Mental Health services are underutilized by military members even when they are aware of a possible mental health disorder (Ben-Zeev, Corrigan, Britt, & Langford, 2012). The recent wars in Iraq and Afghanistan have significantly impacted the mental health of military personnel (Quartana et al., 2014). These wars have resulted in millions of deployments with over 800,000 military members having deployed multiple times (Zinzow, Britt, McFadden, Burnette, & Gillispie, 2012). Military members have significant fears related to stigma, confidentiality, and negative career impact when seeking mental health services (Christensen & Yaffe, 2012; Rowan & Campise, 2006). The following dissertation includes a literature review on the mental health concerns of military members and perceived barriers to care, as well as, a brief review of current strategies for decreasing barriers to mental health services. The aim of this quantitative study was to examine military members' perceived barriers to seeking mental health care. The study seeks to determine whether (a) there are gender differences in perceived barriers to seeking mental health services; (b) whether there are differences between deployed members' versus non-deployed members' perceived barriers to seeking mental health care; (c) to determine whether differences exist in military members' preferences for providers of mental health care; and (d) to determine if prior engagement in mental health care treatment reduces stigma. In order to investigate military members' perceived barriers to seeking mental health care within the military population, the current study administered the Military Stigma Scale (MSS) and the General Help Seeking Questionnaire-adaptation (GHSQ-a) to members of the Kansas Air National Guard at the 184th Intelligence Wing (IW) located at McConnell Air Force Base (AFB) in Wichita, Kansas. The military members were asked demographic questions about themselves, followed by two scales which assessed their a (open full item for complete abstract)

Emergence agitation (EA) is a post-anesthetic complication that occurs when the patient is in a self-limited, nonfluctuating state of excitement while transitioning into a state of consciousness. EA can lead to negative adverse outcomes including, accidental invasive line removal, bleeding, respiratory depression, unintentional extubation, and injury to the staff and the patient. EA is often observed in military veterans who have a medical history of post-traumatic stress disorder (PTSD). For patients with a history of military exposure undergoing elective general anesthesia who also have PTSD, anxiety, and or depression, the incidence of EA was estimated to be around 27%. The pathophysiology of EA is unknown; however, a collection of risk factors has been associated with a higher incidence of EA. These risk factors include pre-operative anxiety, history of pre-existing mental disorders like PTSD, use of volatile agents with low solubility, age, sex, invasive lines and tubes, and the use of premedications like benzodiazepines and anticholinergics. There are currently no evidence-based guidelines or policies in place to properly manage and prevent the incidence of EA in military veterans with a history of PTSD scheduled for general anesthesia. Dexmedetomidine is an alpha-2 adrenoceptor agonist that produces sedation that resembles a patient's natural sleep without causing respiratory depression and allowing for patient arousal. The combination of high-risk identifying assessment tools including the DSM-5, the Richmond Agitation Sedation Scale (RASS), and the utilization of Dexmedetomidine in the peri-operative setting has been proven to decrease the incidence of EA in patients with a history of PTSD.

In three papers, this dissertation challenges the ideology of military service by developing a critical theory of the military with a focus on labor alienation, affective attachments to violence, and the potential of anti-war narratives and activism to disalienate soldiers and lead to more reciprocal relationalities with civilians and the world at large. I first theorize the different forms of affective attachments that soldiers develop to martial violence, explaining how those attachments are supported or disrupted by discourses of military service and martial labor. To supplement my account of affective attachments, I address and expands theories of alienation to contend with the question of martial labor alienation and the specificities of this phenomenon among soldiers. I then turn to the antiwar G.I. Movement to argue that martial disalienation requires centering the material and structural character of martial labor, which encourages relations of transnational solidarity and political responsibility. Thus, I offer an integrated account of how militarism and the notion of military service obscures both the role of the U.S. military in the world and the effects over the subjectivity of soldiers and their estrangement from communities at home and abroad.

Abstract Over the years, the Servicemen's Readjustment Act (1944) and subsequent funding legislation has enabled vast numbers of American military service members and veterans to attend colleges and universities (Osborne, 2014). For institutions that experienced declines in traditional age students due to changing demographics, Post 9/11 veterans are an attractive enrollment target because of guaranteed government funding. Veterans are particularly appealing to private, online institutions as a viable revenue stream. We know that student veterans share many of the same attributes of nontraditional students (Navarre Cleary, M., & Wozniak, K., 2013) but often do not perform as well as their nonveteran counterparts in the areas of academic performance, retention and in bachelor's degree completion (Cate, Lyon, Schmeling, & Bogue, 2017; Durdella & Kim, 2012). While the amount of research into veteran transitions has increased in the past 10 years, previous studies have often focused on the provision of veteran services or on the mental and physical health issues of combat veterans. Little has been revealed about the lived college experience of Post 9/11 veterans and the difficulties they encounter. Although it has been established that student veterans tend to default to avoidance coping strategies (Romero, Riggs, & Ruggero, 2015), data about the effectiveness of their coping choices and the repercussions on their persistence in college is lacking. More research on veteran college transitions is needed, so this study seeks to address a critical gap in the literature. The purpose of this phenomenological study is to examine the lived experiences, academic challenges, and the coping strategies of Post 9/11 student veterans at a large, Midwestern university.

This dissertation explores the reintegration of military Veterans into the civilian population and factors that influence their return through higher education after the 2008 changes to the Post-9/11 G.I. Bill. Student Veterans bring to campus nontraditional student characteristics plus Veteran culture that include unique strengths and challenges of military service. Adult transition theory frames many of the student Veteran studies that identify specific support requirements stemming from military Service experiences. This study uses a modified version of the U.S. Department of Veterans Affairs culturally informed Military to Civilian Questionnaire to examine the utility of using the measure with the student Veteran demographic. The questionnaire results were used to identify a sub-demographic purposeful sample of student Veterans to interview and to shape semi-structured interview questions to further explore their reintegration experiences. Veteran Critical Theory serves to frame themes of the student Veteran reintegration experiences. This five-chapter mixed methods dissertation includes three manuscripts that characterize student Veteran research, examine the military to civilian questionnaire to use with this sub-demographic of Veterans, and explore participants experiences using Veteran critical theory to identify institutional factors. The overarching research questions that guided this work included: What student Veteran experiences identified after full-time military service, influenced reintegration from military service into the civilian population through higher education? What insight can a culturally sensitive reintegration measure give support services about the student Veteran subpopulation within higher education? And what meta-inferences do reintegration questionnaire results and student Veterans experiences characterized by Veteran critical theory suggest? Future research suggestions include expanding the scale of research to examine using the mi (open full item for complete abstract)

This qualitative research study explored the influence of life experiences and personal ethics of George Ciampa, a United States military veteran; his work in establishing American military cemeteries in Europe; and later work as a community leader committed to teaching American youth about the cost of freedom. Dimensions of ethical leadership and public service motivation served as the theoretical framework for the study. The research extended knowledge on ethical constructs within the fields of leadership studies and public administration; recorded personal experiences that were absent in military historical archives; and increased awareness of aspects of the U.S. military subculture. The research exploration was guided by an overarching question of how Ciampa reflected on his sense of public service over his lifetime. The study employed narrative life story methodology and visual research methods. Data collection was an iterative process and included segmented life story interviews and historical archival research. Findings included identification of a major theme (liberty) and three supporting sub-themes (duty, honor, and country) influencing Ciampa's life and leadership path. A comparative analysis of the themes discovered with shared tenets of ethical leadership and public service motivation is provided. This dissertation is available in open access at AURA: Antioch University Repository and Archive, http://aura.antioch.edu/, and OhioLINK ETD Center, https://etd.ohiolink.edu/.

Disordered eating behaviors such as binge eating, restrained eating, and compensatory behaviors are becoming increasingly common among U.S. Military Personnel. Previous research suggests that there may be a number of variables related to eating disorder development in this population: symptoms of post-traumatic stress disorder (PTSD), symptoms of body dysmorphic disorder (BDD), gender, military branch, and pre-military food insecurity. Although previous research has identified factors related to disordered eating in military personnel, this study sought to better understand the associations between each of these variables and the moderators of these associations as they influence the development of disordered eating behaviors in this population. A diverse sample of the military population was recruited using Amazon's Mechanical Turk (MTurk) to participate in an online survey, which included demographic measures, measures of psychopathological symptomatology (i.e., the Post-Traumatic Stress Disorder Checklist – Military and the Yale-Brown Obsessive Compulsive Scale modified for Body Dysmorphic Disorder), food insecurity (U.S. Household Food Security Survey Module: Six-Item Short Form), and disordered eating behavior (Eating Disorder Examination Questionnaire and the Binge Eating Scale). Researchers hypothesized that each of these variables would be related to disordered eating behavior and exacerbated by the presence of PTSD and BDD symptoms. In this sample, military personnel reported greater disordered eating symptoms than the civilian population. Findings indicated that symptoms of PTSD and BDD were significantly associated with disordered eating even when controlling for pre-military food insecurity and gender. Symptoms of PTSD moderated the associations between gender and disordered eating behavior, but BDD symptoms only moderated the association between gender and binge eating.

Veterans are enrolling in higher education in increasing numbers. Many institutions are positioning themselves to receive these students by providing support services and personnel. Despite these efforts, the success rates of this student population have been called into question, and they report poor goodness of fit within the classroom. Professional development initiatives which specifically explore the needs of student veterans within the classroom environment have been limited, or not readily accessible to faculty. This study took place at a community college in the Midwest United States. The purpose of this qualitative study was to invite feedback from both student veterans and faculty who are veterans by asking them to provide context for, and direct input into, a proposed faculty professional development product. An interpretivist epistemology was used so as to capture the social reality of these stakeholders. This feedback served to validate and enhance critical content for three online training modules entitled The VET RESPECT CHECK. Each word within The VET RESPECT CHECK is an acronym for the content of three topic areas: first module: the veteran as student; second module: the classroom environment; and third module: resources. The development of these three modules was guided by Lawler and King's Adult Learning Model for Faculty Development, as well as Allen's CCAF best practice model for online learning. Both groups independently voted and agreed that content regarding the physical, emotional, and behavioral environment was the most important information for faculty to understand. Despite the fact that the topic of suicide was not directly brought forth within the program outline, both groups expressed clear concerns for the safety of veteran students. Furthermore, these groups believe that there is a need for faculty to be sensitive to the issue of veteran suicide and understand their role in facilitating access to resources.

This study reviewed the literature regarding the effectiveness of evidence-based treatments in addressing traumatic stress injuries such as post-traumatic stress disorder in active military personnel and their families. Top tier treatments recommended by the Department of Defense and Department of Veteran Affairs Clinical Practice Guidelines for the treatment of traumatic stress disorders are discussed, and the literature is critically examined with a focus on exploring the reported evidence of effectiveness. In addition, this study contributed unpublished archival clinical outcome data from evidence-based treatment of active military personnel and their families in real-world clinical settings. The effectiveness of an evidence-based treatment is examined utilizing the most consistently utilized outcome measures in the reviewed literature. The electronic version of this dissertation is at OhioLink ETD Center, www.ohiolink.edu/etd

Having to work inside of an unforgiving military environment can and does change an individual. Some have to face the worst elements of what humanity has to offer. Some fulfill their obligations without any looming physical, legal, or mental ailments; they carry a burden with them for the rest of their lives without incident. However, some turn to deviant behavior to either cope, or simply survive. Many of our veterans have developed some issue or residual mental disorder which may have had an effect on behaviors turning criminal. What we are trying to understand is who may be at risk in developing these issues or mental disorders through service, and whether they may be more likely to commit criminal acts because of their military service or the residual effects of mental disorders possibly developed through service. The eventual goal of determining whether there is a cause and effect relationship between the veterans' issues and criminality cannot be achieved without first gathering basic data that is lacking in the relevant literature. This exploratory study intends to provide raw material in the quest for understanding larger issues of causality. In particular, this study looks at veteran status, criminal and legal issues, and whether or not these individuals have been diagnosed with a mental disorder such as Post-Traumatic Stress Disorder (PTSD), any Anxiety Disorder, Stressor Disorders, Depressive Disorders, or any other disorder that can or may be related to their service. The data is analyzed to identify factors that correlate to a veteran's involvement in Veterans court. Through this study, we hope to help improve our understanding of these rising issues, and develop additional strategies and techniques to combat them.

The dissertation project combines three theoretical models that inform conceptualizations of the origins, manifestations, and consequences of stigma: the Social Psychological model (SPM), the Sociological model (SM), and the Cognitive-behavioral model (CBM). These models merge into a single, integrative lens, through which stigma can be examined on both cultural and individual levels. This lens is then applied to the cultural and individual manifestations of the stigma of seeking psychological treatment experienced by veterans who have served in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). Through this lens, an understanding of the inception, maintenance, and effects of this treatment stigma is presented. Strategies for the reduction of this stigma are then offered, including a review of current stigma-reducing programs in which the branches of the military are currently engaged. As the purpose of the creation of this integrative lens is to provide a foundation of understanding about the cultural and individual implications of stigma, future directions in stigma research, treatment implications, and influences on public policy are also discussed.