"Toughness" in Association with Mental Health Symptoms among Iraq and Afghanistan War Veterans seeking Veterans Affairs health care

Abstract: The association between endorsement of emotional “toughness” (i.e., extreme self-reliance and the
suppression of outward displays of emotional distress) and likelihood for screening positive for mental
health conditions was examined in a male sample of 198 Iraq and Afghanistan veterans presenting for
postdeployment Veteran Affairs health care. After accounting for relevant covariates, veterans endorsing
higher levels of emotional toughness were more likely to screen positive for posttraumatic stress disorder
and depression. There was also a nonsignificant trend (p = .08) associated with a positive relationship
between toughness and likelihood of self-reported alcohol abuse. Results are discussed in terms of
identifying and addressing toughness norms among returning veterans to promote effective use of mental
health services.