43% of veterans report increased posttraumatic growth linked to COVID-19 pandemic

More than 40% of U.S. military veterans reported moderate or greater levels of posttraumatic growth linked to the COVID-19 pandemic, according to results of a survey study published in JAMA Network Open.

Most common areas of growth included greater appreciation of life, improved social relationships and increased personal strength.

“Given the preponderance of research documenting the negative mental health effects of the COVID-19 pandemic, we wondered whether some veterans might experience positive psychological effects or post-traumatic growth in the midst of the pandemic,” Robert H. Pietrzak, PhD, MPH, of the U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, told Healio Psychiatry. “A large body of research in a broad range of trauma-exposed populations has revealed that a considerable proportion of trauma-exposed individuals, particularly those who have posttraumatic stress disorder symptoms, experience positive psychological changes, such as a greater appreciation of life, closer relationships with others, greater awareness and utilization of personal strengths, enhanced spiritual development and identification of new possibilities or purpose for one's life. However, no study has looked at whether the COVID-19 pandemic may foster positive psychological changes, so we looked into this using data from a nationally representative sample of U.S. military veterans.”

Pietrzak and colleagues obtained baseline survey data between Nov. 18, 2019, and March 8, 2020, and 1-year follow-up data between Nov. 9, 2020, and Dec. 19, 2020, from veterans who participated in the 2019 to 2020 National Health and Resilience in Veterans Study. They analyzed baseline and follow-up data of 3,078 veterans (mean age, 63.3 years; 91.6% men) and assessed posttraumatic growth linked to COVID-19 via the short form of the Posttraumatic Growth Inventory. Further, they computed total scores and five subscales that related to personal strength, relating to others, new possibilities, spiritual change and appreciation of life. The researchers adjusted for numerous background characteristic and risk factors associated with the pandemic and then conducted multivariable logistic regression analysis to assess the link between posttraumatic growth and suicidal ideation.

Results showed 12.8% of veterans in the study screened positive for PTSD symptoms associated with COVID-19. A total of 1,328 (weighted percentage = 43.3%) reported having experienced moderate or greater levels of posttraumatic growth linked to the pandemic, with the most common being appreciation of life, relating to others and personal strength. Those who screened positive for COVID-19-linked PTSD symptoms more often endorsed all aspects of posttraumatic growth than those who screened negative. A total of 7.7% of veterans screened positive for suicidal ideation at the baseline assessment and 8% at the follow-up assessment. The researchers adjusted for background and pandemic-associated risk factors and found an independent association between lower risk for suicidal ideation at the follow-up assessment and COVID-19-linked improvements in appreciation of life (OR = 0.59; 95% CI, 0.35-0.98) and relating to others (OR = 0.58; 95% CI, 0.34-0.99).

“Our results suggest that, in addition to the negative mental health effects of the global pandemic, a considerable proportion of veterans report positive psychological changes,” Pietrzak said. “These changes are particularly pronounced among veterans with pandemic-related posttraumatic stress symptoms, who are likely engaging in deeper, reflective processing of the pandemic that can help stimulate such changes. Our finding linking greater pandemic-related posttraumatic growth, particularly greater appreciation of life and improved relationships with others, with a significantly lower likelihood of suicidal thinking during the pandemic underscores the importance of evaluating posttraumatic growth-promoting interventions as part of suicide risk prevention and treatment efforts in veterans.”