Predicting stress, anxiety, and depression in military personnel: A multivariate regression analysis
Journal of Behdasht dar Arseh (i.e., Health in the Field),
Vol. 13 No. 3 (1404),
10 Khordad 2026
,
Page 37-48
https://doi.org/10.22037/jhf.v13i3.50912
Abstract
Background and aims: The mental health of military personnel is of particular importance due to their exposure to multiple stressors. This study was conducted to determine the factors affecting stress, anxiety, and depression among personnel of a military center in Iran using multivariable regression analysis.
Materials and Methods: This cross-sectional analytical study was conducted among 420 personnel of a military center using a simple random sampling method. Data were collected using the standard questionnaires including DASS‑21, the Short Form Health Survey (SF‑12) for quality of life, the Pittsburgh Sleep Quality Index (PSQI), the Minnesota Satisfaction Questionnaire (MSQ) for job satisfaction, and the Multidimensional Scale of Perceived Social Support (MSPSS). Data were analyzed using multivariable regression in Stata software version 14, with a significance level set at (P< 0.05). Ethical considerations were observed throughout all stages of the research.
Results: A significant inverse association (P< 0.05) was observed between sleep quality, quality of life, and social support with depression, anxiety, and stress. Marital status and work experience were significantly associated with stress and depression, while educational level showed a significant association with stress (P< 0.05). It should be noted that age, income, and job satisfaction did not show any significant relationship with stress, anxiety, or depression in any of the models.
Conclusion: Psychosocial factors, including quality of life, sleep quality, and social support, play a determining role in the mental health of military personnel. Designing multidimensional interventions with a focus on these factors can be effective in promoting their mental well-being.
- Mental health
- Military personnel
- Multivariate regression
- Quality of life
- Sleep quality
How to Cite
References
1- Wang JQ, Wang XZ, Wang WX. Acceptance and commitment therapy for enhancing mental health in military personnel: A comprehensive review and meta-analysis. World Journal of Psychiatry 2025; 15(3):100959. Doi: 10. 5498/ wjp. v15. i3. 100959.
2-. Eslamimehr F, Rakhshani F, Ramezankhani A, Khodakarim S. Assessment of an educational intervention effectiveness on promoting menstrual knowledge and related health behaviors in female high school students in Khamir city in 2015-2016. Journal of Health in the Field 2017; 5(1):53-62 (In Persian).
3-. Moradi Y, Dowran B, Sepandi M. The global prevalence of depression, suicide ideation, and attempts in the military forces: a systematic review and Meta-analysis of cross sectional studies. BMC Psychiatry 2021; 21(1):510. Doi: 10.1186/s12888-021-03526-2
4-. Rona RJ, Burdett H, Bull S, Jones M, Jones N, Greenberg N, et al. Prevalence of PTSD and other mental disorders in UK service personnel by time since end of deployment: A meta-analysis. BMC Psychiatry 2016; 16(1):333. Doi: 10. 1186/ s12888-016-1038-8
5-. Hosseini SM, Hesam S, Hosseini SA. Burnout among military personnel: A systematic review. Iranian Journal of Psychiatry 2023; 18(2):213. Doi: 10. 18502/ ijps. v18i2. 12371.
6-. Brooks SK, Greenberg N. Non-deployment factors affecting psychological wellbeing in military personnel: literature review. Journal of Mental Health 2018; 27(1):80-90.
7-. Edgelow M, Scholefield E, McPherson M, Legassick K, Novecosky J. Organizational factors and their impact on mental health in public safety organizations. International Journal of Environmental Research and Public Health 2022; 19(21):13993. Doi: 10. 3390/ ijerph192113993.
8-. Yamada A-M, Atuel HR, Weiss EL. Military culture and multicultural diversity among military service members: Implications for mental health providers. In: Handbook of Multicultural Mental Health 2013; 389-410.
9- Flood A, Keegan RJ. Cognitive resilience to psychological stress in military personnel. Frontiers in Psychology 2022; 13:809003. Doi: 10 .3389/ fpsyg. 2022. 809003.
10- Bakhshi E, Kalantari R, Salimi N, Ezati F. Assessment of quality of work life and factors related to it based on the walton's model: A cross-sectional study in employment of health and treatment sectors in Islamabad City. Journal of Health in the Field 2019; 6(4):13-19 (In Persian).
11- Latza U, Hampel E, Wiencke M, Prigge M, Schlattmann A, Sommer S. Introducing occupational health management in the German Armed Forces. Health Promotion International 2018; 33(6):938-45.
12- Heydarabadi AB, Mohammadpuor H, Madvari ARF, Qarkhani MM, Madvari RAF, Afshin AA. Study the status of job stress and work-related stressors among the employees of a Spinning industry. 2017.
13- Trautmann S, Goodwin L, Höfler M, Jacobi F, Strehle J, Zimmermann P, et al. Prevalence and severity of mental disorders in military personnel: A standardised comparison with civilians. Epidemiology and Psychiatric Sciences 2017; 26(2):199-208.
14- Sadeghi-Bahmani D, Rigotti V, Stanga Z, Lang UE, Blais RK, Kelley ML, et al. Sleep disturbances and psychological well-being among military medical doctors of the Swiss Armed Forces: Study protocol, rationale and development of a cross-sectional and longitudinal interventional study. Frontiers in Public Health 2024; 12:1390636.Doi: 10. 3389/ fpubh. 2024. 1390636.
15- Seelig AD, Jacobson IG, Donoho CJ, Trone DW, Crum-Cianflone NF, Balkin TJ. Sleep and health resilience metrics in a large military cohort. Sleep 2016; 39(5):1111-20.
16- Blaisure KR, Marini CM, Saathoff-Wells T, O’Neal CW, Lucier-Greer M, Dombro AL, et al. Serving military and veteran families: theories, research, and application Routledge; 2024.
17- Mohammadi R, Karbin F, Khazaei S, Karampourian A. Relationship between of mental health and job satisfaction with professional ethics in emergency medical personnel. Health in Emergencies and Disasters Quarterly 2024; 9(4):313-20.
18- Cypel YS, Vogt D, Maguen S, Bernhard P, Lowery E, Culpepper WJ, et al. Physical health of post-9/11 us military veterans in the context of healthy people 2020 targeted topic areas: Results from the comparative health assessment interview research study. Preventive Medicine Reports 2023; 32:102122. Doi: 10. 1016/ j. pmedr. 2023.102122.
19- Green SB. How many subjects does it take to do a regression analysis. Multivariate Behavioral Research 1991; 26(3):499-510.
20- Manavipour D. Psychometric properties of the sleep questionnaire. Shefaye Khatam 2015; 3(3):15-20.
21- Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. Journal of Personality Assessment 1988; 52(1):30-41.
22- Besharat MA. Multidimensional Scale of perceived social support: Questionnaire, instruction and scoring. Journal of Developmental Psychology Iranian Psychologists 2019; 15(60):449-447.
23- Buitendach JH, Rothmann S. The validation of the minnesota job satisfaction questionnaire in selected organisations in South Africa. SA Journal of Human Resource Management 2009; 7(1):1-8.
24- Sharifi N, Najar, L. Psychometric features of minnesota job satisfaction questionnaire (MSQ) on the staff of manufacturing companies in Tehran and its suburbs who worked on the years 1392 & 1393. Psychometry 2016; 4(15):1-10.
25- Ware JE, Kosinski M, Keller SD. A 12-Item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care 1996; 34(3):220-33.
26- Sharif-Nia H, Fatehi R, Hosseini L, Nowrozi P. Psychometric properties of the short-form-12 questionnaire of quality of life among iranian hemodialysis patients. Journal of Mazandaran University of Medical Sciences 2024; 34(237):100-14 (In Persian).
27- Ballenger-Browning KK, Schmitz KJ, Rothacker JA, Hammer PS, Webb-Murphy JA, Johnson DC. Predictors of burnout among military mental health providers. Military Medicine 2011; 176(3):253-60.
28- Levin‐Rector A, Hourani LL, Van Dorn RA, Bray RM, Stander VA, Cartwright JK, et al. Predictors of posttraumatic stress disorder, anxiety disorders, depressive disorders, and any mental health condition among US soldiers and marines, 2001–2011. Journal of Traumatic Stress 2018; 31(4):568-78.
29- Morgan JK, Hourani L, Tueller S. Health-related coping behaviors and mental health in military personnel. Military Medicine 2017; 182(3-4):e1620-e1627.
30- Green S, Nurius PS, Lester P. Spouse psychological well-being: A keystone to military family health. Journal of Human Behavior in the Social Environment 2013; 23(6):753-68.
31- Chong YK. The Role of social support and Perceived Stress in coping with academic pressure. Developmental Psychology Innovations 2026; 2(1):1-9.
32- Karney BR, Loughran DS, Pollard MS. Comparing marital status and divorce status in civilian and military populations. Journal of Family Issues 2012; 33(12):1572-94.
33- Parker PG. Resilience and stress: Trauma, grit, resilience, and perceived organizational support in first responders. Pepperdine University; 2026.
34- Robinson-Sandiford D. The Role of Quality of marriage on life satisfaction and psychological well-being among us military spouses. Northwest University; 2026.
35- Martins L, Lopes C. Military hierarchy, job stress and mental health in peacetime. Occupational Medicine 2012; 62(3):182-87.
36- Dacey L. Work-family conflict, job burnout, and couple burnout in high-stress occupations. Walden University; 2019.
37-Gün İ, Balsak H, Ayhan F. Mediating effect of job burnout on the relationship between organisational support and quiet quitting in nurses. Journal of Advanced Nursing 2025; 81(8): 4644-52.
38- Kravchenko K. Experience of military psychologists working with service members affected by combat-related psychological trauma. European Journal of Trauma & Dissociation 2025; 9(2):100537. Doi: 10. 1016/ j. ejtd.2025.100537.
39- Sun Y, Pan W, Zhang Y, Xu G, Xi J, Bao Q, Bian X. The relationship between stress, resilience, and quality of life in Chinese high school students. Annals of Palliative Medicine 2021; 10(5). Doi: 10.21037/apm-21-929.
40- Santos ERd, Filho MAR, Borges WdS, Martinez WD, Menezes JDdS, Silva MQd, et al. Resilience, quality of life, and minor mental disorders in nursing professionals: a study in challenging work environments. International Journal of Environmental Research and Public Health 2025; 22(9):1375.
41- Asmar NE, Yazbeck Karam V, Sakr R, Khoury Malhame ME, Chatila R, Akiki Z. Assessing burnout and quality of life among residents and fellows in a high-stress environment: A cross-sectional study. BMC Psychology 2025; 13(1):557.
42- LICA PV. Quality of life and anxiety in military personnel. Serbian Journal Clinical Research 2019; 47. DOI: 10. 1515/ SJECR20170068.
43- Villaruz Fisak JF, Turner BS, Shepard K, Convoy SP. Buddy care, a peer-to-peer intervention: a pilot quality improvement project to decrease occupational stress among an overseas military population. Military Medicine 2020; 185(9-10):e1428-e1434.
44- Hughes JM, Ulmer CS, Hastings SN, Gierisch JM, Workgroup M-AVM, Howard MO. Sleep, resilience, and psychological distress in United States military veterans. Military Psychology 2018; 30(5):404-14.
45- Kim TK, Lee H-C, Lee SG, Han K-T, Park E-C. The combined effect of sleep duration and quality on mental health among Republic of Korea armed forces. Military Medicine 2016; 181(11-12):e1581-e1589.
46- Bai W, Gui Z, Chen M-Y, Zhang Q, Lam MI, Si TL, et al. Global prevalence of poor sleep quality in military personnel and veterans: A systematic review and meta-analysis of epidemiological studies. Sleep Medicine Reviews 2023; 71:101840. Doi: 10. 1016/ j. smrv. 2023.101840.
47- Ellis J, Estevez Burns R, Mallawaarachchi I, Wang X-Q, Aycock C, Krunnfusz A, et al. Project sandman: A quasi-experimental evaluation of a group-based brief sleep intervention in Air Force technical training. Behavioral Sleep Medicine 2024; 22(6):910-20.
48- Mysliwiec V, McGraw L, Pierce R, Smith P, Trapp B, Roth BJ: Sleep disorders and associated medical comorbidities in active duty military personnel. Sleep 2013; 36(2):167-174.
49-Gehrman P, Seelig AD, Jacobson IG, Boyko EJ, Hooper TI, Gackstetter GD, et al. Predeployment sleep duration and insomnia symptoms as risk factors for new-onset mental health disorders following military deployment. Sleep 2013; 36(7):1009-1018.
50- Brown CA, Berry R, Schmidt A. Sleep and military members: Emerging issues and nonpharmacological intervention. Sleep Disorders 2013; 2013(1):160374. Doi: 10.1155/2013/160374.
51- Siaki L, Hasslen S, Hoffecker L, Trego LL. Sleep health in US military women. A scoping review of the literature, 2000–2019. Women's Health Issues 2021; 31:S22-S32.
52- Haines VA, Hurlbert JS, Zimmer C. Occupational stress, social support, and the buffer hypothesis. Work and Occupations 1991; 18(2):212-35.
53- Du Preez J, Sundin J, Wessely S, Fear N. Unit cohesion and mental health in the UK armed forces. Occupational Medicine 2012; 62(1):47-53.
54- Hajiamini Z, Cheraghalipour Z, Azad Marzabadi E, Ebadi A, Norouzi Koushali A. Comparison of job stress in military and non-military drivers in Tehran. Journal of Military Medicine 2011; 13(1):25-30.
55- Mintz A. Foreign policy decision making in familiar and unfamiliar settings: An experimental study of high-ranking military officers. Journal of Conflict Resolution 2004; 48(1):91-104.
56-Sadeghikho S, Ghaffari M, Rakhshanderou S. Investigating the factors affecting mental health and its components in health workers in provinces with red Covid-19 status. Journal of Health in the Field 2023; 10 (3):53-64 (In Persian).
- Abstract Viewed: 99 times