Broadening the focus in supporting reintegrating iraq and Afghanistan veterans: Six key domains of functioning

As the major ground troop presence in the Middle East is reduced, it is time to reflect, maximize lessons learned, and look forward to what lies ahead for the nearly 2.6 million service members of the United States military who have deployed in support of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn. A systematic review of the literature on postdeployment functioning of Iraq and Afghanistan troops was conducted. Findings are described and contextualized in terms of service members' ongoing strengths, needs, and challenges. The corpus of research on deployed personnel indicates that service members demonstrate resilience in the face of war-related stressors. However, postdeployment impairment in 6 functional domains emerged in the literature review, including mental health, social and role functioning, relationship functioning and family life, spirituality, physical health, and financial well-being. Although risk factors and future trajectories vary across these domains, psychiatric difficulties are a consistent predictor of a worsened course. Implications for clinical practice are described based on the review findings. To promote wellbeing in the years ahead, it is important that service members are supported in their various roles (such as in the classroom, the workforce, and the family). In addition, routine assessment of functioning across domains is highly recommended for postdeployment service members.