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Suicide is a significant public health concern in the U.S., with over 40,000 suicides reported in 2014. For veterans, risk for suicide is even greater; for instance, of the over 40,000 suicides in 2014, 18% were comprised of veterans, although veterans account for only 8% of the U.S. population. Heightened suicide risk in veterans may be due to increased exposure to trauma (e.g., military sexual trauma, combat) and its negative cognitive-emotional sequelae (i.e., shame, guilt, PTSD). However, not all veterans who experience these negative symptoms manifest suicide risk, potentially due to the presence of protective factors. One such factor, self-compassion, involves responding to oneself in a caring and helpful manner in times of distress and may buffer against suicide risk by allowing the individual to look past global negative self-evaluations (i.e., shame), breaking the ruminative cycle over past actions (i.e., guilt), and helping to alleviate PTSD symptoms. This premise, however, has not been tested. We hypothesized that shame/guilt and PTSD symptoms (in two separate models) would mediate the relation between self-compassion and suicide risk, such that higher levels of self-compassion will be associated with lower levels of shame/guilt and, in turn, to decreased PTSD symptoms and reduced suicide risk. Participants (N=317; 65.6% male (n=208); 83.6% Caucasian (n=265), Mean Age=47.54, SD=16.34) were community-dwelling veterans who self-identified as having experienced a trauma, and completed the Self-Compassion Scale-Short Form, Differential Emotions Scale-IV, PTSD Checklist-Military Version, and the Suicide Behaviors Questionnaire-Revised. Bivariate correlations and serial mediation analyses were conducted covarying age, sex, ethnicity, VHA usage, service era, and depressive symptoms. Supporting hypotheses, in serial mediation analyses (10000 bootstrapped samples), the direct effect of self-compassion on suicide risk was reduced, but remained significant, when shame and PTSD symptoms (Model 1; c'=-.846, p=.002, CI=-1.39 to -.306) and guilt and PTSD symptoms (Model 2; c'=-.588, p=.043, CI=-1.15 to -.020), were added as mediators, indicating mediation. Further, there were significant total and specific indirect effects in both models. Our results suggest that the relation between self-compassion and suicide risk may be due, in part, to beneficial changes in cognitive-emotional factors and subsequent decreased severity of PTSD symptoms. Engaging in self-kindness and mindfulness may provide a more-balanced, rather than judgmental and overly-responsible, view of one’s self, thereby reducing risk for psychopathology and suicide. Our findings may have clinical implications. Encouraging the development of self-compassion (e.g., Mindful Self-Compassion, Compassion-Focused Therapy) and addressing shame, guilt, and PTSD symptoms (e.g., Cognitive Processing Therapy, Adaptive Disclosure), may reduce suicide risk in the veteran population.

This project reports on the results of a study that investigated the social networking use of student and non-student veterans, with a particular focus on the narrative building and identity presentation practices involved in this use. In this dissertation, I argue that stereotypical and exclusionary tropes of the veteran, such as the veteran as war hero and the veteran as wounded warrior, are damaging to our veterans and to others, in both the society and the classroom. However, through the detailed analysis of survey data and data collected from an interview and social networking profile tour with one student veteran participant, I highlight the exclusionary nature of these tropes and argue that the complex digital narratives crafted in social networking spaces can offer resistance to popular tropes of the veteran. The complexity of my participants' digital narratives also offers support for the argument that elements of one's social networking profiles, when viewed independently and decontextualized, can lead to invalid and unfair assumptions about the users' identity. Additionally, I argue that, for my participants, many of whom demonstrated a nuanced and critical understanding of audience, decisions to self-identify as military personnel in social networking spaces are intertwined with perceptions of privacy. Finally, this project culminates in the identification of a number of digital literacy practices present in my participants' social networking use, as well as a set of pedagogical and programmatic recommendations for writing teachers and writing program administrators interested in aiding student veterans in the process of transition and reintegration.

The negative effects of traumatic combat experiences on combatants' psychological functioning is well documented in the literature. The Global War on Terrorism (GWOT) has resulted in many veterans returning from deployments with mental health conditions related to trauma exposure, such as posttraumatic stress disorder, depression, general anxiety, and suicidality. Past researchers found significant ethnic differences in psychological functioning, with Latino-American veterans reporting more symptoms of PTSD. Furthermore, Latino-American cultural values place importance on collective orientation and secrecy of mental health concerns which may affect treatment. Thus, this study built on limited research about Latino-American male combat veterans by focusing on the effects of social support and working therapeutic alliance during mental health treatment. Using a cross-sectional design, a sample of 42 GWOT Latino-American Veterans undergoing mental health treatment at a VA Medical Center in the Southeastern U.S. was recruited and surveyed. Participants completed a set of nine questionnaires (Beck Scale for Suicidal Ideation, PTSD Checklist – Military Version, Beck Depression Inventory – 2nd Edition, Beck Anxiety Inventory, Postdeployment Social Support Scale, Combat Exposure Scale, Working Alliance Inventory – Short Form. Network Orientation Scale, and Multidimensional Scale of Perceived Social Support). Descriptive and bivariate statistics were calculated, and regression models were tested. The results indicate that social support improved overall PTSD and intrusive symptoms, separately, but working therapeutic alliance had a marginal effect on avoidance symptoms. Working alliance was found to exert a negative effect on depressive symptoms. The study did not yield evidence to support significant effects of social support or working alliance on suicidality and generalized anxiety. These results have implications for mental health service systems and for future research. Therapists serving veterans with PTSD should work with the patient/client to increase perceived social support. When serving veterans with depressive symptoms, therapists should place special effort on developing a strong working alliance.

This dissertation examined the relationship between meaningful employment and self-esteem in male veterans. Meaningful employment is an important element of reintegration, the process all veterans go through to transition from active duty military service back into society. Reintegration involves three major areas: physical and mental health, employment, and family and friend relationships. A sample of 30 male veterans were interviewed. After the interviews, two instruments were used to further examine the variables (meaningful employment and self-esteem). The instruments were administered to measure the individual's perception regarding meaningful employment and level of self-esteem. The interviews were the primary focus, with the instruments providing additional evidence to support the information gathered in the interviews. This mixed-methods study involved analyzing the interviews for consistent themes related to answering the research questions and, through systematic coding, identifying and categorizing the connectivity of concepts and trends. The two instruments were analyzed using cross-tabulations to triangulate information gathered in the interviews. A significant correlation was found between meaningful employment and self-esteem in male veterans. The study also identifies traits male veterans consider necessary for employment to be meaningful. Future studies should examine the relationship between meaningful employment and veteran suicides.

The suicide rate in the United States continues to rise, and rates of Veteran deaths are 1.5 times greater than those of non-Veteran adults. Previous research demonstrates that higher rates of suicide acceptability are positively related to suicide planning, suicidal ideation, and attempts. Examining rates of suicide acceptability in a Veteran and non-Veteran sample may be one pathway to understand the process by which attitudes are linked to behaviors. Study 1: Study 1 included a preliminary examination of a pre-screening measure, the Veteran Verification Questionnaire (VVQ), which aims to increase the validity of a Veteran sample online and reduce possible misrepresentation. Results indicated that the VVQ successfully differentiated between Veterans and non-Veteran students. Additionally, participants that answered 8 out of 12 possible items correctly were more likely to be Veterans (89%) whereas a score of 7 or less indicated that the participant was more likely to be a student. Study 2: Study 2 first examined whether or not veterans and non-Veterans differed significantly on suicide acceptability when accounting for age and sex. Study 2 also examined whether Veteran status predicted suicide acceptability using the Attitudes Towards Suicide Scale in the sample after accounting for age, sex, suicide risk and exposure to suicide. The results demonstrated that suicide acceptability rates varied significantly between Veterans and non-Veterans such that Veterans endorsed higher rates of suicide acceptability. The results from a hierarchical multiple regression analysis indicate that suicide risk, suicide exposure, and Veteran status accounted for a total of 25% of the variance in acceptability scores. The findings also demonstrate that Veteran status only accounted for 4% of the total variance whereas suicide risk accounted for 10% and exposure to suicide behaviors accounted for 11%. Interestingly, the direction of these predictions between suicide risk and exposure to suicide with suicide attitudes were opposite of expected.

Thesis (Ed.M.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

This dissertation is a comprehensive study of the content, author demographics, publishing history, and media representation of the most prominent Vietnam veteran memoirs published between 1967 and 2005. These personal narratives are important because they have affected the collective memory of the Vietnam War for decades. The primary focus of this study is an analysis of how veterans' memoirs depict seven important topics: the demographics of American soldiers, combat, the Vietnamese people, race relations among U.S. troops, male-female relationships, veterans' postwar lives, and war-related political issues. The central theme that runs through these analyses is that these seven topics are depicted in ways that show veteran narratives represent constructed memories of the past, not infallible records of historical events. One reoccurring indication of this is that while memoirists' portrayals are sometimes supported by other sources and reflect historical reality, other times they clash with facts and misrepresent what actually happened. Another concern of this dissertation is the relationship of veteran memoirs to broader trends in public remembrance of the Vietnam War, and how and why some books, but not others, were able to achieve recognition and influence. These issues are explored by charting the publishing history of veteran narratives over a thirty-eight year period, and by analyzing media coverage of these books. This research indicates that mainstream editors and reviewers selected memoirs that portrayed the war in a negative manner, but rejected those that espoused either unambiguous anti- or pro-war views. By giving some types of narratives preference over others, the media and the publishing industry helped shape the public's collective understanding of the war. / History

A troubled Marine Corps veteran, home from a combat tour in Iraq in 2003, must choose between making a better life for himself in college or staying with the self-destructive friends he served with during the war. / Master of Fine Arts