Thesis (M.S. in psychology)--Washington State University. / Includes bibliographical references.

Thesis (M.P.H.)--University of Michigan, 1945.

Thesis (M.B.A.)--Naval Postgraduate School, March 2005. / Thesis Advisor(s): Stephen Mehay, Suzanne Bosque. Includes bibliographical references (p. 55-56). Also available online.

Thesis (M.S.) University of Missouri-Columbia, 2006. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file viewed on (May 20, 2007) Vita. Includes bibliographical references.

AN ABSTRACT OF THE THESIS OF CATHRINE HOEKSTRA, for the Master of Arts Degree in English, presented on May 6, 2016 at Southern Illinois University Carbondale. TITLE: INVISIBLE WOUNDS: PROCESSING TRAUMA IN WAR NARRATIVES THROUGHOUT LITERATURE MAJOR PROFESSOR: Dr. Edward Brunner Many Veterans face “invisible wounds” of war. By examining various types of war narratives in literature we can understand how these veterans cope with their invisible wounds and what others can do to help them process their trauma. This project considers types of trauma theory in addition to several short stories by Tim O’Brien and Phil Klay. Veterans of Vietnam, Iraq, and Afghanistan often face these “invisible wounds,” and these stories help us see that trauma in its complexity. War itself is a traumatic experience, but for some veterans post-traumatic-stress occurs after the war is over. It is my hope through this project we can understand the invisible wounds of war such as post-traumatic-stress disorder and traumatic brain injury while also understanding combat stress and the struggles that veterans face in their civilian life. By examining two texts of short stories from two completely different wars, we can look at trauma from different points of view. During Vietnam some veterans were faced with isolation, often times tempted with alcohol, drugs and suicide. These members of the armed forces were not welcomed home in most cases, and Tim O’Brien’s short stories let us understand just how daunting it was to be at war, and how storytelling is key to comprehending the difficulties of this war. Drawing on another kind of wartime experience is Phil Klay, who brings about the bureaucracies of Iraq and the difficulty that some Marines face when they are home trying to integrate into civilian life. Sometimes the stories are difficult, raw, and hard to comprehend, but processing trauma also allows one to improve the quality of life. By listening to these stories we are making the storyteller valued, and we are also learning about historical and cultural contexts. In my time as a Graduate Teaching Assistant, I was fortunate to work with student-veterans returning to the university after deployments. These students, all from diverse backgrounds allowed me to understand what it truly means to listen to the story and be attentive to what these students wanted and needed. By introducing war narratives, short stories, and poems in the classroom we give student-veterans an opportunity to see that writing is not only an outlet for self-expression, but also a way to let the public know what military life and deployments are like.

Using the 2014 State of the Union Address as an example, I show that the public honoring of physically wounded veterans hides the emotional, psychological, social, and moral wounds of military service, creating a normative veteran identity based on mental toughness, and essentializes all veterans as honorable by default. Using Michel Foucault’s notion of Panopticism from <i>Discipline and Punish</i>, I argue that this unquestioned heroism of the veteran disciplines the nation, disengages the population from involvement, and enables unchecked, perpetual war. In response, I propose that we avoid thanking veterans publicly and abstractly, instead approaching each and every veteran personally in full recognition of their unique set of relations. This would improve veteran reintegration, politically engage the population in discourse regarding military conflict, and ultimately serve as a check on the use of state violence.

There are more women enlisting in the military and, as a result, the Veterans Administration (VA) is experiencing an increase in women veteran's utilization of healthcare services. This study examined the factors that facilitate and/or impede women veterans with a substance use disorder seeking VA substance use treatment. The current study examined predisposing, enabling, and need factors related to utilization of VA substance use treatment. An intact dataset of 1004 participants were utilized in addition to a subset of 143 women veterans with a substance use disorder who sought substance use treatment. Predisposing factors significantly differentiated women veterans with and with a substance use disorder. A significant difference was not found between severity of substance use diagnosis and health insurance status. Marital status and socio-economic status were the only predictor variables that significantly predicted women veterans with a substance use disorder and utilization of VA substance use treatment. The results provide mixed support related to previous research. Future directions for research are discussed.

No description available.

There is heightened risk for physical and mental health concerns among U.S. veterans. For instance, 26% of veterans experience insomnia (i.e., chronic difficulty initiating or maintaining sleep), compared to 15% of the general population. This may be due, in part, to the presence of post-traumatic stress disorder (PTSD) symptoms, as veterans are twice as likely to be diagnosed with PTSD. Rumination or flashbacks focused on traumatic events (e.g., witnessing death) may contribute to problems with the onset and quality of sleep. However, not all veterans experience insomnia or PTSD symptoms, perhaps due to a positive future orientation (FO). Adaptive, goal-directed thinking may lessen risk for rumination about past actions or experiences (e.g., combat exposure), with consequent beneficial effects on sleep quality. Yet, to the extent that other negative emotions remain in the presence of FO, potential benefits may be thwarted. Specifically, feelings of shame (i.e., judging self as intolerable or defective) or anger may arise from discrepancies between military actions taken or witnessed and one’s moral beliefs. In turn, this may limit future-oriented coping abilities, with negative implications for PTSD symptoms and insomnia. At the bivariate level, we hypothesized that PTSD symptoms, insomnia, shame, and anger would be positively related, and that these variables would be negatively related to FO. At the multivariate level, we hypothesized that PTSD symptoms would mediate the relation between FO and insomnia, such that greater FO would be associated with fewer PTSD symptoms and, in turn, to fewer insomnia symptoms. Further, we hypothesized that shame and anger would moderate these linkages, reducing beneficial effects and exacerbating risk. Our sample of U.S. veterans (n=551) was recruited online from national organizations and social media groups and was primarily white (n=469; 85.1%) and male (n=382; 69.3%). Participants completed self-report measures, including the Zimbardo Time Perspective Inventory - Brief (future subscale), PTSD Checklist - Military Version, Insomnia Severity Index, and Differential Emotions Scale (shame and anger subscales). Bivariate correlations and moderated-mediation analyses, per Hayes (2013), were conducted, covarying age, sex, and ethnicity. In bivariate analyses, all variables were significantly related in hypothesized directions (p<.01). In mediation analyses, the total effect of FO on insomnia was significant (t=-5.336, p<.001), and the direct effect was nonsignificant when PTSD was added (t=-1.840, p=.07), indicating mediation. In moderated-mediation analyses, the PTSD-insomnia linkage was strengthened by shame (b2=-.011, t=-2.451, p=.015, CI=[-.019, -.002])and anger (b2=-.012,t=-3.1, p=.002, CI=[-.020, -.005]), in separate models. In our veteran sample, to the extent one is future-oriented, PTSD symptoms may be ameliorated, with consequent beneficial impact on sleep quantity and quality. Yet, shame and anger may exacerbate the linkage between PTSD symptoms and insomnia, suggesting that therapeutic interventions to reduce shame (e.g., Acceptance and Commitment Therapy) and anger (e.g., cognitive reframing) may promote better sleep. Clinical strategies to promote positive future-oriented thinking (e.g., Cognitive Processing Therapy) may also help to alleviate PTSD symptoms and associated insomnia within the veteran population.

The present study sought to evaluate whether a brief ACT session which utilized values and committed action activities was effective in changing how student veterans responded on two different discounting surveys. Participants in experimental and control groups completed a monetary temporal discounting survey and a death probability discounting survey before and after completing either a brief ACT session or completing a control activity. Twenty-three student veterans participated in the present study and a pre-, post-group control group design was utilized to evaluate the effects of the intervention. Independent t-tests were conducted, and the results of those analyses showed that ACT was effective in decreasing discounting on the monetary temporal discounting survey (t(10) = 1.997, p = 0.0368) when compared to the control group (t(11) = 0.2088, p = 0.4192). However, there were no statistically significant changes on the death probability survey in the ACT group (t(10) = 0.2459 p = .4504) or control group (t(11) = 0.8784, p = 0.1992). Implications of these findings and future research are discussed.