Expressions of emotional distress in active duty military personnel with mild traumatic brain injury: A qualitative content analysis

Wesley R. Cole, Jo Ann Brockway, Jesse R. Fann, Angelica P. Ahrens, Samantha Hurst, Tessa Hart, Simona Vuletic, Nigel Bush, Kathleen R Bell

Research output: Contribution to journalArticle


Service members (SMs) who sustain traumatic brain injury (TBI) during deployment have increased risk for mental health issues. Mental health treatment can be challenging in military settings where treatment seeking is often stigmatized. Adequate care relies on accurate interpretations of SMs’ verbal accounts of distress, but little is known about how SMs, embedded in a culture that values resilience and self-reliance, relay emotional distress. We performed qualitative analyses of recordings from a telephone-based intervention with 25 SMs who sustained deployment-related mild TBI (mTBI) to elucidate thematic and dialectal patterns. Consistent with our expectations, SMs rarely used explicit depressive terms while discussing their emotional distress. More prevalent was language suggestive of an overarching theme of loss of control, whereby SMs’ stress, anxiety, and anger were often attributable to SMs’ perceptions that they had incomplete jurisdiction over their own lives. This study may help mental health providers improve engagements with SMs and Veterans, preventing misunderstandings and even improper diagnoses or referrals that could result from a strict reliance on the more customary expressions of distress.

Original languageEnglish (US)
JournalMilitary Psychology
StatePublished - Jan 1 2019



  • deployment
  • Depression
  • military
  • stigma
  • TBI

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Social Sciences (miscellaneous)
  • Psychology(all)

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