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Author ORCID Identifier

https://orcid.org/0009-0000-4177-6663

Date Available

4-10-2028

Year of Publication

2026

Document Type

Doctoral Dissertation

Degree Name

Doctor of Philosophy (PhD)

College

Social Work

Department/School/Program

Social Work

Faculty

Karen A Lawrence

Faculty

Natalie Pope

Abstract

Childhood Family Functioning (CFF) represents an early positive resource that may influence subsequent support systems throughout military service and beyond. Yet, the role of pre-military protective factors remains understudied in veteran research with a focus on sex-specific effects even rarer. This cross-sectional secondary analysis of 1031 U.S. post- 9/11 combat veterans (53.5% female, 46.5% male) examined whether deployment preparation, deployment unit support, and post-deployment support exert indirect effects on the relationship between CFF and mental health outcomes including posttraumatic stress disorder (PTSD), depression, and alcohol misuse symptom severity as well as life satisfaction. Analyses were sex-stratified to capture sex-specific outcomes. In models adjusted for combat experience, rank, marital status, education, and deployment support constructs, CFF exerted significant indirect effects on mental health and well-being outcomes through post-deployment support among male and female veterans. For PTSD symptom severity, indirect effects among males were B = -0.11 (95% CI [-0.17, -0.05]; and females, B = -.15 (95% CI [-.21, -.09]. Parallel indirect effects were observed for depressive symptoms (males: B = −0.04, 95% CI [−0.07, −0.02]; females: B = −0.06, 95% CI [−0.08, −0.03]) and life satisfaction (males: B = 0.04, 95% CI [0.02, 0.07]; females: B = 0.06, 95% CI [0.04, 0.08]), such that greater CFF was associated with increased post-deployment support, which in turn predicted lower PTSD and depressive symptom severity and higher life satisfaction. These effects were significant across sexes, though stronger in magnitude for females suggesting that the post-deployment support period represents a critical window for intervention, particularly among females who may benefit disproportionately from enhanced support during this phase.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2026.35

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