Evaluating the Association of Military Unit Cohesion with Depressive Symptoms, Suicidal Ideation, and Alcohol Use Among U.S. Military Members Meeting Diagnostic Criteria for PTSD

Mental health issues such as depression, suicidal ideation, and hazardous alcohol use have become increasingly common among military populations in the United States. Current research into the potential protective influences of unit cohesion for these mental health outcomes has yielded mixed results and primarily focused on post-deployment samples despite a relatively high burden of mental health issues among non-deployed service members. The aim of this study is to evaluate the association between unit cohesion and depressive symptoms, suicidal ideation, and alcohol use among military service members that met criteria for post-traumatic stress disorder (PTSD) (n = 153) and whether the association differs based on combat exposure or gender. Linear regression and negative binomial models were used to assess the association between unit cohesion and the mental health outcomes, and stratified analyses were used to explore the differences in associations based on combat exposure and gender. Results indicated a significant negative association between unit cohesion and depression symptoms and that the association may be stronger in men and those with combat exposure. These findings imply that efforts to improve mental health outcomes in United States service members with PTSD could have varying effects based on gender and index trauma and that additional research into these relationships is needed.