"Toughness" in association with mental health symptoms among Iraq and Afghanistan war veterans seeking veterans affairs health care

The association between endorsement of emotional "toughness" (i.e., extreme self-reliance and the suppression of outward displays of emotional distress) and likelihood for screening positive for mental health conditions was examined in a male sample of 198 Iraq and Afghanistan veterans presenting for postdeployment Veteran Affairs health care. After accounting for relevant covariates, veterans endorsing higher levels of emotional toughness were more likely to screen positive for posttraumatic stress disorder and depression. There was also a nonsignificant trend (p = .08) associated with a positive relationship between toughness and likelihood of self-reported alcohol abuse. Results are discussed in terms of identifying and addressing toughness norms among returning veterans to promote effective use of mental health services.