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The impact of traditional masculinity ideology on veteran mental health and treatment outcome O'Loughlin, Julia Iman

Abstract

This dissertation examines the intersections between traditional masculinity ideology, mental health, and psychotherapeutic treatment outcome among veteran men. This is an important line of inquiry as endorsement of traditional masculinity ideology is common among veteran men and linked to mental health concerns that can negatively impact the transition from military to civilian life. A better understanding of how, and through which means, traditional masculinity impacts veteran men’s mental health and treatment outcomes may elucidate how negative effects of masculinity on the transition trajectory may be mitigated. To this end, three distinct, but interrelated studies were conducted. The first study aimed to determine the relevance of traditional masculinity ideology to veterans’ transition trajectory by examining the relationship between individual masculinity facets and mental health. Results indicated that restrictive emotionality predicted posttraumatic stress disorder (PTSD), depression, and lack of perceived social support, and avoidance of femininity predicted alcohol-related problems. To build on these findings, we sought to assess whether the relationship between traditional masculinity ideology and veteran mental health extends to psychotherapeutic treatment outcome. We began by assessing whether individual masculinity facets impacted pre-to post-treatment change in PTSD symptomatology. Results indicated that higher endorsement of self-reliance and dominance attenuated positive treatment outcomes. To build on our learnings, we conducted a subsequent treatment-focused study to determine if similar results would be observed when measurement of treatment outcome was expanded beyond a single mental health category. To do so, treatment outcome was assessed according to changes in general psychosocial functioning. Additionally, we conducted three post-treatment follow-ups over 18 months to increase our understanding of how masculinity influences symptom change over a longer trajectory of time. Results indicated that higher endorsement of self-reliance may impede treatment outcome and endorsement of toughness may improve outcomes overtime. Combined, results of the three studies can be used to identify means of interrupting the effects of masculinity on the military to civilian transition trajectory. They may also be useful in potentiating positive treatment outcome by indicating interventions points related to interrupting masculinity facets that may disrupt veteran wellbeing and bolstering those with possible protective effects.

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Attribution-NonCommercial-NoDerivatives 4.0 International