Psychological flexibility as a dimension of resilience for posttraumatic stress, depression, and risk for suicidal ideation among Air Force personnel

• We model the association of psychological flexibility and emotional distress.
• Psychological flexibility was related to less depression and posttraumatic stress.
• Psychological flexibility moderated the effect of depression on suicidal ideation.

Rates of psychological disorders and suicide have increased dramatically among military personnel since the onset of combat operations in Iraq and Afghanistan. To date, few studies have identified psychological factors that insulate service members from emotional distress and suicide risk following combat. The current study investigates the protective effects of psychological flexibility on emotional distress and suicidal ideation in 168 active duty Air Force convoy operators. Self-report data were collected before deployment and at 1, 3, 6, and 12 months postdeployment. Robust generalized estimating equations with repeated measurements indicated that, over time, service members with greater psychological flexibility reported less severe posttraumatic stress (B=−.039, SE=.011, p=.001) and depression (B=−.053, SE=.009, p<.001) than subjects with less psychological flexibility. Greater psychological flexibility was also associated with decreased suicide risk (B=−.035, SE=.010, p<.001), significantly moderating the effects of depression on suicidal ideation over time (B=.115, SE=.044, p=.008). Results suggest that psychological flexibility guards against emotional distress among service members and buffers the effects of depression on suicide risk.