Systematic Review of Financial Interventions for Adults Experiencing Behavioral Health Conditions.

OBJECTIVE: The authors reviewed the literature on finance-based interventions used to improve clinical and psychosocial outcomes among adults experiencing mental disorders, substance use disorders, or both. METHODS: A systematic review of the peer-reviewed literature, published from 1900 to 2022, was conducted. Only studies with participants with a mental disorder or a substance use disorder, a structured finance-based intervention or program, a quantitative dependent variable in a behavioral health outcomes domain, and a defined research design were included. Studies were rated with a quality assessment tool, and overall evidence (levels I-VII) for the outcomes was rated. RESULTS: In total, 544 articles were identified, screened for eligibility, and reduced to 55 articles. These articles were rated by two independent raters, and 18 articles were ultimately included. Of these 18 articles, four reported findings of randomized controlled trials (RCTs), one conducted a secondary analysis of an RCT, and the remaining articles were observational studies. The most studied intervention was representative payeeship, which reduced substance use and enhanced money management, showing the strongest evidence for improving outcomes among adults with behavioral health conditions. Weaker evidence suggested that financial education and assistance interventions could improve health care utilization and other psychosocial outcomes among individuals with mental or substance use disorders. CONCLUSIONS: Level II-V evidence indicates that finance-based interventions can improve outcomes among adults experiencing behavioral health conditions. Further research is needed to assess the impact of interventions beyond representative payee programs on objectively measured outcomes.

Nonsuicidal self-injury among veterans is associated with psychosocial impairment, suicidal thoughts and behaviors, and underutilization of mental health services.

Nonsuicidal self-injury (NSSI) is a robust predictor of suicide attempts. However, understanding of NSSI and associated treatment utilization among Veterans is limited. Although impairment may be assumed, few studies examine the association between NSSI and psychosocial functioning, a core component of the rehabilitation framework of mental health. In a national survey of Veterans, current NSSI (n = 88) was associated with higher rates of suicidal thoughts and behaviors and more severe psychosocial impairment after adjusting for demographics and probable diagnoses of posttraumatic stress disorder, major depressive disorder, and alcohol use disorder, compared to Veterans without NSSI (n = 979). Only half of Veterans with NSSI were engaged with mental health services, with few appointments attended, suggesting that these Veterans are not receiving treatment interventions. Results underscore the adverse outcomes associated with NSSI. Underutilization of mental health services highlights the importance of screening for NSSI among Veterans to improve psychosocial outcomes.

Anger and suicidality in veterans: Impact of postseparation time and combat.

OBJECTIVE: The study investigated the association over time between the rates of anger/hostility and suicidality in post-9/11 veterans as a function of time following separation from the military and combat exposure. METHOD: Structured clinical interviews were conducted with N = 2,580 Iraq/Afghanistan-era U.S. military veterans serving since 9/11/01. For each participant, a postseparation interval was calculated as the time between military separation and the clinical interview, with a range of up to 9 years. Combat exposure was assessed using a three-level categorical proxy derived from the Combat Exposure Scale indexing levels of none, below, and above median exposure. Three separate estimates measuring anger/hostility and three separate measures of suicidality were modeled variously across separation intervals and levels of combat exposure. RESULTS: In bivariate analyses, higher levels of combat exposure were associated with overall significantly higher levels of both anger/hostility and suicidality. Based on multivariable analyses, rates in measures indexing suicidality among veterans did not decrease as a function of the number of years postseparation. In contrast, rates in measures indexing anger/hostility among veterans endorsing above-median levels of combat exposure decreased significantly with increasing time since separation. Nonetheless, even at longer time points, both suicidality and anger/hostility remained elevated among respondents endorsing above-median combat exposure. CONCLUSIONS: These findings illustrate the importance of implementing suicide prevention and anger management programs for postseparation adjustment as well as for the period beyond the immediate postseparation, with particular attention paid to the level of combat exposure experienced. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The prevalence of traumatic brain injury (TBI) among people impacted by the criminal legal system: An updated meta-analysis and subgroup analyses.

OBJECTIVE: Traumatic brain injury (TBI) is a significant public health concern and has implications for people directly impacted by the criminal legal system during arrest, conviction, incarceration, and community supervision. This meta-analysis estimated the lifetime prevalence of TBI among people supervised by the criminal legal system across settings. HYPOTHESES: Building on previous research, we hypothesized that prevalence estimates would be impacted by methodological, clinical, and demographic factors. METHOD: Eligible studies included those with adult participants supervised by the criminal legal system (i.e., prison, jail, probation, parole, inpatient/forensic hospital) and that provided sample TBI prevalence and method of ascertaining TBI history. We employed subgroup analyses and metaregression to investigate the effects of setting, TBI definition and method of detection, lifetime history of mental illness and substance use disorders, and gender. RESULTS: The sample ultimately included 64 studies totaling 52,540 participants. Using a random-effects model and logit transformation, we found that the overall estimate of TBI prevalence was 45.8% (95% confidence interval, CI [37.8, 54.1], 95% prediction interval, PI [5.5, 92.5]) across all studies and 32.0% (95% CI [25.0, 39.8], 95% PI [11.2, 63.6]) for moderate-to-severe TBI. Significant effects were found for TBI definition and method of detection on the pooled estimate. CONCLUSIONS: The prevalence of TBI among people impacted by the criminal legal system may be larger than in the general population. However, despite recent and ongoing progress in this area of study, the reliability of prevalence estimates remains limited by methodological factors related to TBI definitions and detection methods. Implications for TBI research and clinical service provision are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

How often does homelessness precede criminal arrest in veterans? Results from the U.S. survey of prison inmates.

Research has shown links between homelessness and criminal legal involvement in military veterans. The present study aimed to determine the magnitude and directionality of this association by investigating the incidence of, and factors associated with, homelessness preceding criminal arrest among veterans. Data on incarcerated veterans (N = 1,602) were analyzed from the 2016 Survey of Prison Inmates conducted by the U.S. Bureau of Justice Statistics. In this survey, 27% of incarcerated veterans reported homelessness 12 months before criminal arrest. In multivariable logistic regression analyses, higher odds of experiencing homelessness preceding criminal arrest were associated with younger age, non-White race, substance use disorder (with or without serious mental illness [SMI]), history of previous arrests, parental history of incarceration, and history of homelessness before age 18. These factors were found to be the same for nonveterans, as were rates of homelessness before arrest. However, incarcerated veterans were more likely to have mental disorders, including SMI, posttraumatic stress disorder (PTSD), and personality disorders. In contrast, incarcerated nonveterans were more likely to have a criminal history, including past arrests, parental incarceration, and juvenile detention. Although policymakers may be aware that some veterans they serve are at risk of criminal legal involvement, these national data reveal the magnitude and directionality of this problem: more than one in four incarcerated veterans experienced homelessness before criminal arrest. Identifying characteristics of veterans who experienced homelessness before criminal arrest directly informs service providers of demographic, historical, and clinical factors to evaluate and address to prevent criminal legal involvement. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Retention of older veterans with serious mental illness in a clinical exercise program.

Older adults with serious mental illness (SMI) have compromised physical function that could be improved with exercise; however, retention in exercise programs is a challenge. This study was a retrospective analysis of retention for the 150 older veterans with SMI that enrolled in Gerofit, a clinical exercise program offered in the Veterans Health Administration. Chi-square and t-tests were conducted to evaluate baseline differences between those that were and were not retained at six and 12 months. Retention was 33% and better health-related quality of life and endurance were related to retention. Future work is needed to improve exercise program retention in this population.

Prevalence and characteristics associated with firearm ownership among low-income U.S. veterans.

This study examined the prevalence of firearm ownership among low-income U.S. military veterans and associated sociodemographic, trauma, and clinical characteristics. Data were analyzed from a nationally representative study of low-income U.S. veterans conducted in 2021 (n = 1,004). Hierarchical logistic regression analyses identified characteristics associated with firearm ownership and mental health correlates of firearm ownership. The results revealed 41.7% of low-income U.S. veterans (95% confidence interval [CI] = 38.7-44.8%) reported owning firearms in their household. Controlling for other factors, firearms owners were significantly more likely to be male and living in their own house. There were no significant associations between trauma exposure (history of assault, unwanted social contact, death of close friend/family, homelessness) or mental health characteristics (history of bipolar disorder, suicide attempt, drug use problems) with firearm ownership. In conclusion, two of five low-income U.S. veterans own a firearm; the prevalence of firearm ownership is higher among men and homeowners. Targeted research on these key segments of the U.S. veteran population and ways to mitigate their firearm misuse may be needed.

Food Insecurity and Suicidal Ideation: Results from a National Longitudinal Study of Military Veterans.

OBJECTIVE: Research examining social determinants of suicide risk in veterans suggests a potential link between food insecurity and subsequent suicidal ideation in military veterans. The objective of this study is to investigate, if and how, food insecurity predicts subsequent suicidal ideation in a nationally representative longitudinal survey of veterans. METHODS: A national longitudinal survey was analyzed of participants randomly drawn from over one million U.S. military service members who served after September 11, 2001. N = 1,090 veterans provided two waves of data one year apart (79% retention rate); the final sample was representative of post-9/11 veterans in all 50 states and all military branches. RESULTS: Veterans with food insecurity had nearly four times higher suicidal ideation one year later compared to veterans not reporting food insecurity (39% vs 10%). In multivariable analyses controlling for demographic, military, and clinical covariates, food insecurity (OR = 2.37, p =.0165) predicted suicidal ideation one year later, as did mental health disorders (OR = 2.12, p = .0097). Veterans with both food insecurity and mental health disorders had a more than nine-fold increase in predicted probability of suicidal ideation in the subsequent year compared to veterans with neither food insecurity nor mental health disorders (48.5% vs. 5.5%). CONCLUSION: These findings identify food insecurity as an independent risk marker for suicidal ideation in military veterans in addition to mental disorders. Food insecurity is both an indicator of and an intervention point for subsequent suicide risk. Regularly assessing for food insecurity, and intervening accordingly, can provide upstream opportunities to reduce odds of suicide among veterans.HIGHLIGHTSMilitary veterans with food insecurity were at elevated risk of suicidal ideation.Veterans with mental health disorders had higher odds of suicidal ideation one year later.Food insecurity plus mental health disorders led to a substantial increase in suicidal ideation.

Development and refinement of the mobile anger reduction intervention for veterans with posttraumatic stress disorder.

OBJECTIVE: Problematic anger is commonly reported among veterans with posttraumatic stress disorder (PTSD) and is associated with numerous psychosocial impairments. There is a clear need to develop innovative and effective anger interventions. One of the cognitive mechanisms associated with anger is the hostile interpretation bias, which is the tendency to interpret ambiguous interpersonal situations as hostile. The current study presents a successive cohort design methodology to develop and refine a mobile treatment application, entitled Mobile Anger Reduction Intervention (MARI), which uses interpretation bias modification techniques to modify hostile interpretation bias. METHOD: Two cohorts (total N = 13) of veterans with PTSD and problematic anger used the MARI application for 4 weeks. After each cohort, qualitative and quantitative data were used to modify the MARI application. The intervention is described, as well as the qualitative and quantitative findings and subsequent changes made to the mobile application based on participant feedback. RESULTS: Treatment adherence was high (90% of participants completed all sessions). Participants reported that they found the treatment helpful and easy to use and experienced improvements in hostile interpretation bias and problematic anger. CONCLUSIONS: This study demonstrates the utility of a successive cohort treatment design for the development of mobile interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Physical Function Assessment of Older Veterans With Serious Mental Illness.

OBJECTIVE: To characterize the physical function of older veterans with serious mental illness (SMI) across endurance, strength, and mobility domains. DESIGN: Retrospective analysis of clinical performance data. SETTING: Gerofit program, a national outpatient supervised exercise program for older veterans, delivered in Veterans Health Administration sites. PARTICIPANTS: Older veterans aged 60 and older (n = 166 with SMI, n = 1,441 without SMI) enrolled across eight national Gerofit sites between 2010 and 2019. MEASUREMENTS: Performance measures of physical function covering endurance (6-minute walk test), strength (chair stands, arm curls), and mobility (10-m walk, 8-foot-up-and-go), were administered at Gerofit enrollment. Baseline data from these measures were analyzed to characterize the functional profiles of older veterans with SMI. One sample t tests were examined to compare functional performance of older veterans with SMI to age- and sex-based reference scores. Propensity score matching (1:3) and linear mixed effects models were used to evaluate differences in function between veterans with and without SMI. RESULTS: Older veterans with SMI performed worse on all measures of function (chair stands, arm curls, 10-m walk, 6-minute walk test, 8-foot-up-and-go) compared to age- and sex-based reference scores with statistically significant differences present in the male sample. Functional performance of those with SMI was also worse compared to propensity-score matched older veterans without SMI with statistically significant differences on chair stands, 6-minute walk test, and 10-m walk. CONCLUSION: Older veterans with SMI have compromised strength, mobility, and endurance. Physical function should be a core component of screening and treatment for this population.

Criminal legal involvement among recently separated veterans: Findings from the LIMBIC study.

OBJECTIVE: This study investigated individual-level and neighborhood-level predictors of criminal legal involvement of veterans during the critical transition period from military to civilian life. HYPOTHESES: We hypothesized that substance use, mental health, and personality disorders will increase the incidence of criminal legal involvement, which will be highest among veterans living in socioeconomically disadvantaged neighborhoods after military discharge. METHOD: We analyzed data from a longitudinal cohort study of 418,624 veterans who entered Department of Veterans Affairs (VA) health care after leaving the military. Department of Defense (DoD) data on clinical diagnoses, demographics, and military history were linked to VA data on neighborhood of residence and criminal legal involvement. RESULTS: Criminal legal involvement in the 2 years following military discharge was most strongly predicted by younger age, substance use disorder, and being male. Other predictors included the military branch in which veterans served, deployment history, traumatic brain injury, serious mental illness, personality disorder, having fewer physical health conditions, and living in socioeconomically disadvantaged neighborhoods. These factors combined in multivariable analysis yielded a very large effect size for predicting criminal legal involvement after military separation (area under the curve = .82). The incidence of criminal legal involvement was 10 times higher among veterans with co-occurring substance use disorder, serious mental illness, and personality disorder than among veterans with none of these diagnoses, and these rates were highest among veterans residing in more socioeconomically disadvantaged neighborhoods. CONCLUSIONS: To our knowledge, this is the largest longitudinal study of risk factors for criminal legal involvement in veterans following military discharge. The findings supported the hypothesis that veterans with co-occurring mental disorders living in socioeconomically disadvantaged neighborhoods were at higher risk of criminal legal involvement, underscoring the complex interplay of individual-level and neighborhood-level risk factors for criminal legal involvement after veterans leave the military. These results can inform policy and programs, such as the DoD Transition Assistance Program (TAP) and the VA Military to Civilian Readiness Pathway program (M2C Ready), to enhance community reintegration and prevent criminal legal involvement among veterans transitioning from military to civilian life. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A National Study of Zoom Fatigue and Mental Health During the COVID-19 Pandemic: Implications for Future Remote Work.

Overuse of videoconferencing for work may contribute to what has been called "Zoom fatigue": feeling anxious, socially isolated, or emotionally exhausted due to lack of social connection. Given implications for employee well-being, this study investigated Zoom fatigue at work and its potential link to mental health symptoms. A national survey of mental health symptoms was conducted in the United States during the COVID-19 pandemic in August 2020. Adults (n = 902) endorsing a shift at work to videoconferencing completed an online survey; survey criteria included an age minimum of 22 years and reported annual gross income of <$75,000. Statistical raking was employed to weight the sample using U.S. census data on geographic region, age, gender, race, and ethnicity. A three-item Zoom Fatigue Scale measuring perceived stress, isolation, and depression associated with videoconferencing at work showed good internal consistency (α = 0.85). Higher scores on this scale were related to being married, nonwhite race, post-high school education, severe mental illness, greater loneliness, lower social support, lacking money for food, and more weekly videoconference calls. Depressive symptoms demonstrated a significant association with Zoom fatigue, even when adjusting for demographic, psychosocial, and clinical covariates. The study findings indicated that employers and employees should consider a complex array of individual-level and environment-level factors when assessing how videoconferencing at work may engender stress, social isolation, and emotional exhaustion. This impact could adversely impact mental health, work productivity, and quality of life, even after the COVID-19 pandemic.

Comparing psychosocial functioning, suicide risk, and nonsuicidal self-injury between veterans with probable posttraumatic stress disorder and alcohol use disorder.

BACKGROUND: Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) are each common among Unites States (U.S.) military veterans and frequently co-occur (i.e., PTSD+AUD). Although comorbid PTSD+AUD is generally associated with worse outcomes relative to either diagnosis alone, some studies suggest the added burden of comorbid PTSD+AUD is greater relative to AUD-alone than to PTSD-alone. Furthermore, nonsuicidal self-injury (NSSI) is more common among veterans than previously thought but rarely measured as a veteran psychiatric health outcome. This study sought to replicate and extend previous work by comparing psychosocial functioning, suicide risk, and NSSI among veterans screening positive for PTSD, AUD, comorbid PTSD+AUD, and neither disorder. METHODS: This study analyzed data from a national sample of N = 1046 U.S. veterans who had served during the Gulf War. Participants self-reported sociodemographic, functioning, and clinical information through a mailed survey. RESULTS: Veterans with probable PTSD+AUD reported worse psychosocial functioning across multiple domains compared to veterans with probable AUD, but only worse functioning related to controlling violent behavior when compared to veterans with probable PTSD. Veterans with probable PTSD+AUD reported greater suicidal ideation and NSSI than veterans with probable AUD, but fewer prior suicide attempts than veterans with probable PTSD. LIMITATIONS: This study was cross-sectional, relied on self-report, did not verify clinical diagnoses, and may not generalize to veterans of other military conflicts. CONCLUSIONS: Findings underscore the adverse psychiatric and functional outcomes associated with PTSD and comorbid PTSD+AUD, such as NSSI, and highlight the importance of delivering evidence-based treatment to this veteran population.

Neuropsychological deficits associated with medical conditions: Implications for psychological services in criminal legal settings.

Criminal legal system-involved populations are disproportionally impacted by chronic health conditions relative to the general population. These discrepancies are thought to be due to both health disparities and increased likelihood to engage in health-compromising behaviors. Medical conditions can significantly influence neuropsychological functioning and, in turn, thinking and behavior relevant to clinical forensic decision-making and psychological practice in criminal legal settings. The aim of this article is to review medical conditions commonly observed among system-involved populations-specifically cardiovascular disease, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), traumatic brain injury, cancer, diabetes, and medication side effects-and describe the complex and important links between these conditions, their associated neuropsychological deficits, and applications to psychological assessment and treatment in criminal legal settings. Ultimately, this discussion will be useful to staff providing psychological services in these settings by increasing their familiarity with these concepts, and providing practical applications to inform their case conceptualization, assessment, and treatment services with system-involved individuals. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Financial Status and Well-being in Recently Separated Military Veterans.

INTRODUCTION: Veterans transitioning from military service to civilian life manage numerous changes simultaneously, in health, employment, social relationships, and finances. Financial problems may impact financial well-being as well as adjustment to civilian life in general; yet, research on Veterans' financial challenges remains limited. This study examined six indicators of perceived financial status among newly transitioned Veterans over a period of 3 years and then examined perceived financial well-being measured in two domains-satisfaction and functioning-and difficulty adjusting to civilian life as functions of financial status. MATERIALS AND METHODS: A sample representing 48,965 Veterans who separated from active duty/activated status in fall 2016 provided informed consent and survey data over their first 33 post-military months; data were analyzed in weighted regression models that included demographics, military characteristics, social support, resilience, life stress, and indicators of financial status. RESULTS: Financial status immediately post-separation included having stable housing (88%), being able to pay for necessities (83%), keeping up with creditors (88%), having insurance for catastrophic events such as disability (79%), saving for retirement (62%), and setting aside 3 months of salary (50%). Thirteen percent of Veterans disclosed troubled financial status, having achieved no more than two of these financial goals; 38% had moderate and 49% excellent financial status. Troubled or moderate financial status, Black race, enlisted, and higher levels of stress predicted lower financial functioning. Older age, college degree at baseline, employment, and social support predicted better financial satisfaction. Veterans with troubled financial status reported greater difficulty adjusting to civilian life (odds ratio 1.34); women were less likely to report difficulty adjusting to civilian life (odds ratio 0.85). CONCLUSIONS: Findings indicate that financial satisfaction and functioning may be sensitive to psychosocial factors (social support and stress). Findings also underscore the value of assessing Veterans' financial status (poor debt management and lack of future planning), providing encouragement and assistance to pursue a college degree, and improving household financial management, thus increasing the likelihood that Veterans will have the necessary tools to manage their finances after separation and achieve whole health well-being.

Establishing a Research Agenda for Suicide Prevention Among Veterans Experiencing Homelessness.

Suicide among Veterans experiencing or at risk for homelessness remains a significant public health concern. Conducting research to understand and meet the needs of this at-risk population remains challenging due to myriad factors (e.g., clinical complexity including multimorbidity, difficulty monitoring risk across systems). To address this challenge, the United States Department of Veterans Affairs (VA) convened the Health Services Research and Development (HSR&D) Suicide Prevention in Veterans Experiencing Homelessness: Research and Practice Development meeting, bringing together subject-matter experts in the fields of homelessness and suicide prevention, both from within and outside of VA. During the meeting, attendees identified 10 potential research priorities at the intersection of suicide prevention and homelessness. After the meeting, Delphi methodology was used to achieve consensus on the relative importance of the identified research domains. Through this iterative Delphi process, agreement was reached regarding the need to increase understanding of barriers and facilitators to suicide risk assessment and emergency intervention for Veterans experiencing homelessness by examining the perspectives of both Veterans and healthcare providers. Elucidating the complex relationships between risk periods, subgroups, suicide means, and drivers of suicide among Veterans experiencing homelessness was also considered a top priority. This article documents the Delphi process and provides a research agenda for researchers, funding agencies, and policymakers to prioritize the most relevant and potentially impactful research domains aimed at preventing suicide among Veterans experiencing or at risk for homelessness.

Evictions and tenant-landlord relationships during the 2020-2021 eviction moratorium in the US.

This study provisionally examined the effects of the US eviction moratorium instituted in response to the Coronavirus Disease 2019 (COVID-19) pandemic. Three waves of data collected May 2020-April 2021 from a nationally representative sample of middle- and low-income US tenants (n = 3393 in Wave 1, n = 1311 in Wave 2, and 814 in Wave 3) were analyzed. Across three waves, 4.3% of tenants reported experiencing an eviction during the moratorium and 6%-23% of tenants reported delaying paying rent because of the moratorium. Multivariable analyses found that tenants who delayed paying their rent, were female, or had a history of mental illness or substance use disorder were more likely to report the eviction moratorium had a negative effect on their landlord relationship. COVID-19 infection was not predictive of eviction but tenants with a history of homelessness were more than nine times as likely to report an eviction than those without such a history. Together, these findings suggest the eviction moratorium may have had some unintended consequences on rent payments and tenant-landlord relationships that need to be considered with the end of the federal eviction moratorium.

Psychosocial well-being among veterans with posttraumatic stress disorder and substance use disorder.

OBJECTIVE: Concurrent posttraumatic stress disorder and substance use disorder (PTSD/SUD) in U.S. military veterans represents an urgent public health issue associated with significant clinical challenges. Although previous research has shown that veterans with PTSD/SUD endorse more psychosocial risk factors and fewer protective factors than veterans with neither or only one of these disorders, no study has applied a comprehensive framework to characterize the vocational, financial, and social well-being of veterans with PTSD/SUD. Furthermore, it is not fully known how well-being among veterans with PTSD/SUD compares to that of veterans with posttraumatic stress disorder (PTSD) only, substance use disorder (SUD) only, or neither disorder. METHOD: This cross-sectional observational study analyzed data from the National Post-Deployment Adjustment Survey, which recruited a random national sample of U.S. veterans who served on/after September 11, 2001. Participants (weighted N = 1,102) self-reported sociodemographic, clinical, and military background information in addition to aspects of their vocational, financial, and social well-being. RESULTS: Veterans with PTSD/SUD were particularly likely to report lifetime experiences of homelessness, violent behavior, suicidal ideation, and suicide attempts. Veterans with PTSD/SUD reported worse social well-being than the PTSD-only, SUD-only, and neither-disorder groups. They also reported worse vocational and financial well-being than veterans with SUD only or with neither disorder but did not significantly differ from the PTSD-only group on vocational or financial well-being. CONCLUSIONS: The findings underscore the importance of assessing multiple aspects of well-being in veterans with PTSD and/or SUD. The findings also point to promising treatment targets to improve psychosocial functioning and overall quality of life among veterans with PTSD and/or SUD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Prospective association between receipt of the economic impact payment and mental health outcomes.

BACKGROUND: The Coronavirus Aid, Relief, and Economic Security Act of 2020 provided 'economic impact payments' (EIPs) of $1200 to US adults with annual personal income of $75 000 or less. This study examined the prospective association between EIP receipt and mental health outcomes. METHODS: A nationally representative sample of 3169 middle-income and low-income US adults completed a baseline assessment of their health and well-being in May-June 2020 and a 3-month follow-up assessment during the period of the COVID-19 pandemic when EIPs were distributed. RESULTS: Controlling for sociodemographic characteristics, EIP recipients had higher odds of reporting a positive COVID-19 test, endorsing a history of post-traumatic stress disorder and reporting any illicit drug use in the past month than participants who did not receive EIP. Participants who did not receive EIP were more likely to report a history of anxiety disorder or alcohol use disorder and recent suicidal ideation than EIP recipients. There was no association between EIP receipt and financial distress, although over one-third to over half of EIP recipients were not employed at baseline. Between baseline and 3-month follow-up, receipt of EIP was significantly associated with reduced medical conditions and alcohol use problems, but increased depression, suicidal ideation and COVID-19 era-related stress. CONCLUSION: The EIP provided a brief income stimulus to many adults in need but was not associated with improvements in financial distress or mental health among middle-income and low-income recipients. Long-term income security and employment may be more important to improving and sustaining positive mental health outcomes.

Correlates of Incarceration History Among Military Veterans.

Veterans with histories of incarceration are at greater risk for poor physical and mental health outcomes, yet prior research in this population has focused on specific subsets of veterans or a narrow range of predictors. We utilized the Bronfenbrenner Socioecological Model as the framework to evaluate correlates of incarceration history in a large sample of Iraq and Afghanistan-era veterans at four levels: demographic, historical, clinical, and contextual. Participants were 2,904 veterans (76.9% male; 49.5% White and 46.5% Black; mean age 38.08, SD = 10.33), 700 of whom reported a history of incarceration. Four logistic regression models predicting history of incarceration were tested, adding demographic, historical, clinical, and contextual variables hierarchically. In the final model, younger age (OR=0.99, 95% CI=0.98-1.00), male gender (OR of being female =0.28, 95% CI=0.21-0.38), belonging to a historically marginalized group (OR of being White =0.69, 95% CI=0.56-0.84), family history of incarceration (OR=1.47, 95% CI=1.10-1.94), adult interpersonal trauma (OR=1.39, 95% CI=1.28-1.51), problematic alcohol use (OR=1.03, 95% CI=1.02-1.05), drug abuse (OR=1.15, 95% CI=1.11-1.19), and unemployment (OR for being employed=0.76, 95% CI=0.62-0.92) were significantly associated with a history of incarceration. Implications of these findings for developing interventions and supporting systems to effectively target this high-risk population of veterans are discussed.