Graduate School of Nursing Dissertations

Publication Date


Document Type

Dissertation, Doctoral


Graduate School of Nursing

Dissertation Committee Chair

Carol Bova


Military Personnel, Iraq War, 2003 -, Post-Traumatic Stress Disorders, Combat Disorders, Psychological Adaptation

Subject Categories



The purpose of this study was to identify health and emotional-related issues of service members after a deployment to Iraq. Secondary data analysis and a cross-sectional descriptive design, were used to analyze data from the Department of Defense Post Deployment Health Assessment (PDHA) database. The cognitive appraisal model of stress and coping (Lazarus and Folkman, 1984) guided this study. Several statistical techniques were used including: frequency distributions cross tab evaluations, factor analysis, reliability calculations, regression analysis and tests for mediation.

The study sample included 510, 352 service members (49,998 females, 460,349 males) with a mean age of 29 years. The sample represented all components and branches of the military. Of the total sample, 51.9% (n=264,777) saw wounded, killed or dead individuals and 22.1% (n=112,620) discharged their weapon in combat. Environmental exposures were an important source of stress. Exposures to sand and dust were the largest complaint (89.8% of the sample). Multiple physical symptoms were identified and 40% of the sample reported four or more symptoms (e.g. diarrhea, back pain, headache, fatigue). PTSD symptoms were identified in 11.8% (n = 60,200) and depressive symptoms in 26.5%, (n=123,808) of participants. Results of the study indicated that age, gender, rank, race/ethnicity, military component and branch were important predictors of emotional and health-related concerns in this sample. Appraisal variables (danger of being killed and exposure concerns) mediated the relationship between immediate (physical and depressive symptoms) and long term outcomes (health perception, PTSD symptoms) for the majority of the analyses; supporting the study hypothesis. However, length of deployment did not have a significant impact on stress-related outcomes in this study. Implications for practice, policy and future research are discussed.



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