Veterans with family support have better functional recovery and reintegration outcomes. However, families’ ability to support the veteran with PTSD’s rehabilitation and reintegration oftentimes is hindered by interpersonal challenges. We report findings of a qualitative study that examined OEF/OIF veterans with PTSD/TBI and their significant others’ (SOs’) perceptions of family functioning. We conducted 24 in-depth interviews with 12 veteran/SO dyads using an adapted version of the Family Assessment Device Structured Interview. Descriptive qualitative analytic methods were used to analyze the data. Data show that the impact of deployment and the resulting changes in the individuals and the family dynamics lingered years after the veterans returned home and had a lasting influence on veterans’ and SOs’ perceptions of family functioning. Most couples acknowledged growth in their relationships several years postdeployment. However, many continued to struggle with disruptions generated by deployment. Four themes emerged from the data: individual changes, coping strategies, relationship changes, and a “new normal.” Postdeployment family functioning was influenced by a dynamic interplay of individual and relationship factors and the development of coping strategies and a new normal. This study contributes to the understanding of the prolonged postdeployment family reintegration experiences of veterans and their SOs. Findings underscore the importance of continuing to advance the current knowledge base about the long-term impact of deployment on veterans and their families, especially factors that contribute to positive postdeployment family functioning. Additional empirical studies are needed to provide more in-depth understanding of the long-term postdeployment reintegration experiences of veterans and their families. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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Exploring the post-deployment reintegration experiences of veterans with PTSD and their significant others
APA Citation:
Freytes, I. M., LeLaurin, J. H., Zickmund, S. L., Resende, R. D., & Uphold, C. R. (2017). Exploring the post-deployment reintegration experiences of veterans with PTSD and their significant others. The American Journal of Orthopsychiatry, 87(2), 149-156. https://doi.org/10.1037/ort0000211
Focus:
Deployment
Mental health
Trauma
Veterans
Branch of Service:
Multiple branches
Population:
Adulthood (18 yrs & older)
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Freytes, I. Magaly; LeLaurin, Jennifer H.; Zickmund, Susan L.; Resende, Rosana D.; Uphold, Constance R.
2017
A latent profile analysis of aggression and victimization across relationship types among veterans who use substances
APA Citation:
Anderson, R. E., Bonar, E. E., Walton, M. A., Goldstick, J. E., Rauch, S. M., Epstein-Ngo, Q. M., & Chermack, S. T. (2017). A latent profile analysis of aggression and victimization across relationship types among veterans who use substances. Journal Of Studies On Alcohol And Drugs, 78(4), 597-607. doi:10.15288/jsad.2017.78.597
Focus:
Substance use
Trauma
Veterans
Branch of Service:
Multiple branches
Population:
Adulthood (18 yrs & older)
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Anderson, RaeAnn E.; Bonar, Erin E.; Walton, Maureen A.; Goldstick, Jason E.; Rauch, Sheila A. M.; Epstein-Ngo, Quyen M.; Chermack, Stephen T.
2017
Objective: This study examined patterns of violence victimization and aggression in both intimate partner and nonpartner relationships among U.S. military veterans using latent profile analysis to identify subtypes of violence involvement. Method: Participants were 839 substance use treatment–seeking veterans (93% male) from a large Veterans Affairs Medical Center who completed screening measures for a randomized controlled trial. Results: Past-year violence involvement, including both intimate partner violence (IPV) and nonpartner violence (NPV), was common in the sample, although NPV occurred at somewhat higher rates. When we included either IPV or NPV aggression or victimization, more than 40% reported involvement with physical violence, 30% with violence involving injury, and 86% with psychological aggression. Latent profile analysis including both aggression and victimization in partner and nonpartner relationships indicated a four-profile solution: no/low violence (NLV; n = 377), predominantly IPV (n = 219), predominantly NPV (n = 134), and high general violence (HGV; n = 109). Multinomial logistic regression analyses revealed that, compared with the NLV group, the remaining three groups differed in age, cocaine use, posttraumatic stress disorder (PTSD) symptoms, and legal involvement. Legal issues appeared to differentiate the profiles most, with the predominantly NPV and HGV profiles reporting more instances of driving under the influence and the HGV profile reporting legal problems related to aggression. Conclusions: IPV and NPV are fairly common among veterans seeking substance use treatment. The clinical characteristics of violence profiles indicate that cocaine use, PTSD symptoms, and legal involvement are treatment needs that vary with violence profile and may be useful for clinical decision making.
Longitudinal changes in combat-related posttraumatic stress disorder among Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans with hazardous alcohol use: The role of avoidance coping
APA Citation:
Lee, J., Possemato, K., & Ouimette, P. C. (2017). Longitudinal changes in combat-related posttraumatic stress disorder among Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn Veterans with hazardous alcohol use: The role of avoidance coping. The Journal of Nervous and Mental Disease, 205(10), 805-808. doi:10.1097/NMD.0000000000000713
Focus:
Mental health
Substance use
Veterans
Branch of Service:
Multiple branches
Population:
Adulthood (18 yrs & older)
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Lee, Joohyun; Possemato, Kyle; Ouimette, Paige C.
2017
Military personnel who have experienced combat trauma are at risk for developing posttraumatic stress disorder (PTSD). A greater recognition of the complex array of vulnerability factors that contribute to PTSD severity has led researchers to examine other non-combat-related factors. This longitudinal study examined a number of pre-, peri-, and postdeployment factors hypothesized to contribute to PTSD symptomatology among returning Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans presenting with at least subthreshold PTSD symptoms and hazardous alcohol use in a primary care setting. Purported risk factors included childhood family environment, severity of combat exposure, postdeployment social support, alcohol dependence severity, and an avoidant coping style. At baseline, postdeployment social support and avoidant coping contributed to PTSD severity. Only avoidant coping was associated with changes in PTSD symptom at 1-year follow-up. Reducing avoidant coping may deter the maintenance of PTSD among veterans with PTSD symptoms and hazardous alcohol use.
Thwarted belongingness as an explanatory link between insomnia symptoms and suicidal ideation: Findings from three samples of military service members and veterans
APA Citation:
Hom, M. A., Chu, C., Schneider, M. E., Lim, I. C., Hirsch, J. K., Gutierrez, P. M., & Joiner, T. E. (2017). Thwarted belongingness as an explanatory link between insomnia symptoms and suicidal ideation: Findings from three samples of military service members and veterans. Journal of Affective Disorders, 209, 114-123. http://dx.doi.org/10.1016/j.jad.2016.11.032
Focus:
Deployment
Mental health
Veterans
Branch of Service:
Multiple branches
Population:
Adulthood (18 yrs & older)
Aged (65 yrs & older)
Middle age (40 - 64 yrs)
Thirties (30 - 39 yrs)
Very old (85 yrs & older)
Young adulthood (18 - 29 yrs)
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Hom, Melanie A.; Chu, Carol; Schneider, Matthew E.; Lim, Ingrid C.; Hirsch, Jameson K.; Gutierrez, Peter M.; Joiner, Thomas E.
2017
Background Although insomnia has been identified as a robust predictor of suicidal ideation and behaviors, little is known about the mechanisms by which sleep disturbances confer risk for suicide. We investigated thwarted belongingness as an explanatory link between insomnia symptoms and suicidal ideation across three military service member and veteran samples. Methods Data were collected among United States military service members and veterans (N1=937, N2=3,386, N3=417) who completed self-report measures of insomnia symptoms, thwarted belongingness, suicidal ideation, and related psychiatric symptoms (e.g., anxiety, hopelessness). Bias-corrected bootstrap mediation analyses were utilized to examine the indirect effects of insomnia symptoms on suicidal ideation through thwarted belongingness, controlling for related psychiatric symptoms. Results Consistent with study hypotheses, thwarted belongingness significantly accounted for the relationship between insomnia and suicidal ideation across all three samples; however, insomnia symptoms did not significantly account for the relationship between thwarted belongingness and suicidal ideation, highlighting the specificity of our findings. Limitations This study utilized cross-sectional self-report data. Conclusions Insomnia may confer suicide risk for military service members and veterans, in part, through the pathway of thwarted belongingness. Additional prospective studies are warranted to further delineate this model of risk. Our results offer a potential therapeutic target for the prevention of suicide, via the promotion of belongingness, among service members and veterans experiencing insomnia symptoms.
Social skills deficits as a mediator between PTSD symptoms and intimate partner aggression in returning veterans
APA Citation:
LaMotte, A. D., Taft, C. T., Weatherill, R. P., & Eckhardt, C. I. (2017). Social skills deficits as a mediator between PTSD symptoms and intimate partner aggression in returning Veterans. Journal of Family Psychology, 31(1), 105-110. http://dx.doi.org/10.1037/fam0000215
Focus:
Couples
Mental health
Trauma
Veterans
Branch of Service:
Multiple branches
Population:
Adulthood (18 yrs & older)
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LaMotte, Adam D.; Taft, Casey T.; Weatherill, Robin P.; Eckhardt, Christopher I.
2017
This study examined social skills deficits as a mediator of the relationship between posttraumatic stress disorder (PTSD) symptoms and use of intimate partner aggression (IPA) among returning veterans. Prior research with veterans has focused on PTSD-related deficits at the decoding stage of McFall's (1982) social information processing model, and the current study adds to this literature by examining social skills deficits at the decision stage. Participants were 92 male veterans recruited from the greater Boston area. PTSD symptoms were assessed through clinician interview, IPA use was assessed through self- and partner report, and social skills deficits were assessed in a laboratory task in which veterans listened to a series of problematic marital situations and responded with what they would say or do in the situation. Responses were coded for social competency. Bivariate correlations revealed several significant associations among PTSD symptoms, social skills deficits, and use of IPA. When all PTSD symptom clusters were entered into a regression predicting social skills deficits, only emotional numbing emerged as a unique predictor. Finally, social skills deficits significantly mediated the relationship between veterans' PTSD symptoms and use of psychological (but not physical) IPA. Findings extend prior research on McFall's (1982) social information processing model as it relates to veterans' PTSD symptoms and use of IPA. More research is needed to understand the associations between PTSD symptoms and deficits at each individual step of this model. (PsycINFO Database Record; (c) 2017 APA, all rights reserved).
6 Modeling risk for intimate partner violence among recent-era veteran-partner dyads
Modeling risk for intimate partner violence among recent-era veteran-partner dyads
APA Citation:
Kelley, M. L., Montano, H.G., Lam, N., Hernandez, M., Miller, M. M., & Workgroup, V. M. A. M. (2017). Modeling risk for intimate partner violence among recent-era veteran-partner dyads. Journal of Family Violence, 5(32), 505-512. https://doi.org/10.1007/s10896-016-9903-2
Focus:
Couples
Deployment
Mental health
Physical health
Substance use
Veterans
Branch of Service:
Multiple branches
Population:
Adulthood (18 yrs & older)
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Kelley, Michelle; Montano, Hilary; Lam, Nick; Hernandez, Monica; Miller, Marinell
2017
Using an actor-partner interdependence model, we examined whether veterans' posttraumatic stress symptoms (PTSS) contributed to partners' drug abuse symptoms, whether partners' drug abuse symptoms contributed to intimate partner violence (IPV) perpetration, and whether drug abuse symptoms mediated PTSS-IPV perpetration associations. Participants were recent-era veterans who participated in the Mid-Atlantic Mental Illness Research, Education and Clinical Center Post-Deployment Mental Health study. Veterans who took part at one site and their partners ( N = 49 couples) completed a follow-up study in which drug abuse symptoms and IPV perpetration were assessed. Veterans' PTSS contributed to veterans' drug abuse symptoms. Veterans' drug abuse symptoms were associated with their IPV perpetration (i.e., an actor effect) and their partners' IPV perpetration (i.e., a crossover effect). Drug abuse symptoms mediated the association between veterans' PTSS and partners' reports of IPV perpetration. Findings suggest complex relationships between PTSS, drug abuse problems and IPV perpetration among these dyads.
7 Military sexual assault and homeless women veterans: Clinical correlates and treatment preferences
Military sexual assault and homeless women veterans: Clinical correlates and treatment preferences
APA Citation:
Decker, S. E., Rosenheck, R. A., Tsai, J., Hoff, R., & Harpaz-Rotem, I. (2013). Military sexual assault and homeless women veterans: Clinical correlates and treatment preferences. Womens Health Issues, 23(6), e373-e380. doi:10.1016/j.whi.2013.09.002
Focus:
Mental health
Physical health
Trauma
Veterans
Branch of Service:
Army
Population:
Adulthood (18 yrs & older)
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Research Summary
Decker, Suzanne E.; Rosenheck, Robert A.; Tsai, Jack; Hoff, Rani; Harpaz-Rotem, Ilan
2013
Background Both homeless women and women who have experienced military sexual assault (MSA) are at high risk of serious psychological sequelae. However, little is known about the combined impact of MSA and current homelessness on psychological distress, or about distinctive treatment preferences among homeless female veterans affected by MSA. Methods This observational study compared clinical symptoms, pre-military experiences, and treatment preferences among 509 female veterans with and without MSA who enrolled in 11 VA Homeless Women Veterans Programs. Results Over one third of participants (41.1%) reported MSA. In multivariate analyses, homeless female veterans who reported MSA endorsed greater severity of PTSD and other psychiatric symptoms. Those who had experienced MSA were more likely to report interest in treatment, and treatment focused on safety was reported as especially attractive. Conclusions Among homeless female veterans, MSA is associated with greater mental health symptoms and greater interest in safety-focused treatment. Services targeting the needs of homeless MSA survivors should be encouraged.
8 Veteran–child communication about parental PTSD: A mixed methods pilot study
Veteran–child communication about parental PTSD: A mixed methods pilot study
APA Citation:
Sherman, M. D., Larsen, J., Straits-Troster, K., Erbes, C., & Tassey, J. (2015). Veteran-child communication about parental PTSD: A mixed methods pilot study. Journal of Family Psychology, 29(4), 595-603. doi:10.1037/fam0000124
Focus:
Children
Mental health
Parents
Veterans
Youth
Branch of Service:
Multiple branches
Population:
Adolescence (13 - 17 yrs)
Adulthood (18 yrs & older)
Aged (65 yrs & older)
Childhood (birth - 12 yrs)
Middle age (40 - 64 yrs)
Preschool age (2 -5 yrs)
School age (6 - 12 yrs)
Thirties (30 - 39 yrs)
Young adulthood (18 - 29 yrs)
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Sherman, Michelle D.; Larsen, Jessica; Straits-Troster, Kristy; Erbes, Christopher; Tassey, John
2015
The majority of adults with posttraumatic stress disorder (PTSD) are parents. Parents with PTSD report lower levels of parenting satisfaction, poorer parent–child relationships, and elevated incidence of child distress and behavioral problems in comparison with parents without PTSD. Although literature exists regarding parent–child communication about serious mental illness and physical health problems, research has yet to examine this communication regarding parental PTSD. This 3-site, mixed methods study involved 19 veteran parents who had a diagnosis of PTSD; participants were recruited from VA medical centers. Veterans participated in focus groups or individual interviews and completed questionnaires, responding to questions about motivations and barriers for disclosure of their PTSD to their children, the content of such disclosure, experiences at the VA as a parent, and desired VA family resources. Although many veterans described a desire to talk with their children about PTSD, they experience many barriers to doing so, including both personal reservations and feelings (e.g., avoidance of discussing PTSD, shame) and concerns about the consequences of disclosure on their children (e.g., child distress, loss of child’s respect for veteran). Regarding veterans’ experience at the VA, 21% reported that none of their providers had assessed if they have children, and 21% experienced the VA system as not welcoming to them as parents, citing both logistical issues (e.g., lack of childcare) and provider neglect of parenting concerns. Veterans indicated they would like the VA to offer parenting classes, workshops for families, child care, and family therapy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Couple treatment for alcohol use disorder and posttraumatic stress disorder: Pilot results from U.S. military veterans and their partners
APA Citation:
Schumm, J. A., Monson, C. M., O'Farrell, T. J., Gustin, N. G., & Chard, K. M. (2015). Couple treatment for alcohol use disorder and posttraumatic stress disorder: Pilot results from U.S. military veterans and their partners. Journal of Traumatic Stress, 28(3), 247-252. doi:10.1002/jts.22007
Focus:
Couples
Mental health
Substance use
Veterans
Branch of Service:
Multiple branches
Population:
Adulthood (18 yrs & older)
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Schumm, Jeremiah A.; Monson, Candice M.; O'Farrell, Timothy J.; Gustin, Nancy G.; Chard, Kathleen M.
2015
We studied 13 U.S. male military veterans and their female partners who consented to participate in an uncontrolled trial of couple treatment for alcohol use disorder and posttraumatic stress disorder (CTAP). CTAP is a 15-session, manualized therapy, integrating behavioral couples therapy for alcohol use disorder (AUD) with cognitive–behavioral conjoint therapy for posttraumatic stress disorder (PTSD). Due to ineligibility (n = 1) and attrition (n = 3), 9 couples completed the study, and 7 completed 12 or more sessions. There were 8 veterans who showed clinically reliable pre- to posttreatment reduction of PTSD outcomes. There were also significant group-level reductions in clinician-, veteran-, and partner-rated PTSD symptoms (d = 0.94 to 1.71). Most veterans showed clinically reliable reductions in percentage days of heavy drinking. Group-level reduction in veterans’ percentage days of heavy drinking was significant (d = 1.01). There were 4 veterans and 3 partners with clinically reliable reductions in depression, and group-level change was significant for veterans (d = 0.93) and partners (d = 1.06). On relationship satisfaction, 3 veterans and 4 partners had reliable improvements, and 2 veterans and 1 partner had reliable deterioration. Group-level findings were nonsignificant for veteran relationship satisfaction (d = 0.26) and for partners (d = 0.52). These findings indicate that CTAP may be a promising intervention for individuals with comorbid PTSD and AUD who have relationship partners.
10 Gender differences in the impact of warfare exposure on self-rated health
Gender differences in the impact of warfare exposure on self-rated health
APA Citation:
Wang, J. M., Lee, L. O., & Spiro, A. (2015). Gender differences in the impact of warfare exposure of self-rated health. Women’s Health Issues, 25(1), 35-41. doi:10.1016/j.whi.2014.09.003
Focus:
Deployment
Physical health
Veterans
Branch of Service:
Multiple branches
Population:
Adulthood (18 yrs & older)
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Research Summary
Wang, Joyce M.; Lee, Lewina O.; Spiro, Avron
2015
Background This study examined gender differences in the impact of warfare exposure on self-reported physical health. Methods Data are from the 2010 National Survey of Veterans, a nationally representative survey of veterans from multiple eras of service. Regression analyses assessed gender differences in the association between warfare exposure (deployment to a war zone, exposure to casualties) and health status and functional impairment, adjusting for sociodemographics. Findings Women reported better health status but greater functional impairment than men. Among men, those who experienced casualties only or both casualties and deployment to a war zone had worse health compared with those who experienced neither stressor or deployment to a war zone only. Among women, those who experienced casualties only or both stressors reported worse health than those who experienced war zone only, who did not differ from the unexposed. No association was found between warfare exposure and functional impairment in women; in men, however, those who experienced exposure to casualties or both stressors had greater odds of functional impairment compared with those who experienced war zone only or neither stressor. Conclusions Exposure to casualties may be more predictive of health than deployment to a war zone, especially for men. We did not find a stronger association between warfare exposure and health for women than men. Given that the expansion of women's military roles has allowed them to serve in direct combat, their degree and scope of warfare exposure is likely to increase in the future.