Gender Differences in Post-deployment Adjustment of Air Force Personnel: The Role of Wartime Experiences, Unit Cohesion, and Self-efficacy.

Introduction: With the changing roles of female military personnel, it is important to understand how wartime experiences and their impacts are similar and different for military men and women. This study examined gender differences in exposure to wartime events and post-deployment post-traumatic stress disorder (PTSD) and depressive symptoms, as well as mediators of these relations, in a large sample of male and female active duty Air Force personnel. Materials/Methods: The study included data from male (N = 21,879) and female (N = 3,741) active duty Air Force personnel who had experienced at least one deployment and completed the anonymous U.S.A.F. Community Assessment (CA) Survey in 2011. Participants reported on the number of wartime events they experienced during deployment (e.g., discharging weapons, seeing dead bodies), their perceptions of self-efficacy and the cohesiveness of their units, and their depression and PTSD symptoms post-deployment. We examined mean-level differences between men and women on both independent (wartime experiences) and dependent (PTSD and depression symptoms) measures, basic correlations among variables, and mediation of the relations between wartime experiences and mental health outcomes by unit cohesion and self-efficacy. Results: Participants reported exposure to 0-6 wartime events during deployment. A greater number of wartime events was associated with higher rates of PTSD and depression and lower ratings of unit cohesion and self-efficacy for both men and women. Men reported more wartime events, while women reported higher rates of PTSD and depression at all levels of exposure to wartime events, including zero. Depression and PTSD were most highly related to reports of being injured during deployment and feelings of danger of being killed. Unit cohesion partially mediated the relation between wartime experience and mental health for both men and women, but self-efficacy was a partial mediator only for women. Direct effects of wartime exposure on subsequent mental health were also observed for both groups. Conclusion: There are similarities and differences in the wartime experiences of military men and women. Increased exposure to combat experiences is a risk factor for both groups. Women appear to have greater vulnerability to PTSD and depression at all levels of combat exposure, and also report lower levels of unit cohesion and self-efficacy. It is possible that interventions that boost self-efficacy and unit cohesion could promote resilience for combat-exposed military personnel. Because self-efficacy operated differently for men and women, the role of this variable in post-deployment adjustment should be examined more closely.