| ObjectiveVeterans are those who have military service experience and do not continue to serve.The service experience and military culture make veterans face problems of adaptation and development in identity roles,working environment and interpersonal relationships.Many stressors affect veterans’ mental health,social stabilization and even military combat effectiveness.Major military powers around the world have made veterans’ mental health a priority and conduct research on mental health assessment and its influence mechanism,psychological problems diagnosis and treatment,and the establishment of psychosocial service system.China now has 57 million veterans,and establishes the Ministry of Veterans Affairs in 2018.In October 2022,the report of the 20 th National Congress of the Communist Party of China calls for good work on veterans’ services and protection,raising the work of veterans to a strategic level.However,China’s research in the field of veterans’ mental health starts late,with only sporadic small-sample,research on depression,anxiety and other psychological problems,ignoring the positive factors of mental health;single research factors,with few effects of service experience and psychosocial factors;only variable-centered methods for data statistics,and no application of person-centered methods to study individual differences and network model methods to study psychosocial network characteristics.Therefore,this study conducts a large sample cross-sectional survey under the perspective of two factors of mental health(negative and positive).We use variable-centered,individual-centered,and network model methods to analyze the characteristics of mental health variables,type characteristics,and network associations of Chinese veterans in terms of demographic,service experience,and psychosocial factors.The purpose of this study is to provide a basis for grasping the current situation of mental health of Chinese veterans and carrying out targeted psychological services.SubjectsStratified convenience sampling was used to form nine sampling frames by combining Chinese three major economic zones(eastern,central,western)with urban economic development levels(high,medium,low),and cities within the sampling frames that could receive support from local veterans’ affairs bureaus(stations)were selected for the field research,which included a total of 3017 veterans from 15 cities in 8 provinces.Methods1.Survey instruments.Self-administered general condition questionnaire: included 10 demographic variables such as gender,age,and 9 service experience variables such as service length and military service type.Negative indicator scales included Patients’ health questionnaire depression module-9 item,Generalized Anxiety disorder-7 and Posttraumatic Stress Disorder Checklist for DSM-5,positive indicator measurement tools included the Adult Psychological Quality Questionnaire and Satisfaction with Life scale.Psychosocial factor measurement tools included the Quality of marriage index,Social Avoidance and Distress Scale and Maslach burnout inventory-General Survey.2.Research quality control.Trained questionnaire research implementer.Contacted the Veterans Affairs Bureau(station)of the research city to select the venue and recruit the subjects.Controlled the number of on-site assessment ≤50 and the time was 30～40 minutes.Collected questionnaires on site.3.Data processing and statistical analysis.Invalid questionnaires were excluded and common method bias tests were performed.Variable-centered study: SPSS25.0 was used for descriptive statistics,non-parametric test and chi-square test.Person-centered study: Mplus8.3 was used to conduct a latent profile analysis and SPSS 25.0 was used to conduct a binary logistic regression equation.Network analysis study: R language package qgraph was applied for network estimation,and the mixed graphical model(MGM)and Gaussian graph model(GGM)were constructed;the package network comparision test(NCT)was applied to compare the GGM networks of mental health types.Results1.Characteristics of mental health and related factors of Chinese veterans: based on variable-centered study(1)The prevalence of depression,anxiety,and PTSD symptoms among our veterans were 37.4%,30.0%,and 12.7%,respectively.The results of the intergroup comparison in the three symptoms prevalence together showed:(1)the prevalence of depression,anxiety,and PTSD symptoms was higher among veterans in the western economic belt,female,urban,currently ill,25 years of age or older,with junior high school education or less,and divorced than in the eastern economic belt,male,rural,not ill,18～24 years old,college and above,and married(P < 0.05);(2)the prevalence of the three symptoms was higher among veterans who served with serious illness than those who were not seriously ill;(3)the prevalence of the three symptoms in veterans: marital quality low subgroup > intermediate group > high subgroup(P < 0.05),social distress,social avoidance and emotional exhaustion high group >intermediate group > low group(P < 0.05),and low occupational effectiveness intermediate group > low group > high group(P < 0.05).(2)The life satisfaction scored 26.00(20.00,30.00).Intergroup comparisons of psychological quality and life satisfaction scores together showed:(1)Central/Eastern economic zone,male,and not currently ill scored higher than Western economic zone,female,and currently ill(P < 0.05);(2)service ≥ 30 years,up to age/year retirement,and retirement scored higher than service < 16 years,collective retirement,planned placement/independent career choice/demobilization(P < 0.05);(3)both score in veterans:marital quality high group > middle group > low group(P < 0.05),social distress,social avoidance low group > middle group > high group(P < 0.05),emotional exhaustion low group > middle group,low group > high group,low occupational effectiveness high group >low group > middle group(P < 0.05).2.Characteristics of mental health types and related factors of Chinese veterans: based on person-centered study(1)Mental health types and population distribution ratio of Chinese veterans: partial psychological problem group(40%),psychological health group(36%),psychological problem group(18%),partial psychological health group(6%).(2)The binary logistic regression equation showed that between the high symptom groups(psychological problem group versus partial psychological problem group),veterans in the eastern economic zone,military operations other than war,and the intermediate/high subgroup of marital quality tended to partial psychological problem group(P<0.05);between the low symptom groups(psychological health group versus partial psychological health group),veterans in the intermediate/high subgroup of marital quality were more inclined to be in psychological group(P<0.05).3.Characteristics of mental health networks and related factors of Chinese veterans:based on network model study(1)The mental health network of Chinese veterans formed two clusters of negative indicators(depressive symptoms-anxiety symptoms-PTSD symptoms)and positive indicators(cognitive-personality-adaptive dimensions of psychological quality).(2)In the MGM network of demographic and service experience factors: life satisfaction connected to negative symptom clusters through PTSD symptoms(borderline weights-0.10,-0.10)and to positive symptom clusters through personality dimensions(borderline weights0.52,0.22).(3)In the GGM network of psychosocial factors: the high expected influence nodes were personality dimension,anxiety symptoms and social distress.(4)The overall strength of the GGM network of psychosocial factors was higher in the partial psychological group than in the other three groups.Conclusion1.The prevalence of depressive symptoms,anxiety symptoms,and post-traumatic stress disorder symptoms among our veterans is higher than that of the general population,and the high incidence is influenced by the factors such as western economic belt,low socioeconomic status,participation in war,and low marital quality.Life satisfaction of Chinese veterans is higher than that of the general population,and the high psychological quality and life satisfaction scores are influenced by the factors such as central/eastern economic zone,high socioeconomic status,high marital quality.2.There are four types of mental health for our veterans.In the high negative symptom groups(psychological problem group vs.partial psychological problem group),economically developed areas,non-war military operations,and high marital quality are protective factors for positive indicators of mental health;in the low negative symptom groups(psychological health group vs.partial psychological health group),high marital quality is the protective factor for positive indicators of mental health.3.Life satisfaction,personality dimension have a bridging role in the mental health network.Personality dimension,anxiety symptom,and social distress are the cores of the psychosocial network.Veterans in partial psychological health group are susceptible to negative psychological symptoms. |
PDF Full Text Request