Effects of reintegration difficulties, perceived message acceptance and perceived autonomy support on U.S. military Veterans’ evaluations of messages encouraging them to seek behavioral health care

ABSTRACT

This online experiment integrates confirmation, politeness, and self-determination theories to examine how Veterans evaluate family members’ messages encouraging them to seek behavioral health care. Veterans (N = 226) evaluated messages manipulated to express high or low levels of acceptance and autonomy support, completed outcome measures (persuasiveness, relational impact, identity management, emotions), and reported on their own reintegration difficulties. Positive associations were found between perceived message acceptance and three outcomes, and perceived autonomy support and two outcomes. Reintegration difficulties were associated with more negative message perceptions. Perceived acceptance and autonomy support also mediated a number of associations between manipulated message features and outcomes, as well as reintegration difficulties and outcomes. Theoretical and practical implications are discussed.

KEYWORDS:

• Behavioral health care
• military families
• confirmation theory
• multiple goals

Acknowledgments

The authors would like to thank Skylar Winter for her assistance with data collection and Purdue University's Military Family Research Institute for their help with participant recruitment.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Patricia E. Gettings (Ph.D., Purdue) is an Assistant Professor of Communication Studies at Indiana University Southeast. Her research explores how individuals communicatively negotiate intersections of their personal and professional lives.

Elizabeth Dorrance Hall (Ph.D., Purdue) is an Assistant Professor in the Department of Communication at Michigan State University and Director of the Family Communication and Relationships Lab (http://familycommlab.com/).

Steven R. Wilson (Ph.D., Purdue) is a Professor in the Department of Communication at the University of South Florida. His research focuses on processes of influence and identity management in family, health, and workplace contexts.

Daniel M. Kamal (M.Sc., Universiti Putra Malaysia) is a Doctoral Candidate at the Brian Lamb School of Communication, Purdue University. His research examines the influence of online social networking platforms (e.g., Facebook, Instagram) on health and fitness behaviors.

Jill Inderstrodt-Stephens (Ph.D., Purdue) is an Associate Professor at Ivy Tech Community College in Indianapolis, IN. Her research explores Family Communication Patterns and resilience in neighborhoods with high environmental stress.

Linda Hughes-Kirchubel (MA, Purdue) is a Ph.D. student in the Brian Lamb School of Communication at Purdue University and Director of External Relations for the Military Family Research Institute at Purdue University.

ORCID

Patricia E. Gettings http://orcid.org/0000-0002-9276-0423

Elizabeth Dorrance Hall http://orcid.org/0000-0003-4737-3659

Notes

1 In this manuscript we capitalize “V” in “Veteran” in line with usage by the U.S. Department of Veterans Affairs. See, for example, Veterans Health Administration style guide (2012, p. 6) retrieved from: https://www.vets.gov/playbook/downloads/VHA_Style_Guide_508.pdf

2 In this paper we focus on autonomy support and not the broader concept of challenge. Initially we attempted to manipulate challenge (independent of autonomy support) by varying the degree to which family members explicitly talked about the concerning behaviors they were seeing; however, virtually all messages were seen as challenging by Veterans (on a 1 to 5 scale, overall M = 3.49, SD = .75); hence, those that were intended to be “high challenge” messages were not rated differently than those intended to be “low challenge” messages. The speech act of asking a Veteran to seek behavioral health care seems to be inherently challenging, in that doing so at all implies that the Veteran needs to reappraise his/her situation.

3 These percentages exceed 100% because participants selected all branches that applied, and some participants had served in both active-duty as well as Guard/Reserve units.

4 Because the survey was completed anonymously online, we took several steps to ensure that participants (a) were Veterans and (b) responded carefully to the survey. In addition to using recruitment procedures that specifically targeted Veterans of OEF/OIF/OND, responses were excluded if: information about military service was incomplete, less than half of close-ended items were completed, more than two responses originated from the same IP address, IP address was from China, India, Russia or Eastern Europe because of the low likelihood that Veterans are responding from these locations, and/or open-ended prompts did not demonstrate a reasonable grasp of English grammar or word usage.

5 We analyzed whether manipulated messages features (acceptance, autonomy support) and reintegration difficulties interacted in their effect on persuasiveness, emotions, identity, and relational outcomes. Of the 8 two-way interactions (reintegration*acceptance and reintegration*autonomy support for four different outcomes), only one was statistically significant: reintegration difficulties*manipulated acceptance for identity outcomes. We probed this interaction in PROCESS with reintegration difficulties as X, identity as Y and manipulated acceptance as the moderator. Reintegration difficulties were negatively associated with identity outcomes at both levels of acceptance, but the association was weaker when message acceptance was low (b = −.18) rather than high (b = −.45).