Adjustment Disorder in the Armed Forces: a Systematic Review
Abstract: In the UK military, adjustment disorder (AjD) is reported as one of the most diagnosed mental disorders, alongside depression, in personnel presenting to mental health services. Despite this, little is understood about what may predict AjD, common treatment or outcomes for this population. The systematic review aimed to summarise existing research for AjD in Armed Forces (AF) populations, including prevalence and risk factors, and to outline clinical and occupational outcomes. A literature search was conducted in December 2020 to identify research that investigated AjD within an AF population (serving or veteran) following the PRISMA guidelines. Eighty-three studies were included in the review. The AjD prevalence estimates in AF populations with a mental disorder was considerably higher for serving AF personnel (34.9%) compared to veterans (12.8%). Childhood adversities were identified as a risk factor for AjD. AjD was found to increase the risk of suicidal ideation, with one study reporting a risk ratio of 4.70 (95% Confidence Interval: 3.50–6.20). Talking therapies were the most common treatment for AjD, however none reported on treatment effectiveness. This review found that AjD was commonly reported across international AF. Despite heterogeneity in the results, the review identifies several literature gaps.
Abstract:United States military veterans face challenges when reintegrating into civilian society. Among these difficulties often exist barriers for veterans in navigating work and career experiences. This study tested factors that may contribute to experiences of decent work and reintegration in a sample of 90 United States veterans. Utilizing the Psychology of Working Theory as a framework, veterans' social support was hypothesized to be a moderating factor in the relationship between veterans' experiences of marginalization and decent work. Additionally, decent work was examined as a potential mediator in the association between veterans' career adaptability and reintegration. Separate moderation and mediation models were tested to examine the study's hypotheses. Results did not find social support to moderate the relationship between marginalization and decent work. However, decent work significantly and partially mediated the relationship between career adaptability and reintegration. Interpretation of these findings in the context of the literature is discussed, as well as implications for practice and theory, limitations, and future directions.