The Associations Among Existential Isolation, Shared Reality, and Veterans’ Health

Military veterans face elevated risks of mental health issues, including post-traumatic stress disorder (PTSD), depression, and suicide. While previous research has identified loneliness and social isolation as major contributors to these outcomes, less is known about existential isolation (EI), the sense that others cannot understand one's personal experiences. Shared reality, defined as a perceived commonality of inner states with others, may help reduce EI and improve health outcomes. This study examined whether experiences of generalized shared reality (SR-G) in close relationships were associated with reduced EI, and in turn, whether lower EI predicted better mental and physical health outcomes in veterans. The two hypotheses for this study were (1) higher levels of EI will be associated with greater symptoms of anxiety, depression, and PTSD, and with lower levels of physical health and (2) greater shared reality will be associated with lower levels of EI, which, in turn, will be related to reduced symptoms of depression, anxiety, PTSD, and increased physical well-being. A sample of 464 U.S. veterans completed measures of SR-G, EI, loneliness, PTSD, anxiety, depression, and physical well-being. Results showed that SR-G was significantly negatively associated with EI, loneliness, and depression, and positively associated with physical health. Mediation analyses showed that EI partially mediated the relationship between SR-G and both depression and physical health, even when controlling for loneliness. These findings suggest that fostering shared reality in close relationships may serve as a protective factor against EI and its associated negative health outcomes in military veterans. Implications for clinical interventions and veteran reintegration support programs are discussed.