Posttraumatic Growth and Posttraumatic Stress Among Military Medical Personnel Carmen P. McLean and Sonia Handa VA Boston Healthcare System, Boston, Massachusetts Benjamin D. Dickstein VA Boston Healthcare System, Boston, Massachusetts, and Boston University Trisha A. Benson University of Texas Health Science Center at San Antonio Monty T. Baker Wilford Hall Medical Center, San Antonio, Texas William C. Isler Columbus Air Force Base, Columbus, Mississippi Alan L. Peterson University of Texas Health Science Center at San Antonio Brett T. Litz VA Boston Healthcare System, Boston, Massachusetts, and Boston University Military medical personnel deployed to war zones are dually burdened with stressors related to providing healthcare and combat and operational experiences. To better understand how different types and levels of stress exposure relate to positive and negative mental health outcomes among military medical personnel, the associations between combat and healthcare stress exposure and posttraumatic growth and posttraumatic stress disorder (PTSD) were examined among 253 Air Force medical personnel recently redeployed from Iraq. Both types of stress exposure were uniquely associated with increased PTSD symptomatology. However, combat exposure was linearly associated with PTSD, suggesting a dose- response relationship, whereas the relationship between healthcare stress and PTSD was curvilinear. Both forms of stress exposure showed an inverted U-shaped relationship with posttraumatic growth. Keywords: military, posttraumatic growth, PTSD, medical personnel Military medical personnel deployed to war zones provide care to wounded and severely injured service members, and they are also directly exposed to various war zone-related threats. The duties of military medical personnel include providing direct med- ical care to combat casualties in hostile areas (e.g., providing field transfusions and field-expedient anesthesia while under fire), re- moving human remains from combat zones during life-threatening circumstances, being assigned to grave registration, and assisting with the handling and identification of deceased bodies (Peoples, Gerlinger, Budinich, & Burlingame, 2005; Peterson, Nicolas, McGraw, Englert, & Blackman, 2002). In addition to the pressure and stress of treating wounded military personnel and civilians, med- ical personnel are also at risk of personal injury from attacks with small arms fire, mortars, rockets, and improvised explosive devices. Thus, these individuals are potentially dually burdened by the risk of combat stress exposure as well as exposure to high magnitude stres- sors related to their duties as a medical service provider (e.g., bearing witness to the trauma and suffering of those they treat). To date, very little is known about the possible negative or positive psychological effects of these types of experiences on military medical personnel. Most research on service members has focused on examining the effects of combat stress among combat troops. These studies have found evidence of a dose-response relationship between combat exposure and psychological distress, with higher levels of exposure predicting worse mental health outcomes (e.g., McCarroll, Fullerton, Ursano, & Hermsen, 1996; McCarroll, Ursano, Fullerton, Liu, & Lundy, 2002). For example, soldiers and Marines serving in Iraq exposed to high levels of combat stress (e.g., attacks or ambushes, getting shot at, seeing This article was published Online First March 28, 2011. Carmen P. McLean and Sonia Handa, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts; Benjamin D. Dickstein and Brett T. Litz, National Center for PTSD, VA Boston Healthcare System, and Department of Psychology, Boston University; Trisha A. Benson and Alan L. Peterson, Department of Psychiatry, University of Texas Health Science Center at San Antonio; Monty T. Baker, Wilford Hall Medical Center, San Antonio, Texas; William C. Isler, Columbus Air Force Base, Columbus, Mississippi. Carmen P. McLean is now at the Center for the Treatment and Study of Anxiety at the University of Pennsylvania. This research was supported by grant funding from the United States Air Force Surgeon General’s Operational Medicine Research Program (FA7014- 07-C-0036; Alan L. Peterson, Principal Investigator). The views expressed in this article are solely those of the authors and do not represent an endorsement by or the official policy of the U.S. Air Force, the Department of Defense, the Department of Veterans Affairs, or the U.S. Government. Correspondence concerning this article should be addressed to Carmen P. McLean, Center for the Treatment and Study of Anxiety, University of Pennsylvania, 3535 Market Street, 6th floor, Philadelphia, PA 19104. E-mail: mcleanca@mail.med.upenn.edu Psychological Trauma: Theory, Research, Practice, and Policy © 2011 American Psychological Association 2013, Vol. 5, No. 1, 62– 68 1942-9681/13/$12.00 DOI: 10.1037/a0022949 62 This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.