Direct and indirect effects of mindfulness, PTSD, and depression on self-stigma of mental illness in OEF/OIF veterans

Barr, Nicholas; Davis, Jordan P.; Diguiseppi, Graham; Keeling, Mary; Castro, Carl

Abstract

Objective: Two of the most common and costly mental health diagnoses among military veterans who served in the post-9/11 conflicts in Afghanistan and Iraq are posttraumatic stress disorder (PTSD) and depression, but over half of veterans who screen positive for these problems do not seek treatment. A key barrier is self-stigma of mental illness. Mindfulness has shown promise as an explanatory variable in the context of mental health symptoms and self-stigma, but these associations are underexplored in the veterans' literature. This study examines direct and indirect effects among mindfulness, PTSD and depression, and self-stigma in post-9/11-era military veterans. Method: A sample of 577 veterans from 3 large American cities completed surveys capturing mindfulness, symptoms of PTSD and depression, and self-stigma. A structural equation modeling approach was used to examine direct and indirect effects among study variables. Results: Mindfulness was associated with less PTSD and depression and indirectly with less self-stigma through the PTSD pathway. PTSD was associated with more depression and self-stigma, and depression was not significantly associated with self-stigma. Conclusion: PTSD is strongly associated with self-stigma in military veterans, many of whom do not seek mental health treatment. Findings show that mindfulness is a promising intervention target for reducing symptoms of PTSD directly and reducing associated self-stigma of mental illness indirectly. Additional investigation of links between mindfulness, PTSD and depressive symptoms, and self-stigma in military veterans is warranted.

• Journal Article Type: Article
• Acceptance Date: Nov 29, 2019
• Online Publication Date: Dec 5, 2019
• Publication Date: 2022-10
• Deposit Date: Jan 16, 2020
• Publicly Available Date: Jan 17, 2020
• Journal: Psychological Trauma: Theory, Research, Practice, and Policy
• Print ISSN: 1942-9681
• Electronic ISSN: 1942-969X
• Publisher: American Psychological Association
• Peer Reviewed: Peer Reviewed
• Volume: 14
• Issue: 6
• Pages: 1026–1034
• DOI: https://doi.org/10.1037/tra0000535
• Keywords: Clinical Psychology; Social Psychology
• Public URL: https://uwe-repository.worktribe.com/output/5149254
• Publisher URL: https://psycnet.apa.org/doiLanding?doi=10.1037%2Ftra0000535