Importance: Occupational therapists can foster student veterans’ resilience, but targets for intervention must be developed.

Objective: To explain factors influencing student veterans’ successful adaptation to past combat exposure, we hypothesized that participants with high life meaning would have greater levels of protective factors and lower levels of health conditions than those with low life meaning.

Design: Longitudinal panel study with two measurements. Participants were classified by level of combat exposure (high–low) and life meaning (high–low) at follow-up, yielding four possible classifications (e.g., resilient group: high combat exposure, high life meaning). Linear mixed models were fit to obtain adjusted means of protective factors and health conditions for each classification; independent-samples t tests were used to examine differences between classifications.

Setting: Community.

Participants: Convenience sample of 153 combat-exposed student veterans.

Outcomes and Measures: Psychometrically sound measures of combat exposure, life meaning, protective factors (social and instructor autonomy support, coping ability, academic self-efficacy, social–community participation, and meaningful activity), and health conditions (posttraumatic stress [PTSD], depression, somatic symptoms).

Results: Groups with high life meaning at follow-up in response to both levels of combat exposure reported greater meaningful activity and coping ability and fewer depressive symptoms. Participants with high life meaning in response to low combat exposure had greater social support and fewer somatic symptoms; participants with high life meaning in response to high combat exposure had lower PTSD.

Conclusions and Relevance: Occupational therapists may foster student veterans’ resilience by promoting meaningful activity, social support, and coping ability while managing symptoms of health conditions.

What This Article Adds: To the best of our knowledge, this study is the first to offer empirical support for potential targets of occupational therapy intervention that address student veterans’ successful adaptation to combat exposure. Findings suggest that researchers should develop and test interventions that facilitate successful engagement in meaningful and shared activities and that occupational therapists should work within multidisciplinary teams to bolster coping ability and manage symptoms of combat-related health conditions.

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