This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. OBJECTIVE: The proposed research will investigate how experiences of PTSD are understood, negotiated, and lived out by Hispanic and non-Hispanic male veterans, particularly in interaction with family members and as constrained by socioeconomic realities and trauma-related functional impairment. Three main research questions will be addressed during 12 months fieldwork in San Antonio, Texas, among PTSD-diagnosed Hispanic and non-Hispanic veterans of Iraq and Afghanistan. First, how do returning male veterans and their families understand and repond to the experience of trauma-related mental illness? Second, what social and cultural variables appear to most strongly influence the illness experience of PTSD? Third, how are PTSD illness experiences shaped by individual and family members' perceptions of disrupted expectations and life trajectories, particularly those relevant to motivations for entering military service and to the veteran's task of successfully functioning as an adult male following the return home? RESEARCH PLAN: Research questions will be explored among five groups of participants including: 1) the primary veterans group, which will be composed of male, PTSD-diagnosed OIF/OEF veterans (n=70); 2) the secondary veterans group, which will include PTSD-diagnosed female veterans of the conflicts in Iraq and Afghanistan and male veterans of Vietnam, and male veterans of the current conflicts who have not been diagnosed with PTSD (n=15); 3) family members of PTSD-diagnosed veterans (n=40); 4) local mental health clinicians treating veterans with PTSD (n=15); and 5) local community members (n=30). METHODS: The primary methods will be participant observation and semi-structured interviewing, all of which will be conducted by the PI. Methods will combine qualitative and quantitative data collection and analysis strategies, bridging standardized psychosocial and symptom assessment with non-pathologically framed notions of distress to explore combat PTSD as both a biomedical illness and an experience of sociomoral suffering. Participant observation in clinical and community settings will explore how PTSD is discussed and responded to across a variety of social domains with relevance for veterans. Semi-structured interviewing, accompanied among veteran participants by psychosocial and symptom assessments, will investigate explanatory models and phenomenology of PTSD illness, as well as its relationship to family and community life and well being. CLINICAL RELEVANCE: This research will provide badly-needed insight into the social and cultural factors and processes that appear to shape both risk for developing PTSD and the course and severity of the illness itself. Experience with the veterans of Vietnam has taught us how terrible, pervasive, and lasting can be the effects of trauma-related distress for PTSD-diagnosed men and their families. This research will provide in-depth data on the challenges of living with PTSD for recent veterans and their families and communities, in hopes of illuminating new possibilities for responding effectively to such challenges.