Yale Researchers Highlight Prevalence of Anxiety in U.S. Military Veterans
The researchers found that veterans have higher rates of generalized anxiety disorder and offered potential solutions in a study published this month.
HIREN PAREKH FEB 19, 2024
Content warning: This article contains references to suicide.
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In a Yale-led study published earlier this month, researchers investigated the impact of Generalized Anxiety Disorder — a mental health condition characterized by persistent and excessive anxiety that can disrupt daily life and functioning — on military veterans.
The study was led by Grace Macdonald-Gagnon, a former psychiatry research assistant at Yale and current clinical psychology doctoral student at the University of Illinois at Chicago, alongside Robert H. Pietrzak, a professor of psychiatry at the School of Medicine and a researcher at the U.S. Department of Veterans Affairs National Center for PTSD. They found that 7.9 percent of veterans screened positive for probable Generalized Anxiety Disorder, or GAD, while only 2.9 percent of the general United States adult population experiences GAD. The researchers also found that almost one in four veterans experience mild anxiety disorders.
The researchers noted that veterans with GAD or mild anxiety were more likely to have been deployed multiple times and to be young, female and from a racial or ethnic minority. Notably, those with probable GAD were more likely to have combat experience and had higher rates of past-year suicidal ideation and lifetime suicidal attempts compared to both mild anxiety and no-GAD groups. For Macdonald-Gagnon, this has profound implications.
“Importantly, we found that even mild anxiety symptoms, which do not meet the level indicative of a positive screen on commonly used measures, are associated with elevated rates of co-occurring psychiatric and functional difficulties, as well as suicidal thoughts and behaviors,” Macdonald-Gagnon wrote in an email to the News.
The researchers analyzed data extracted from the 2019-2020 National Health and Resilience in Veterans Study, a comprehensive survey of a cross-section of U.S. military veterans. The Yale researchers studied multiple sociodemographic and military factors — such as trauma burden, experiences of military sexual trauma, PTSD symptoms, substance use, mental health resources and thoughts of suicide — and how they are linked to anxiety symptoms.
Macdonald-Gagnon acknowledged that because the study’s data collection predated the onset COVID-19 pandemic, the study may not represent the full impact GAD symptoms have on veterans.
According to Macdonald-Gagnon and Pietrzak, the results suggest that there is a linear correlation between the severity of anxiety symptoms and its negative effects on other psychiatric and daily functions. They argued that brief screening measures that assess both mild and severe anxiety symptoms could increase access to care for veterans.
“Our study suggests that brief screening measures may help identify veterans who are experiencing anxiety symptoms, which are associated with other psychological problems such as depression and suicidal thoughts and behaviors, as well as functional difficulties,” Pietrzak wrote in an email to the News.
Pietrzak suggested that these screenings should be delivered in primary care settings, such as those of the Veterans Health Administration, in order to increase access for veterans, many of whom Pietrzak said don’t actively seek mental health care. Further, Macdonald-Gagnon said that anxiety screenings could occur in primary care settings not specifically designed for veterans, such as college mental health clinics.
“Screening for psychological symptoms in primary care settings could allow veterans to access education and support who maybe are not be actively seeking mental healthcare or may not know where/how to seek available resources,” Pietrzak wrote.
Macdonald-Gagnon noted that while awareness of veterans’ mental health issues, such as PTSD, TBI, depression and substance abuse has grown, many challenges, including stigma, access barriers and service deficits, remain.
Still, she said that many existing organizations seek to improve veteran mental health care. She added that initiatives like the U.S. Preventative Services Task Force, which encourages adults to be screened for anxiety disorders, could be applied to veterans more broadly.
For United States military veterans on college campuses like Yale, Macdonald-Gagnon recommended that they refine their mental health resource referral processes and help them transition to campus life.
“Colleges can ensure that students and faculty/staff who are Veterans are provided with appropriate referrals and resources for mental healthcare, whether that be within the university healthcare systems or assisting individuals in locating resources outside of the university,” Macdonald-Gagnon wrote. “For example, The Department of Veterans Affairs has a VetSuccess on Campus program that provides support to individuals transitioning from the military to college.”
Jason Hug JGA ’27 LAW ’27 is a professional student at both the Jackson School of Global Affairs and Yale Law School. Before arriving at Yale, he worked for five years as a United States Army intelligence officer.
Hug emphasized the importance of limiting the number of obstacles veterans have to face when transitioning to college. In particular, he said that having veteran representation on campus and bolstering institutional support to aid veterans during their transition is crucial.
“When applying to Yale, it was clear that the institution emphasized veteran representation within the current and incoming cohorts,” Hug wrote in an email to the News. “The institutional support in helping Veterans transition from military service and use their VA Benefits (i.e., Post 9/11 GI Bill, Veteran’s Readiness & Employment) has truly been unmatched.”
In November 2023, Yale News estimated that there are over 200 student veterans across the college and graduate schools.