The process by which combat-exposed student veterans achieve a meaningful and purposeful life

Kinney, Adam R., author
Eakman, Aaron M., advisor
Schmid, Arlene A., advisor
Henry, Kimberly L., committee member
Coatsworth, J. Douglas, committee member
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Background: Studies investigating risk and resilience among combat-exposed student Veterans emphasize the impact of combat exposure upon negative health-related outcomes (e.g., depression or posttraumatic stress disorder [PTSD]). Little is known regarding the risk that combat exposure poses to positive outcomes, such as meaning in life, and protective factors that promote such outcomes despite combat exposure. In particular, there is a lack of research investigating whether activity engagement promotes student Veterans' resilience. Objective: The purpose of this dissertation was to test a series of theoretical propositions that explain the process by which student Veterans achieve resilience. First, I investigated whether combat exposure poses an indirect risk to student Veterans' sense of meaning and purpose in life, through its association with health-related symptoms. Second, I investigated whether protective factors, including indicators of activity engagement, promoted student Veterans' sense of meaning and purpose in life despite combat exposure and health-related symptoms (combat-related risk). Protective factors were considered to operate in two models of resilience: 1) a compensatory model, whereby protective factors promote life meaning independently of combat-related risk, or 2) a moderator model, whereby the protective factors weaken the effect of combat exposure upon life meaning. Method: This dissertation is composed of three studies, each of which analyzed data obtained through an online survey of 153 combat-exposed student Veterans at two time points. The online survey contained psychometrically sound assessments of: combat exposure, health status (PTSD; depressive; somatic symptoms), meaning in life, and six protective factors (social support; instructor autonomy support, coping ability; academic self-efficacy; social and community participation; and meaningful activity). In study one, I considered meaning and purpose in life as an inferential construct, whereby a meaningful life was operationalized as high levels of composite indicators of belonging (social support; instructor autonomy support), self-understanding (coping ability; academic self-efficacy) and doing (social and community participation; meaningful activity). I used path analysis to explore whether baseline health status mediated the relationship between combat exposure and belonging, self-understanding, and doing at follow-up. In study two, I considered meaning in life as student Veterans' self-appraisal of their lives as meaningful and purposeful. I used path analysis to: 1) explore whether baseline health status and life meaning mediated the relationship between combat and follow-up life meaning, and 2) test whether protective factors operated in compensatory and/or moderator models of resilience. In study three, I classified student Veterans by level of combat exposure (high/low) and self-reported meaning in life (high/low) at follow-up, which yielded four possible classifications (e.g., resilient group: high combat exposure and high life meaning). I fit linear mixed models to obtain adjusted means for the six protective factors and the health-related conditions for each classification. I used independent samples t tests to examine differences between classifications with respect to adjusted levels of protective factors and health-related conditions. Patterns of differences between groups provided insight into whether the protective factors operated in a compensatory or moderator model of resilience, and whether health-related symptoms influence student Veterans' adaptive response to combat exposure. Results: All three studies revealed that health-related symptoms help explain the risk posed by combat exposure to student Veterans' sense of meaning and purpose in life. Specifically, greater combat exposure was associated with more severe health-related symptoms, which in turn was associated with less meaning and purpose in student Veterans' lives. Studies two and three provided evidence that coping ability and meaningful activity operate in compensatory models of resilience, and that social support operates in a moderator model of resilience. Study two also provided evidence that instructor autonomy support, coping ability, and academic self-efficacy operate in moderator models of resilience. Conclusion: This dissertation supported my initial theoretical propositions. This dissertation revealed that health-related symptoms help explain the risk posed by combat exposure to student Veterans' sense of meaning in life. Thus, this dissertation supports an expanded conception of combat-related risk, in which the effect of combat exposure upon positive outcomes, such as a sense of meaning in life, is emphasized. This dissertation also revealed that the majority of the proposed protective factors, including personally meaningful activity engagement, fostered student Veterans' sense of meaning in life despite combat-related risk. I 1) expand upon these findings, 2) discuss implications for research and practice, and 3) explain how these findings advance occupational science and rehabilitation science.
2019 Summer.
Includes bibliographical references.
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meaning in life
student veterans
combat exposure
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