U.S. military veterans face unique stressors such as combat deployments and suffer from a variety of health problems, such as post-traumatic stress disorder (PTSD), which can negatively impact numerous areas of functioning.

For more than a decade, the U.S. Department of Veterans Affairs has implemented its Whole Health initiative, a holistic, personalized approach to health care aimed at maintaining veterans’ functioning and improving their well-being.

To support the ongoing delivery of holistic health, a new study led by the National Center for PTSD and researchers at Yale University analyzed data from a large population-based sample of U.S. military veterans to identify both positive and negative factors associated with mental, physical, psychosocial and cognitive functioning.

The results were published online on August 9 in JAMA network opened.

“We have a general understanding of factors that can negatively impact functioning, such as chronic illness, sleep problems and PTSD symptoms. There is also evidence that positive psychological characteristics such as meaning in life and optimism can enhance functioning,” said lead author Ian C. Fischer, Ph.D., a clinical psychologist and postdoctoral fellow in the Department of Psychiatry at Yale University and the National Center for PTSD.

“However, little is known about whether certain factors of vulnerability or resilience play a greater role for certain types of functioning or whether they interact to influence the types of functioning.”

The authors found that physical disability, total number of illnesses, and insomnia were most strongly associated with physical functioning. For mental, psychosocial, and cognitive functioning, positive psychological characteristics and insomnia were most strongly associated.

The authors also found that certain positive psychological characteristics attenuated the strong negative effects of insomnia on mental, psychosocial, and cognitive functioning. Specifically, among veterans with clinical insomnia, those who also reported high levels of meaning in life demonstrated similar levels of functioning to those without insomnia.

“There are several evidence-based strategies that can help strengthen meaning in life. Psychological treatments such as acceptance and commitment therapy can help, but there are also less formal strategies,” Fischer said.

“For example, taking a moment to clarify your values ​​and take stock of what matters most, figuring out what makes you feel most alive, and participating in community events are all activities that can help develop a stronger sense of purpose. As the German philosopher Friedrich Nietzsche noted, having a ‘why’ to live for can help us deal with almost any ‘how.'”