach to explain job burnout (cf. Hobfoll & Shi-
rom, 1993, 2000) and PTS (Hobfoll, 1991). Job burn-
out 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 deploy-
ment 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 Opera-
tion Iraqi Freedom, it is important to consider differ-
ent 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 person-
nel 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 Re-
serve force are placed in active duty status. Com-
pared 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 sep-
arations 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 de-
manding combat environment.
Using a longitudinal data collection from a repre-
sentative sample of deployed U.S. Air Force person-
nel 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 trau-
matic events occur. Therefore, it is more likely to
5EFFECTS OF WAR EXPOSURE
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 experi-
ence 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 in-
creased 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 medi-
ate (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 ex-
perience in ways that increase job burnout and job strain
and also produce negative attitudes 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 rele-
vant 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 are 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
a decrease in job involvement and deployment read-
iness. In addition, the depletion of resources due to
deployment would make the organization, the mili-
tary, 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 lev-
els, experiencing PTS symptoms and loss of
resources have adverse effects on (a) function-
ing and perceived health and on (b) organiza-
tional-relevant personal outcomes.
Method
This study was conducted with the approval of the
Institutional Review Boards of The University of
Michigan and the Uniformed Services University of
the Health Sciences.
Sampling and Data Collection
The Defense Manpower Data Center (DMDC) of
the U.S. Department of Defense (DOD) provided a
probability sample with contact information for
2,250 Air Force men and women who were deployed
during the period of October 7, 2001 to the time of
the sample request (September, 2004). A random
stratified sample was constructed with 52% men,
6 VINOKUR, PIERCE, LEWANDOWSKI-ROMPS, HOBFOLL, AND GALEA
31% from the Active Duty component of the Air
Force, 34% from Reserve, and 35% from the Guard.
Deployment to the theater of war was defined based
on the designation of the DOD as deployment to at
least one of the following locations: Iraq, Afghani-
stan, Qatar, Kuwait, or Saudi Arabia. This DOD
designation is used for such benefits as hazardous
duty pay, combat-related decorations, and combat
veteran status. Deployments to nontheater locations
included deployment to such regions as Europe,
Southeast Asia, or other countries (e.g., Korea,
Japan).
All men and women in the probability sample were
sent a small incentive with a recruitment letter invit-
ing them to participate in the study. They were then
called to complete a short telephone interview (about
20 minutes). Those participating in the interview
were then sent another small incentive with a mailed
self administered questionnaire (SAQ). The option of
completing the SAQ online (on the web) was offered
and 40% did so. Of the 2,250 men and women who
were invited to the study, 1,451 (64%) completed the
telephone interview,
1
and 1,009 (45%) provided data
using the mailed SAQ (60%), or its equivalent online
(40%). Approximately 14 months later, all partici-
pants received an announcement letter and a modest
incentive, inviting them to complete a follow-up
SAQ. A follow-up period of one year was originally
selected since it was thought to provide enough time
for changes in the deployment conditions and stresses
to show up. A 4-wave longitudinal study that focused
on job-related constructs such as job demands, job
control, and mental health by De Lange, Taris, Kom-
pier, Houtman, & Bongers, (2004) demonstrated
causal effects using a 1-year follow-up period.
Of the 1,009 men and women completing the ini-
tial Time 1 (T1, June 2005) SAQ, 796 (79%) also
completed the follow-up Time 2 (T2, September
2006) SAQ or its equivalent online (32% and 68%,
respectively). The demographic characteristics of the
sample including military background information
are provided in Table 1.
Measures
Basic demographic information about the respon-
dents was collected with standard questions used in
national surveys by the Institute for Social Research.
The questions provided data on age, marital status,
education, income, ethnic/racial identification, and
dependent children.
Military background information regarding rank,
service component (Active vs. Reserve and Guard),
and deployment in theater of war (vs. elsewhere),
was obtained from the respondent and from the da-
tabase provided by DMDC.
Exposure to trauma was assessed using a list of 18
stressful events (␣⫽.79) most likely to occur in
theater of war such as “come under small arms fire,”
“take shelter in a bunker.” This scale was a revised
version of similar scales from the war in Vietnam era
known as combat exposure scales. The scale has been
validated (e.g., Keane, Fairbank, Caddell, Zimering,
Taylor, & Mora, 1989) and used in numerous studies
on veterans of the war in Vietnam (e.g., Laufer,
Gallops, Frey-Wouters, 1984). Our revised version
included additional items to incorporate a broader set
of traumatic events due to participation in the war
effort. Respondents were asked about experiencing
the events from October 2001 to the present time and
to indicate whether they experienced each event, and
if they did, they rated the extent to which they were
afraid, horrified, or felt helpless on a 4-point scale
ranging from “1 not at all” to “4 a great deal.”
Respondents who did not experience the event re-
ceived a “0” rating on the scale and the mean of all 18
items on the recoded 5-point scale was used as a
measure of exposure to trauma.
Symptoms of Post Traumatic Stress (PTS) were
assessed using a scale with 17 items (␣⫽.94) from
the PTSD Checklist-Military version (PCL–M)
(Weathers, Huska, & Keane, 1991). The items de-
scribe various distress symptoms including emotional
(e.g., get very upset or anxious), cognitive (trouble
keeping your mind on what you are doing) and phys-
ical/physiological (heart pound . . . begin to sweat)
stress reactions. The respondents were asked to rate
the frequency of experiencing these symptoms from
October 2001 to the present time on a 5-point scale
ranging from “1 never” to “5 very frequently.”
Loss of resources were assessed using 13 items
(␣⫽.88) preceded by the question “To what extent
did you have losses in the following areas of your life
as a result of your deployment from October 2001 to
the present time?” (Hobfoll & Lilly, 1993). The items
were based on COR theory’s definition of resources
(Hobfoll, 1998) and included aspects of losses in
family and social relationships (e.g., your relation-
ship with your personal friends), financial matters
(e.g., your financial situation or financial resources),
career (e.g., your career advancement prospects), and
1
Of the letters sent to 2,250 men and women, 141, or 6%,
of the letters were returned due to inaccurate addresses and
these individuals could not be located by other searches.
7EFFECTS OF WAR EXPOSURE
personal matters (e.g., your feeling of pride serving
the country). For rating each item, a 5-point response
scale was used ranging from “1 not at all” to “5
large extent.”
Functioning and Perceived Health were assessed
by the following measures:
Role and emotional functioning was measured
with a 15-item scale (␣⫽.95) which was developed
by Caplan et al. (1984) and validated in other studies
(e.g., Vinokur, Price, & Schul, 1995). Respondents
were asked “In the last two weeks, how well have
you been doing with respect to the following activi-
ties?” They then provided their ratings for each of the
15 activities on 5-point scale ranging from “1 very
poorly” to “5 exceptionally well.” The activities
covered social and emotional tasks such as handling
responsibilities and daily demands, staying level-
headed and making the right decisions.
Perceived health was assessed with four questions
(␣⫽.78) that were based on similar items from the
Medical Outcome Study (Stewart & Ware, 1992).
Participants were asked to answer the following
questions: “In general, would you say your health is
excellent, good, fair, or poor?” “To what extent do
you have any particular health problems?” (“1
never/no extent” to “5 a very great extent”).
“Thinking about the past 2 months, how much of the
time has your health kept you from doing the kind of
things other people your age do?” (“1 none of the
time” to “5 all of the time”), and “To what extent
do you feel healthy enough to carry out things that
you would like to do?” (“1 never/no extent” to
“5 a very great extent”).
Organizational-Relevant Personal Outcomes were
assessed using the following measures:
Job burnout was assessed using the 12-item (␣⫽
.95) Shirom-Melamed Burnout Measure (SMBM).
This measure has been validated in several studies
(Lerman et al., 1999; Melamed, Shirom, Kahana,
Lerman & Froom, 1999). The SMBM includes sub-
scales of emotional exhaustion (e.g., “I feel emotion-
ally exhausted”); physical fatigue (e.g., “I feel tired;
I feel physically fatigued”); and cognitive weariness
(e.g., “I am too tired to think clearly; I feel that I think
slowly”). Respondents completing the SMBM were
asked to rate the frequency of each feeling while at
work in their military occupation during the past
month. All items are scored on a 7-point frequency
scale, ranging from “1 almost never” to “7
almost always.”
Job strain or distress was assessed using 8 items
(␣⫽.86) of which 6 were developed by Kandel and
colleagues (Kandel, Davies, & Raveis, 1985) and
also used by Frone, Russell, and Cooper (1992). The
two additional items were added in our earlier study
(Vinokur, Pierce, & Buck, 1999) to represent aspects
Table 1
Demographic and Military Background of Sample Respondents (N 1,009)
Characteristics Percent (n) Characteristics Percent (n)
Age (M 38.2 yrs) Race
30 and younger 27.2 (274) White 76.5 (772)
31–40 31.9 (322) Non-white 22.0 (222)
41 and older 40.9 (413) Dependent child (During deployment)
Education (Md 14.9 yrs) Yes 42.4 (428)
13 yrs and below 23.2 (234) No 52.5 (530)
14 yrs 23.7 (239) Rank
15 yrs and above 52.4 (529) Officer 25.5 (257)
Gender Enlisted 73.4 (741)
Male 50.1 (506) Component
Female 49.9 (503) Active 25.5 (257)
Household income (Md $55,365.00) Reserve 39.0 (394)
39,999 and below 29.2 (295) Guard 35.5 (358)
40,000–59,999 24.4 (246) Deployment location
60,000 and above 42.3 (427) Theater of war
a
65.1 (657)
Marital status Elsewhere
b
34.9 (352)
Married 53.1 (536)
Unmarried 46.3 (467)
a
Theater locations include Iraq, Kuwait, Qatar, Afghanistan and Saudi Arabia. Participants in the theater of war may have
also served in other locations.
b
Participants deployed “elsewhere” were not deployed in any location defined as “in
theater.”
8 VINOKUR, PIERCE, LEWANDOWSKI-ROMPS, HOBFOLL, AND GALEA
of distress in military jobs (feeling harassed, intimi-
dated). The items assessed the degree of experiencing
various daily emotional reaction on the job (e.g.,
relaxed, frustrated, fortunate, bothered or upset, using
a 4-point scale ranging from “1 not at all” to “4
very”). The scores of the answers to the three positive
items were reversed.
Work-family conflict included a two-item scale
(␣⫽.84) used by Frone et al., (1992). Respondents
were asked “How often does your Air Force job or
career interfere with your responsibilities at home?”
and “How often does your Air Force job or career
keep you from spending the amount of time you
would like to spend with your family?” Answers
were provided on a 5-point scale ranging from “1
almost never, or never” to “5 almost always, or
always.”
Deployment readiness was an investigator-
developed measure based on personal military expe-
rience and commentaries in the public media regard-
ing problematic areas reported by troops preparing
for deployment. Deployment readiness was assessed
with a 5-item scale (␣⫽.83) including statements
about their preparation for deployment. The state-
ments covered various personal issues that need to be
addressed in order to be ready for deployment. Re-
spondents were asked “Should you be deployed
again, how strongly do you agree or disagree with
each of the following statements about deployment
for you and your family?”: “My personal life and
affairs are organized so that I am ready to deploy
with little advance notice,” “I am emotionally pre-
pared for deployment at any time,” “I always keep
my legal and financial affairs in order,” I am physi-
cally able to deploy at any time,” and “I am mentally
prepared for deployment at any time.” Respondents
provided their answer to each statement on 5-point
scale ranging from “1 strongly agree” to “5
strongly disagree.” Ratings were recoded so that high
scores represent greater readiness for future deploy-
ments.
Job satisfaction in the Air Force was assessed with
an index based on 10 rating scales (␣⫽.83) devel-
oped by Andrews and Withey (1976). Respondents
asked to indicate how they felt about various aspects
of their job on scales that vary from “1 terrible” to
“7 delighted.” The aspects of the job that were
covered include coworkers, supervisor, the work it-
self, the pay, chances for promotion, job security,
skill utilization, benefits, and the mission of the Air
Force.
Job involvement was assessed with a 5-item scale
(␣⫽.89) adapted by Frone and colleagues (1992)
from a measure developed by Kanungo (1982). Job
involvement items focused on the extent to which the
job is central to one’s self-concept or sense of iden-
tity based on the job. The items included statements
such as “my job is a very important part of my life”
and “most of my interests center around my job” and
required ratings on a 6-point scale ranging from “1
strongly disagree” to “6 strongly agree.”
Organizational commitment was assessed using an
8-item measure (␣⫽.82) that focused on the affec-
tive component of commitment (Allen & Meyer,
1990; Meyer & Allen, 1991). The respondents were
asked to rate how much they agree or disagree with a
series of statements regarding the role of the Air
Force in their life on a 6-point scale ranging from
“1 strongly disagree” to “6 strongly agree.” The
statements included feeling attached to the Air Force,
feeling a strong sense of belonging to the Air Force,
and the like.
Intention to reenlist was assessed with two item
scale (␣⫽.92) based on Ajzen and Fishbein’s theory
of reasoned action (Ajzen & Fishbein, 1980). One
item asked respondents to rate the likelihood of con-
tinuing or leaving the Air Force on a scale ranging
from “1 extremely likely” to “7 extremely
unlikely.” The second item asked them to rate the
strength of their intention to continue or leave the
Air Force using a scale ranging from “1 defi-
nitely intend to continue” to “5 definitely intend
to leave.” The ratings were scored so that high
scores represent stronger intention to continue mil-
itary service.
Analysis
First, we conducted logistic regression attrition
analysis to determine possible bias in the character-
istics of respondents who participated versus those
who did not participate in the study. For this analysis
we used the data obtained from the DMDC on each
person’s age, gender, parenthood status, rank (officer
vs. enlisted), component (Active, Reserve or Guard),
deployment location in terms of theater of war (vs.
elsewhere), and length of deployment. Second, we
conducted the same type of logistic analysis de-
scribed above to predict attrition at T2 based on the
data from T1. Again, the purpose of this analysis was
to determine possible bias in the characteristics of
respondents who remained in the study at T2.
Third, we conducted structural equation modeling
analyses which included the estimations of basically
the same 10 structural equation models that were
constructed to test our five sets of hypotheses. All the
9EFFECTS OF WAR EXPOSURE
10 estimated models were identical, except for the T1
baseline and the corresponding T2 outcome measure,
which varied across the models. That is, each of the
10 models included a different T1 baseline and its
corresponding T2 outcome than the others (cf.
Table 2, left column). The identical part of the mod-
els was constructed to test the first four sets of hy-
potheses. The changing part across the models, that
is, the different T1 and T2 outcomes, was intended to
test the fifth hypothesis set. The first two models (cf.
Table 2, rows 1 and 2) included the functioning and
perceived health outcomes, and the remaining eight
models (cf. Table 2, rows 3 to 10) included the
organizationally relevant outcomes. Finally, in all of
the models, each latent factor is indicated by two
parcels that were comprised of random half of the items
of the respective measure of the construct.
To estimate our models we used EQS software
(version 6.1, build 94). The estimation of the models
applied the maximum likelihood method with the
Yuan and Bentler (2000) EM-ML imputation proce-
dure for missing data. This procedure also included
the Jamshidian and Bentler (1999) robust method for
adjusting standard errors. The imputation procedure
provided a total sample of 1009 respondents. As
required in estimating longitudinal models, our mod-
els included the correlations between the errors of
corresponding variables across T1 and T2 (that is,
between T1 and T2 of PTS symptoms, of resource
loss, and of T1 and T2 of the respective outcome). In
addition, we also included correlations between the
error of the T1 respective outcome and T2 PTS
symptoms and T2 resource loss. No other correlated
errors were included in the model. Finally, to deter-
mine model fit, we relied on a standard recommen-
dation to examine several fit measures. We follow Hu
and Bentler’s (1999) suggestion to consider models
with CFI and NNFI indices closer to .95 and RMSEA
equal or less than .06 as providing reliable evidence
of acceptable fit.
Results
Analyses of Participation at Baseline
Using a logistic regression analysis, including all
the demographic and military background variables
to predict participation at Time 1 (T1), we found that
age, female gender, parental status, rank, and com-
ponent were significant predictors (Odds Ratio
1.04, 1.20, 1.25, 1.69 and 1.20, respectively, p
.05). Higher response rates were found for older
participants (mean age 38.2 vs. 33.9), females (46%
vs. 43% males), parents (51% vs. 39% non parents),
officers (59% vs. 41% non officers), and Reserve and
Guard members (48% vs. 37% Active duty). In con-
trast, deployment in the theater of the war (vs. else-
where) and length of deployment did not significantly
predict participation. Hence, there were several de-
mographic and military variables that biased the rep-
resentation of our overall sample. However, even
with this bias, the generalizability of our findings is
strengthened by the greater coverage of particular
groups in the military, such as females and parents,
who are typically underrepresented in research.
Analyses of Attrition at Follow-Up
A total of 796 respondents completed the Time 2
(T2) questionnaire for a 79% response rate. Using a
logistic analysis to predict attrition at T2 based on the
data from T1, we found that only age significantly
predicted participation at T2 (Odds Ratio 1.03;
p .01), completers being somewhat older than
noncompleters (M 38.5 vs. 34.6, respectively).
Furthermore, we examined attrition at T2 by compar-
ing the T1 reports of the participants and the nonpar-
ticipants that included various mental health and
functioning variables such as depression, role func-
tioning, perceived health, and job burnout. We found
that none of these comparisons yielded a statistically
significant difference. Hence, attrition did not play a
meaningful role in altering the representativeness of
the original sample used for our analyses.
Structural Equation Modeling Analyses
The results of the estimated model that includes
job burnout as an outcome are displayed in Figure 1
and the corresponding matrix of correlations of the
variables in this model is presented in Table 3.
2
The
results of this model and the estimated other nine
models are also provided in Table 2.
The estimation of the model in Figure 1 with job
burnout as the outcome produced a Yuan-Bentler
scaled
2
(df 83; N 1009) 107.34 with NFI,
NNFI, CFI .99 and RMSEA .00. All the other
nine models also provided the same goodness-of-fit
and RMSEA values above .98 and RMSEA below
.01. Thus, all the 10 models fit the data exceedingly
well.
2
The means, standard deviations and correlations of all
measured variables for our 10 models are available from the
first author upon request.
10 VINOKUR, PIERCE, LEWANDOWSKI-ROMPS, HOBFOLL, AND GALEA
Table 2
Standardized Regression Coefficients of Time 1 (T1) and Time 2 (T2) Predictors of Study Outcomes
a
and R
2
Variable
Predictors of T1 outcomes Predictors of T2 outcomes
Location
b
Exposure Component
c
R2 Outcome, T1 PTS, T1 Loss, T1 PTS, T2 Loss, T2 R2
Health outcomes
1. Functioning .04 .13
ⴱⴱ
.03 .02
.52
ⴱⴱⴱ
.13
.02 .43
ⴱⴱⴱ
.00 .49
ⴱⴱⴱ
2. Perceived health .08
.25
ⴱⴱⴱ
.03 .05
.63
ⴱⴱⴱ
.06 .02 .25
ⴱⴱⴱ
.00 .65
ⴱⴱⴱ
Organizational relevant outcomes
3. Job burnout
d
.09
ⴱⴱ
.20
ⴱⴱⴱ
.17
ⴱⴱⴱ
.06
ⴱⴱ
.59
ⴱⴱⴱ
.08
.04 .21
ⴱⴱⴱ
.16
ⴱⴱⴱ
.49
ⴱⴱⴱ
4. Job strain .11
ⴱⴱ
.20
ⴱⴱⴱ
.16
ⴱⴱⴱ
.06
ⴱⴱ
.59
ⴱⴱⴱ
.09
ⴱⴱ
.01 .19
ⴱⴱⴱ
.12
ⴱⴱ
.47
ⴱⴱⴱ
5. Work-family conflict .09
ⴱⴱ
.23
ⴱⴱⴱ
.15
ⴱⴱⴱ
.07
ⴱⴱ
.63
ⴱⴱⴱ
.05 .08
.09
.23
ⴱⴱⴱ
.50
ⴱⴱⴱ
6. Deployment readiness .06 .07 .01 .01
.67
ⴱⴱⴱ
.11
ⴱⴱ
.09
ⴱⴱ
.16
ⴱⴱⴱ
.20
ⴱⴱⴱ
.52
ⴱⴱⴱ
7. Job satisfaction .05 .09
.13
ⴱⴱⴱ
.02
.72
ⴱⴱⴱ
.02 .07 .05 .15
ⴱⴱⴱ
.58
ⴱⴱⴱ
8. Job involvement .03 .11
ⴱⴱ
.15
ⴱⴱⴱ
.04
.62
ⴱⴱⴱ
.05 .17
ⴱⴱⴱ
.13
ⴱⴱ
.23
ⴱⴱ
.62
ⴱⴱⴱ
9. Organiz. commitment .02 .00 .18
ⴱⴱⴱ
.03
.70
ⴱⴱⴱ
.04 .10
ⴱⴱ
.02 .13
ⴱⴱ
.50
ⴱⴱⴱ
10. Intention to reenlist .01 .02 .19
ⴱⴱⴱ
.04
.68
ⴱⴱⴱ
.04 .07
.09
ⴱⴱ
.08
.47
ⴱⴱⴱ
Note. PTS Post Traumatic Stress symptoms.
a
The results for each outcome are based on a structural model (e.g., Figure 1 for job burnout). The Yuan-Bentler
2
(df 83;
n 1009) for all the models varied from 106.32 to 140.13. NFI, NNFI, and CFI are for all models greater than .98 and RMSEA 0.01.
b
Theater of War 1; Elsewhere
0.
c
Active Duty 1, Reserve/Guard 0.
d
The results for job burnout are also displayed in Figure 1.
p .05.
ⴱⴱ
p .01.
ⴱⴱⴱ
p .001.
11EFFECTS OF WAR EXPOSURE
Results Pertaining to the First Four Sets
of Hypotheses: Effects on PTS Symptoms
and Loss of Resources
Next, we examined the results that pertain to the
first four sets of hypotheses, namely, the various
effects of deployment location, exposure and compo-
nents on T1 PTS symptoms and resource loss, and the
longitudinal effects of PTS symptoms and resource
loss on each other. These are effects that are common
to all the 10 models and can be viewed in Figure 1 for
the model that includes job burnout as an outcome.
Figure 1. Longitudinal effects (standardized coefficients) of service in theater of war and
exposure to trauma on Post Traumatic Stress (PTS) symptoms and on loss of work/economic
and psychosocial resources. All solid line paths are statistically significant at .05. Curved lines
represent correlations among errors. Yuan-Bentler scaled
2
(83, n 1009) 107.34. NFI,
NNFI and CFI .99, and RMSEA .00.
Table 3
Correlations, Means and Standard Deviations of the Measures Displayed in Figure 1
Variable 1 2 3 456789
1. Deployment location
2. Exposure to trauma .34 .79
3. Component .03 .04
4. PTS symptoms, T1 .18 .48 .07 .94
5. PTS symptoms, T2 .14 .37 .09 .64 .95
6. Resource loss, T1 .04 .23 .01 .45 .35 .88
7. Resource loss, T2 .06 .22 .05 .42 .59 .58 .91
8. Job burnout, T1 .01 .13 .21 .35 .31 .32 .25 .95
9. Job burnout, T2 .01 .11 .16 .28 .39 .22 .33 .55 .96
Mean .64 .36 .23 1.42 1.51 1.52 1.53 2.88 2.82
SD .50 .40 .47 .58 .58 .60 .55 1.23 1.10
Note. N 1009. Correlation coefficients larger than .06 are statistically significant at .05. The bold face figures in the
diagonal are the Cronbach reliability coefficients for the multi-item measures. Deployment Location: Theater of War 1;
Elsewhere 0. Component: Active Duty 1; Reserve/Guard 0.
12 VINOKUR, PIERCE, LEWANDOWSKI-ROMPS, HOBFOLL, AND GALEA
We later examined the effects of these variables on
the functioning, health, and organizational outcomes
across the 10 models (cf. Table 2).
As suggested by Hypothesis set 1(a), deployment
to the theater of war (vs. elsewhere) predicted an
increased level of exposure to trauma (Hyp.1(a): ␤⫽
.37, p .001); but, it did not predict elevated PTS
symptoms (Hyp.1(b): ␤⫽.03, ns) or a loss of re-
sources (Hyp.1(c): ␤⫽⫺.07, ns). At the same time,
and unexpectedly, deployment to the theater of war
predicted lower levels of job burnout, job strain, and
work-family conflict (s ⫽⫺.09, .11 and .09,
respectively; p .01. We speculate that the deploy-
ment to the theater of war is associated with in-
creased awareness of the mission importance which
may increase motivation and reduce the negative
effect of the war environment on these outcomes.
However, these appear to be short-term effects that
diminish overtime and do not appear at T2.
As suggested by Hypothesis set 2, exposure to
trauma predicted increased PTS symptoms (Hyp.
2(a): ␤⫽.55, p .001) and greater loss of resources
(Hyp. 2(b): ␤⫽.30, p .001). Thus, these results,
and those related to Hypothesis 1(b) and Hypothesis
1(c), also support Hypothesis 2(c) that exposure to
trauma fully mediated the effects of deployment to
the theater of war on both T1 and T2 PTS symptoms
and resource loss (Sobel test 7.60 and 3.86, re-
spectively, both p .001, for T1; and Sobel test
5.58 and 2.01, p .001, .05, respectively, for T2).
Furthermore, as shown on the left side of Table 2,
exposure to trauma predicted lower levels of func-
tioning and perceived health at T1 (Hyp. 2(c): s
.13, .25, p .01) and a negative impact on
several organizational variables such as job burnout,
job strain, work-family conflict, and job satisfaction
also at T1 (Hyp. 2(d): s .20, .20, .23, .09;
respectively, p .001, .05). But, unexpectedly, ex-
posure predicted higher job involvement (␤⫽.11
p .01). Again, we speculate here that in the context
of war, jobs which are more engaging or more di-
rectly related to the war effort are those associated
with greater risk of exposure to trauma.
We also examined the indirect effects of exposure
to trauma on our 10 outcome variables at T2. We
found that exposure had statistically significant indi-
rect negative effect on T2 functioning and perceived
health (s ⫽⫺.19, .25, p .001) as well as on job
burnout, job strain, work family conflict, deployment
readiness and job satisfaction (s .19, .18, .20,
.09, .10, respectively, p .01). It therefore ap-
pears clear that exposure to trauma is the key mech-
anism that cascades into PTS symptoms, loss of
resources, which in turn adversely affect important
health and organizationally relevant outcomes.
Next we examined the results pertaining to Hy-
pothesis set 3. The results did not support Hypothesis
3(a) in that compared to membership in the Active
duty force, membership in the Reserve force did not
predict greater loss of resources (␤⫽⫺.06, ns).
Furthermore, and contrary to the prediction stated in
Hypothesis 3(b), the results demonstrated that com-
pared to the members of the Reserve force, the mem-
bers of the Active duty force experienced statistically
significant poorer organizational relevant outcomes
(except deployment readiness) (cf. left side of Table
2). A possible reason for these unexpected results is
discussed later.
As predicted by Hypothesis set 4(a), experiencing
a higher level of PTS symptoms at T1 predicted
increased loss of resources at T2 (␤⫽.23, p .001).
And, as predicted by Hypothesis 4(b), loss of re-
sources at T1 predicted increased PTS symptoms at
T2 (␤⫽.09, p .05). We also tested an alternative
model with the diagonal effects from PTS symptoms
to resource loss and resource loss to PTS symptoms
replaced with reciprocal paths at T2. The alternative
model had virtually the same fit with
2
(df 83; N
1009) 134.24, and with NFI, NNFI and CFI .99,
respectively, and RMSEA .01. This alternative
model also demonstrated that PTS symptoms pre-
dicted increase in loss of resources (␤⫽.33, p
.001), and loss of resources also appear to increase
PTS symptoms (␤⫽.15, p .05). The findings
related to Hypothesis set 4 suggests that elevated
level of PTS symptoms triggers the cascading nega-
tive effects resulting in resource losses, and as shown
later, in other important sequelae as well.
Results Pertaining to the Fifth Hypothesis
Set: Effects on Functioning, Health and
Organizational Outcomes
Our final set of results pertain to Hypothesis set 5,
which describes the aftermath of elevated PTS symp-
toms and loss of resources, that is, their hypothesized
effects on (a) functioning and perceived health, and
on (b) organizationally relevant outcomes. The first
set of these results with respect to job burnout is
displayed in Figure 1. Again, these and all other
results pertaining to the additional nine outcomes are
displayed on the left side of Table 2. As can be seen,
T2 PTS symptoms (Hyp. 5(a)), but not loss of re-
sources, predicted a deterioration in role and emo-
tional functioning and in perceived health (s
13EFFECTS OF WAR EXPOSURE
.43, .25, respectively, both p .001). In a similar
vein, as suggested by Hypothesis 5(b), T2 PTS symp-
toms also predicted an increase in job burnout, job
strain, work-family conflict (s .21, .19, .09; p
.001, .001, .05, respectively), and a deterioration in
deployment readiness (␤⫽⫺.16, p .001). In
Figure 1 we also observe the path from T1 PTS
symptoms to T2 job burnout as .08 (p .05) which
according to Maassen and Bakker (2001) represents a
suppression effect. And according to Kessler and
Greenberg (1981), this effect is interpreted, counter-
intuitively according to the negative sign of the pa-
rameter, as a change (increase) in PTS symptoms
producing a change (increase) in job burnout.
In the same vein, also as suggested by Hypothesis
5(b), T2 loss of resources predicted a statistically
significant deterioration in all the organizationally
relevant outcomes. More specifically, resource loss
predicted an increase in job burnout, job strain, work-
family conflict (s .16, .12, .23, respectively), and
a decrease in deployment readiness, job satisfaction,
job involvement, organizational commitment and in-
tention to reenlist (s ⫽⫺.20, 15, .23, .13,
.08, respectively). These results largely support
Hypothesis set 5 in that the PTS symptoms predicted
a decrease in functioning and perceived health, as
well as having adverse impact on several organiza-
tional relevant outcomes at T2. Although not predict-
ing poor health and functioning, loss of resources
predicted deterioration in all the organizational rele-
vant outcomes at T2. Therefore, it appears that the
adverse impact of PTS symptoms is more pro-
nounced with respect to health and functioning out-
comes, and the adverse impact of resource losses is
more pronounced with respect to the organizationally
relevant outcomes.
Discussion
Using data from a sample of U.S. Air Force Active
Duty and Reserve personnel, we found support for
our hypotheses predicting that deployment to the
theater of the war increased risk of exposure to
trauma, which in turn, predicted elevated PTS symp-
toms and resource loss. Furthermore, PTS symptoms
predicted later loss of resources and deterioration in
functioning and perceived health. Resource loss, in
turn, predicted increases in PTS symptoms and neg-
ative job and organizational relevant outcomes such
as job burnout, decreased organizational commitment
and deployment readiness.
The results documented here broadly support the
theoretical and empirical predictions of COR theory.
Yet, in the presence of PTS symptoms, loss of re-
sources did not have independent effects on function-
ing or perceived health. That said, PTS symptoms
and resource loss were moderately intercorrelated
(r .41 to .48), and hence our results can be inter-
preted as indicating that PTS symptoms and resource
loss are related, where at times it is the symptom-
atology of PTS symptoms that predominates, and at
other times, it is resource loss that predominates in
the cascading sequence. These results extend those of
previous studies based on COR theory in that they
demonstrate the adverse effects of loss of resources,
on both mental health outcomes such as job burnout,
and also on the decline in various positive outcomes
including organizational commitment, job involve-
ment, and job satisfaction. These findings suggest
that those who have more resources, and those that
can best replenish their depleted resources, fare better
following trauma in terms of their job and organiza-
tional functioning. They also illustrate that resource
losses affect both the traditional trauma outcome of
PTS symptoms and outcomes that have been previ-
ously not considered when looking at traumatic
events, but that have been found to be relevant to
work and organizational settings.
For the most part, the results of the study supported
our hypotheses. But some results were unexpected
and contrary to the predictions as stated in Hypoth-
esis 3(b). That is, we found that compared to the
members of the Reserve force who were thought to
have endured greater disruptions and resource loss,
the members of the Active duty force experienced
significantly greater job burnout, job strain, work-
family conflict, and significantly lower job satisfac-
tion, job involvement, organizational commitment
and intention to reenlist.
We can offer only a reasonable but speculative
explanation for this pattern of results. It is possible
that a selection bias into the Reserve force can ex-
plain these results. A significant number of the mem-
bers of the Active duty force in the last 10 years may
have exhausted their coping resources due to the high
operational tempo in the war in Iraq and Afghanistan,
leaving them vulnerable to the experience of burnout
and other adverse outcomes. Consequently, they may
be less likely to reenlist with the Active force and
also are less likely to enlist in the Reserve force. In
contrast, the Reserve force may include, for the most
part, those former members of the Active duty, and
others who enlist with the Reserve force, whose
resources have not been depleted by the experience
of high operational tempo and therefore possess a
more positive attitude toward the armed forces as
14 VINOKUR, PIERCE, LEWANDOWSKI-ROMPS, HOBFOLL, AND GALEA
demonstrated by high organizational commitment
and intention to reenlist. In other words, our sample
of the Active duty force includes a significant pro-
portion of those who are “burned out” and do not
have the necessary resources to continue and with-
stand the rigor required by service in the military and
war and would therefore quit the Active duty force
and would not enlist in the Reserve force. Thus we
surmise that the Reserve force is composed of older,
more experienced and resourceful personnel than the
Active duty force. Indeed, we found that the mean
age and mean years of service were significantly and
substantially higher for Reserve than for Active duty
force (respectively for age, 39.7 vs. 31.8 years, and
for years of service 16.4 vs. 10.7 years). However,
the validity of this explanation would require further
investigation based on additional data.
While this study highlighted several important
mental health consequences exposure to traumatic
events experienced in wartime, other hidden or de-
layed consequences of participation in war also take
a toll on the lives of war veterans. Although the
literature is only beginning to emerge with respect to
the current operations, evidence from the Vietnam
and Persian Gulf wars indicates that compromised
mental health is associated with poor physical health,
drug and alcohol abuse, homelessness, violence, un-
employment, divorce, inadequate parenting, and an
alarming rate of suicide (Friedman et al., 1994;
Keane, Marshall & Taft, 2006; Kulka et al., 1990;
Marshall, Panuzio & Taft, 2005). Concerns are
mounting about how returning veterans who are leav-
ing the military, or reservists returning to civilian life,
will fare in finding employment in the current down-
turn of our economy (Alvarez, 2008, November 18).
Unemployment and financial hardship often leads to
depression, substance abuse, spouse and child abuse,
and disintegration of the family (e.g., Barling, 1990).
Certain limitations to our study must be noted.
First, the participation response rate was limited to
45%. Given the information received with the sample
frame, we found biased response rate in that partic-
ipants were older, and more of them were females,
parents, and officers than their counterparts. How-
ever, these were relatively small biases with odd
ratios that did not exceed 1.69. And, most impor-
tantly, deployment in the theater of the war (vs.
elsewhere) and length of deployment did not signif-
icantly impact participation. Participation rate in the
T2 follow-up was high (79%) and was biased only by
age, but not by any of the T1 baseline measures.
Second, our assessment of PTS symptoms was also
limited: It included a several-year time frame and
cannot be considered diagnostic of PTSD, yet it al-
lowed for assessment of PTS symptoms during a
longer time frame. Third, in some instances the pos-
sibility of reverse causation cannot be ruled out. For
example, it is possible that job burnout at Time 1
increased the vulnerability of the respondents to the
trauma of exposure to war stressors. Fifth, possible
effects of confounding factors such as negative af-
fectivity or neuroticism on our study variables were
not controlled and cannot be ruled out.
Last but not least, another limitation of this study
pertains to the absence of a comprehensive assess-
ment of some of the positive benefits that are often
reported generally in relation to serving in the armed
forces or specifically of service during times of war.
Such benefits may include enhancement of various
work related skills, the creation of close bonding ties
with fellow soldiers, increase in self esteem, pride of
serving one’s country, and the like. Nevertheless, our
study included several outcome variables that could
fully capture effects of positive benefits such as role
and emotional functioning, job satisfaction, job in-
volvement, and organizational commitment. Yet, our
results show the negative impact of war exposure on
some of these variables (role and emotional function-
ing and job satisfaction) and the negative impact of
PTS symptoms and resource loss on all of them.
Thus, even in the presence of positive benefits due to
service at times of war, our study demonstrated that
the effects of war exposure on mental health, role and
emotional functioning, and an array of important
personal but relevant organizational outcomes were
by and large negative.
Despite the study limitations, our study is one of
the first to focus on deployed members of the Air
Force, including the rarely studied Reserve and
Guard components, which taken together, represents
25% of the total force (Sollinger, Fisher & Metscher,
2008). Further, the study was based on a large and
diverse sample with a longitudinal design and anal-
yses that controlled for all the baseline outcome
measures. The results provided a much-needed ex-
ploration of wartime deployment outcomes of Air
Force personnel and showed consistent support for
four of our five sets of hypotheses using several
diverse outcome measures, some of which were de-
signed to capture positive effects (e.g., job satisfac-
tion, organizational commitment), while others fo-
cused on negative effects (e.g., job burnout, work
family conflict). Furthermore, the generalizability of
our findings is strengthened by coverage of particular
groups in the military, such as women and parents,
who are a growing demographic in today’s military,
15EFFECTS OF WAR EXPOSURE
but typically underrepresented in research. Our con-
clusion is that for returning veterans, deployment to
the theater of war, exposure to trauma, PTS symp-
toms and resource loss represent a “cascading” chain
of causes that over time results in a decline of health
and of personal and organizational functioning that
has costs to the individuals and to the military’s
ability to fulfill its mission with experienced and
healthy veterans. These findings suggest that inter-
vention to limit resource loss should begin with early
assessment of such loss, and organizational efforts to
limit, offset, or counter resource losses. As military
personnel will inevitably be exposed to high risk
traumatic circumstances, focusing on psychosocial
and material resource losses is a much needed direc-
tion for intervention. This can be included in com-
mander/leader training, organizational structures to
support and replace resources, and planning, in par-
ticular, for those likely to be exposed to trauma and
multiple deployments. As many of these resources
also concern how families are affected by deploy-
ment, interventions that target and enrich family con-
nections and challenges that military families face
will also be valuable.
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17EFFECTS OF WAR EXPOSURE
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