Trauma

Psychology of Men & Masculinity 2011, Vol. 12, No. 1, 55– 63

© 2011 American Psychological Association 1524-9220/11/$12.00 DOI: 10.1037/a0020577

A Preliminary Study of the Association Between Traditional Masculine Behavioral Norms and PTSD Symptoms in Iraq and Afghanistan Veterans
Hector A. Garcia and Erin P. Finley
South Texas Veterans Health Care System and University of Texas HealthScience Center at San Antonio

William Lorber
Clement J. Zablocki VA Medical Center and Medical College of Wisconsin

Matthew Jakupcak
Veterans Affairs Puget Sound Health Care System and University of Washington School of Medicine Studies identifying a high prevalence of posttraumatic stress disorder (PTSD) and low treatment utilization among Operation Enduring Freedom (OEF) and OperationIraqi Freedom (OIF) Veterans reinforce the need for a greater understanding of the disorder in this population. Although traditional masculine norms have been found to relate to both help seeking and PTSD among civilians, little is known about their impact on war Veterans. The current study examined relationships between masculine behaviors, using the Masculine Behavior Scale (MBS), and PTSD symptomsin OEF/OIF Veterans, drawing on archival clinical data from 69 patients at an outpatient PTSD clinic. Despite a positive trend, total MBS scores were not correlated with overall PTSD severity. However, the MBS subscale Exaggerated Self-Reliance and Control positively predicted hyperarousal symptoms in a hierarchical regression model. Unexpectedly, the MBS subscale Success Dedication negativelypredicted avoidance, suggesting that this masculine norm may serve a protective function against avoidance symptoms. Results suggest that elements of masculinity are related to specific PTSD symptom clusters in ways that may be both adaptive and maladaptive. Implications for PTSD treatment are discussed. Keywords: masculinity, PTSD, Veterans, Iraq/Afghanistan War

This article was published OnlineFirst October 4, 2010. Hector A. Garcia, Department of Veterans Affairs, South Texas Veterans Health Care System and Department of Psychiatry, University of Texas Health Science Center at San Antonio; Erin P. Finley, Department of Veterans Affairs, South Texas Veterans Health Care System and Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at SanAntonio; William Lorber, Department of Psychiatry and Behavioral Medicine, Clement J. Zablocki VA Medical Center and Medical College of Wisconsin; Matthew Jakupcak, Veterans Affairs Puget Sound Health Care System and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine. The views expressed in this article are those of the authors and do not necessarilyreflect the position or policy of the Department of Veterans Affairs or the United States government. Correspondence concerning this article should be addressed to Hector A. Garcia, South Texas Veterans Health Care System, Frank Tejeda Outpatient Clinic, 5788 Eckhert Road, San Antonio, TX 78240. E-mail: Hector.Garcia2@va.gov 55

Nearly 1.8 million U.S. Veterans have now served in Afghanistan or Iraq insupport of Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF). Among those who have returned, population based studies have found rates of posttraumatic stress disorder (PTSD) to be as high as 11–22% (Hoge et al., 2004; Mental Health Advisory Team [MHAT], 2003; Tanielian & Jaycox, 2008). Despite the availability and effectiveness of empirically based treatments for PTSD, certaincharacteristics of OEF/OIF Veterans may create challenges for successful treatment. For instance, one study found that OEF/OIF Veterans present for treatment with higher PTSD symptom levels than Vietnam Veterans (Fontana & Rosenheck, 2008). Other research has found that OEF/ OIF Veterans miss more treatment sessions and drop out from psychotherapy twice as frequently as their Vietnam Veteran...