Mindfulness, Self-Efficacy and Stigma: A Latent Profile Approach to Understanding Risk and Protective Factors in Post 9/11 Era Combat Veterans

Document Type

Conference Proceeding

Publication Date


Publication Title

APHA's 2020 Virtual Annual Meeting and Expo

First page number:


Last page number:



Veterans of the recent conflicts in Iraq and Afghanistan are well-studied, but variable-centered analytical approaches may obscure important differences between subgroups in this heterogeneous population. One identifiable subgroup comprises the 15% of veterans with non-routine military discharge status. Variable-centered studies have shown that non-routine discharge status is a predictor of behavioral health problems and is associated with barriers to accessing services. However, few studies have taken a person-centered approach to understanding how subgroups of military veterans vary with respect to psychological risk and protective factors and mental health symptoms, and whether subgroup characteristics may predict discharge status. 509 combat-deployed, post 9/11 era veterans were recruited through partnerships with veterans’ service agencies and educational institutions in the greater San Francisco, Chicago, and Los Angeles areas. Participants completed online surveys capturing the protective factors mindfulness and self-efficacy and the risk factors self-stigma, PTSD, and depression, as well as discharge status. A sequence of latent profile models were fitted to the data and evaluated for parsimony, classification accuracy, and meaningful interpretive utility. After identification of the optimal profile solution, a multivariable logistic regression model with latent profile membership as independent variables and nonroutine discharge status as the dependent variable was fitted to the data. Model comparison supported a 4-profile solution. Latent profiles indicated a high-risk group with mindfulness and self-efficacy below and self-stigma, PTSD, and depressive symptoms above full sample averages. A low-risk group was characterized by above average mindfulness and self-efficacy, low stigma, and PTSD and depressive symptoms 1.5 standard deviations below the sample mean. A third group approximated the sample mean on latent profile indicators. The fourth group was characterized by depressive symptoms at the sample mean and below average estimates on the remaining indicators. Those in the highest risk group had nearly 5 times the odds of nonroutine discharge compared to those in the low-risk group (OR=4.71, 95% CI: 1.37, 16.27). Study findings suggest that meaningful subgroups are present in post 9/11 service-era military veterans with respect to critical risk and protective factors. The highest risk group, characterized by low mindfulness and self-efficacy and high self-stigma, PTSD, and depressive symptoms, had nearly 5 times the odds of nonroutine discharge compared to the lowest risk group. This suggests that those most in need of mental health services likely face external barriers as well as self-stigma. Strengthening protective factors like mindfulness and self-efficacy may be an important intervention target for veterans confronting these barriers.


Iraq and Afghanistan veterans; Post 9/11 era veterans; Self-efficacy; Self-stigma; Mental health services


Military and Veterans Studies | Public Affairs, Public Policy and Public Administration | Social and Behavioral Sciences



Search your library