Running head: PTSD AS RISK FACTOR FOR HOMELESS VETERANS 1

Are Post 9-11 Combat Veterans With Post-Traumatic Stress Disorder (PTSD) at a Higher

Risk of Being Homeless?:

Ashley Dedrick

University of North Florida

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September 2016
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Over the past decade, soldiers from the conflicts in Iraq and Afghanistan reentering life

as civilians have increased the vulnerability to homelessness. It has been recently estimated in

the United States that 14% of our homeless population is composed of military veterans (Creech

et al., 2015). Homelessness has been an issue for public health over the last three decades, and

little progress has been made, especially for veterans. Findings from Carlson, Garvert, Macia,

Ruzek, and Burling (2013) show that combat exposures have been linked to an increased risk for

post-traumatic stress disorder (PTSD) in veterans, which has been thought to increase the risk of

homelessness. Risk factors for homelessness in both men and women veterans tend to be similar,

however female veterans are at a higher risk for being homeless (Boyd, Bradshaw, & Robinson,

2013).

During this research, unclear findings were seen throughout the literature of this topic.

While all the literature agreed that homelessness among veterans is a serious problem, no two

studies had the same solutions, samples, or exposures. Hamilton, Poza, and Washington (2011)

state that PTSD is a primary risk factor for homeless veterans, but that women veterans are four

times more likely to be homeless due to additional traumas they’ve experienced. One

contingency reported in the findings of LePage, Bradshaw, Cipher, Crawford, and Hoosyhar

(2014) was the possible misclassification of housing status in medical records for veterans who

identified as homeless, but were marked as non-homeless. The aim for this review is to

determine whether PTSD has a profound affect with homelessness among combat veterans who

have returned from Iraq or Afghanistan. The hypothesis being tested is: If combat veterans

returning from Iraq and Afghanistan are diagnosed with post-traumatic stress disorder, then they

have a higher risk for becoming homeless.

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Surprisingly, majority of the articles that were reviewed noted PSTD as a risk factor for

homelessness among veterans. While some studies focused on other factors that either influenced

homelessness or were influenced by PTSD, one article directly studied the relationship between

PTSD and homelessness. Veterans who served in Operation Enduring Freedom (OEF),

Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) were the primary veterans that

were being studied in all articles.

According to Tsai, Pietrzak, and Rosenheck (2012), homeless OEF/OIF/OND veterans

have higher rates of PTSD compared to previous homeless veterans and non-veterans. The

authors also found a link between male and female veterans with combat exposure having higher

rates of diagnosed PTSD. The presence of PTSD in the sample of homeless OEF/OIF/OND

veterans 66.60%, the highest of any other diagnosis and disorder noted. With homelessness being

a public health issue,

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Reference List:

Boyd, M. A., Bradshaw, W., & Robinson, M. (2013). Mental Health Issues of Women

Deployed to Iraq and Afghanistan. Archives of Psychiatric Nursing, 27(1), 10-22.

doi:10.1016/j.apnu.2012.10.005

Brooks Holliday, S., Pedersen, E. R., & Leventhal, A. M. (2016). Depression,

posttraumatic stress, and alcohol misuse in young adult veterans: The

transdiagnostic role of distress tolerance. Drug And Alcohol Dependence, 161,

348-355. doi:10.1016/j.drugalcdep.2016.02.030

Carlson, E. B., Garvert, D. W., Macia, K. S., Ruzek, J. I., & Burling, T. A. (2013).

Traumatic stressor exposure and post-traumatic symptoms in homeless

veterans. Military Medicine, 178(9), 970-973. doi:10.7205/MILMED-D-13-00080

Creech, S. K., Johnson, E., Borgia, M., Bourgault, C., Redihan, S., & O'Toole, T. P.

(2015). Identifying Mental And Physical Health Correlates Of Homelessness

Among First-Time And Chronically Homeless Veterans. Journal of Community

Psychology, 43(5), 619-627. doi:10.1002/jcop.21707

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Edens, E. L., Kasprow, W., Tsai, J., & Rosenheck, R. A. (2011). Association of Substance

Use and VA Service-Connected Disability Benefits with Risk of Homelessness

among Veterans. American Journal On Addictions, 20(5), 412-419.

Hamilton, A. B., Poza, I., & Washington, D. L. (2011). Original article: “Homelessness

and Trauma Go Hand-in-Hand”: Pathways to Homelessness among Women

Veterans. Women's Health Issues, 21(4) (Supplement), S203-S209.

doi:10.1016/j.whi.2011.04.005

Jakupcak, M., & Varra, E. M. (2011). Treating Iraq and Afghanistan War Veterans with

PTSD Who Are at High Risk for Suicide. Cognitive and Behavioral

Practice, 18(1), 85-97. doi:10.1016/j.cbpra.2009.08.007

LePage, J., Bradshaw, L., Cipher, D., Crawford, A., & Hoosyhar, D. (2014). Original

Research: The effects of homelessness on Veterans' health care service use: an

evaluation of independence from comorbidities.Public Health, 128(11), 985-992.

doi:10.1016/j.puhe.2014.07.004

Metraux, S., Clegg, L. X., Daigh, J. D., Culhane, D. P., & Kane, V. (2013). Risk Factors

for Becoming Homeless among a Cohort of Veterans Who Served in the Era of

the Iraq and Afghanistan Conflicts. American Journal of Public Health, 103(S2),

S255-S261.

Tsai, J., Pietrzak, R., & Rosenheck, R. (2013). Homeless Veterans Who Served in Iraq and

Afghanistan: Gender Differences, Combat Exposure, and Comparisons with

Previous Cohorts of Homeless Veterans.Administration & Policy in Mental

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Health & Mental Health Services Research, 40(5), 400-405. doi:10.1007/s10488-

012-0431-y