The role of community context and psychological well-being for physical health: A dyadic study of military couples

Drawing from the social organizational theory of community action and change (SOAC) within a systemic biopsychosocial perspective, associations between community context (military community connections and satisfaction with military life), psychological well-being (depressive symptoms, anxiety, and self-efficacy), and physical health were examined for a sample of active duty service members and their civilian spouses (N = 236 couples) using an actor partner interdependence framework. Service members with higher levels of military community connections reported better psychological well-being. When civilian spouses were more satisfied with military life, both partners reported better psychological well-being. In turn, both spouses’ psychological well-being was related to their own reports of physical health. Statistically significant indirect effects were found between community contexts and spouses’ physical health. Enhancing community connections may be an important leverage point for supporting health and family readiness.     

The Importance of Parents' Community Connections for Adolescent Well‐being: An Examination of Military Families

Drawing from the Social Organization Theory of Action and Change (SOAC), this analysis of 223 military families, including active duty (AD) military and civilian partners, examines how parents' sense of community and community engagement (two elements of community connections) are associated with their own resilient coping, and ultimately with important outcomes capturing their adolescent offspring's individual well‐being (depression, anxiety, and self‐efficacy) and family well‐being (family functioning and parenting quality). The roles of child gender and military context were also examined. Parents with stronger community connections, including greater sense of community and community engagement, reported more resilient coping when faced with adversity. The resilient coping of mothers, in turn, was particularly significant for more positive youth outcomes, when compared to that of fathers. While gender and military context were associated with individual and family well‐being, analyses of model invariance indicated that the model fit similarly for male and female adolescents and those experiencing high and low levels of military transitions. Indirect effects were also examined. These findings illuminate malleable dimensions of both community life and family life, primarily showing that community contexts matter for multiple family members.     

Vulnerability and Resilience within Military Families: Deployment Experiences,Reintegration, and Family Functioning

This study examined how family factors that diminish feelings of loss (frequent communication) and reflect system-level adaptation (effective household management) during deployment were associated with enhanced resilience and fewer vulnerabilities during reintegration and, ultimately, the promotion of family functioning following deployment. Multiple reporters from active duty (AD) military families (N?=?214 families; 642 individuals) were examined, including AD members, civilian spouses, and their adolescent offspring. Most service members were men and enlisted personnel (95.3% male; 87.9% enlisted). Most AD and civilian spouses were between the ages of 31 and 40 (68.2% and 72.4%, respectively). Adolescent gender was relatively equal between boys (46.3%) and girls (53.7%), and their average age was 13.58. A SEM assessed the influence of communication frequency (reported by both AD and civilian spouses) and household management during deployment (reported by civilian spouses) on subsequent family functioning (reported by AD spouse, civilian spouse, and adolescent). The mediating role of positive and negative aspects of post-deployment family reintegration (reported by AD spouse, civilian spouse, and adolescent) was also assessed, as indicators of family resilience and vulnerability. Communication during deployment and civilian spouses’ household management during deployment were associated with multiple family members’ reintegration experiences. In turn, reintegration experiences were linked to self-perceptions of subsequent family functioning and, in some cases, other family members’ perceptions of family functioning. Similarities and differences among family members are discussed. While deployment and reintegration create systemic family changes and challenges, results indicated opportunity for growth that can reinforce connections between family members.     

The Significance of Military Contexts and Culture for Understanding Family Well-Being: Parent Life Satisfaction and Adolescent Outcomes

Formal systems and informal networks are presumed to be significant contexts that affect military families. Their effects on both parents and adolescents in active duty military families are examined (N = 236 families). Social organization and contextual model of family stress theories are employed as frameworks for the analyses of how dimensions of military culture influence parents’ life satisfaction, as well as key developmental outcomes of their adolescents (for example, mental health). Key findings from our analyses included a positive relationship between parents support from military leaders and fellow soldiers and parental well-being findings revealed the importance of civilian parents’ satisfaction with military life on adolescent outcomes for families that have experienced stressful military contexts. These findings provide support for the significance of multiple contexts for understanding resilience among military members and their families.     

Coping with Stress in Families of Servicemen: Searching for “Win-Win” Solutions to a Conflict between the Family and the Military Organization

The objective of this research was to explore the coping patterns of servicemen's families with the competing demands of two institutions: the military organization and the family. The sample comprised one hundred career soldiers along with their families. The research instruments included individual interviews, a battery of questionnaires, and a role-playing task. Examination of the couple's joint coping modes yielded two major categories of families — families that were successful in their efforts to resolve the military vs. family conflict, and families that did not manage to reconcile the competing demands of these two domains. Within each of these two categories there were a variety of distinct profiles. To compare the dynamics of successful coping with less successful coping regarding the military vs. family conflict, a conceptual model was suggested. This model subsumes the antecedent variables (job issues, support network, and couple relationships); mediating variables (cognitive appraisal of conflict severity and coping potential, as well as actual coping strategies); and outcome variables reflecting the degree of adjustment to the military vs. family conflict.     

Stroke patients' well-being as a function of caregiving spouses' helpful and unhelpful actions

This study examined the perceptions that 55 older married stroke patients had about themselves and about the motivations of their caregiving spouses when they judged their spouses' actions to be helpful and when they judged them to be unhelpful. It also examined how these perceptions were related to patients' well-being (depression, positive affect, marital satisfaction). Patients had more negative perceptions of themselves and of their spouses when they judged the actions to be unhelpful than when they judged them to be helpful. The hypothesis that perceptions about unhelpful actions would be more strongly related to patients' well-being than would perceptions about helpful actions was only partially supported. Perceptions about unhelpful actions were related to patients' depression, but perceptions about helpful actions were related to positive affect. Both kinds of perceptions were related to marital satisfaction. Findings begin to explicate the complex relationship between perceived helpfulness of actions and well-being.     

Contextualizing the Psychosocial Well‐being of Military Members and Their Partners: The Importance of Community and Relationship Provisions

Evidence of the impact of communities has been documented for a variety of individual and relational outcomes, including mental and physical health as well as the quality of romantic and parent–child relationships. The military represents a rather unique work context; in that, it is generally considered a lifestyle with a distinct culture and community. Yet, military families are also members of their broader, comprehensive community. Drawing from the social organizational theory of action and change (SOC) (Mancini & Bowen, 2013), and relationship provisions theory (Weiss, 1969) and utilizing a sample of 266 active duty military families, this study examined connectedness with the military community and the broader, comprehensive community. A dyadic model was evaluated whereby each partner's perspective of their comprehensive and military community was hypothesized to influence their own psychosocial well‐being as well as their partner's psychosocial well‐being. The role of relationship provisions (that is, having relationship needs met) as a mechanism linking community connections to psychosocial well‐being was also examined. Overall, the findings supported the hypothesized model, particularly for intra‐individual effects and military members. Findings emphasize the importance of considering what is gained from connections within a community rather than a focus solely on the connections themselves.     

Mothers,fathers, and the crisis of newborn intensive care

At hospital discharge of their infant from a newborn intensive care unit, 50 mothers and fathers were interviewed and completed questionnaires. There were significant within-couple correlations for appraisals of the harm that ensued from this crisis, perceptions of personal control over the infant's recovery, and expectations about the infant's future health and development. Mothers perceived more personal control, mobilized more social support, and used more escapist coping strategies than did fathers. Mothers and fathers exhibited different patterns of relations between their own coping strategies and emotional well-being. But, neither the coping strategies used by one's spouse nor differences between spouses in the use of individual coping strategies correlated with emotional well-being. Analysis of parents' perceived differences between their own and their partner's coping strategies suggested the possibility of mutually helpful, complementary strategies of coping with this problem.     

Screening,Brief Intervention,and Referral to Treatment for Military Spouses Experiencing Alcohol and Substance Use Disorders: A Literature Review

This paper provides an overview of alcohol and substance use issues in military spouses, and explore how the screening, brief intervention, and referral to treatment (SBIRT) model may enable health care providers to identify individuals at risk for developing substance use related disorders. The information presented is based on a broad literature scan relating to the characteristics of the military lifestyle, health infrastructure, screening and intervention processes, and the uses of SBIRT in military and civilian settings. Current literature suggests that military spouses, and families, tend to be at different points in their life course than civilian families of similar ages. Marrying earlier and having children sooner coupled with military lifestyle stressors place them at increased risk for developing adverse coping mechanisms, particularly during deployment. SBIRT has been recognized as an effective method among civilian patients although there is limited research on the efficacy of SBIRT for military spouses at risk of or experiencing substance use problems.     

Actor–Partner Interdependence of Compassion toward Others with Qualities of Marital Relationship and Parent–Child Relationships in Chinese Families

Considering the nature of compassion and cultural and times characteristics of Chinese families, individuals' general dispositional compassion toward others may have potential benefits for relationship qualities in Chinese families. In this study, we explored how men's and women's compassion related to their own (actor effects) and the partners' (partner effects) marital relationship and parent–child relationships, respectively, using the Actor–Partner Interdependent Model. Participants were from a cross-sectional sample of 534 Chinese heterosexual married couples (females' mean age = 37.20, SD = 4.28; males' mean age = 40.29, SD = 5.39) whose biological children were pupils (mean age = 9.28, SD = 1.11). Results revealed that: (a) within marital relationships, couple members' actor effects and partner effects were found both significant; but (b) within parent–child relationships, couple members' actor effects were significant, whereas only mothers' partner effect of compassion on father–child relationship was significant. These findings support the benefits of couple members' individual compassion with respect to family relationship quality in contemporary China. Limitations, implications, and future directions are discussed.     

Spousal understanding and marital satisfaction in pain patients and their spouses

The current study tested the hypotheses that knee osteoarthritis (OA) patients and spouses who report more spousal understanding of patient's pain would report greater marital satisfaction. A total of 124 couples completed interviews at three time points across 18 months. Results from dyadic analyses showed that patients who felt more understood by their spouse report, and have spouses who report, higher marital satisfaction concurrently. In addition, patients who felt more understood by their spouse reported higher marital satisfaction over time. Spouses' reports of understanding also had a significant influence on the patients' and their own marital satisfaction concurrently. Results highlight the importance of spouses understanding knee OA patients' pain for both dyad members' marital satisfaction.     

Family Systems and Ecological Perspectives on the Impact of Deployment on Military Families

The scope of sustained military operations in Iraq and Afghanistan has placed great demands on the Armed Forces of the United States, and accordingly, military families have been faced with deployments in more rapid succession than ever before. When military parents fulfill occupational duties during wartime, military children and families face multiple challenges, including extended separations, disruptions in family routines, and potentially compromised parenting related to traumatic exposure and subsequent mental health problems. Such challenges can begin to exert a significant toll on the well-being of both individuals and relationships (e.g., marital, parent–child) within military families. In order to respond more effectively to the needs of military families, it is essential that mental health clinicians and researchers have a better understanding of the challenges faced by military families throughout the entire deployment experience and the ways in which these challenges may have a cumulative impact over multiple deployments. Moreover, the mental health field must become better prepared to support service members and families across a rapidly evolving landscape of military operations around the world, including those who are making the transition from active duty to Veteran status and navigating a return to civilian life and those families in which parents will continue to actively serve and deploy in combat zones. In this article, we utilize family systems and ecological perspectives to advance our understanding of how military families negotiate repeated deployment experiences and how such experiences impact the well-being and adjustment of families at the individual, dyadic, and whole family level.     

Confident,valued and supported: Examining the benefits of employment support for military spouses

ABSTRACT

Military spouses face numerous challenges in obtaining employment as a result of their connection to the military. Previous research has linked military spouses underemployment to reduced well-being and satisfaction with military life, which in turn impacts on retention of the service person. In response to this the UK Ministry of Defence (MOD) trialed a 2 year programme of employment support for spouses in 2015. This paper reports the findings of a qualitative evaluation of this programme and its impact on spouses. Interviews were carried out with 30 spouses and 23 of their serving partners to examine the benefits and impact of the support provided. The majority of spouses and their serving partners perceived the employment support as providing a positive contribution from the military to help spouses get back into employment or improve their employability. Additionally, spouses felt invested in by the military and valued as constituents in their own right. No impact of employment support for spouses on the intention to remain or leave the Armed Forces was identified. Longitudinal follow up will be required to determine any long-term impact of employment support on employment outcomes and retention.     

Partners' internal stress and well-being: The role of dyadic coping and problem resolution

Couples' experiences of daily stress can be detrimental for partners' individual and relational well-being, specifically their identity as a couple, their relational satisfaction, and their life satisfaction. Grounded in the Systemic Transactional Model, this study aimed at analyzing factors that may safeguard partners and their relationship from detrimental effects of internal stress (i.e., stress that originates inside the relationship). We examined the buffering effect of partners' positive dyadic coping and internal problem resolution. Daily diary data were collected across 7 days from 82 heterosexual couples. Multilevel dyadic analyses showed that internal stress was negatively associated with partners' individual and relational well-being. Positive dyadic coping moderated the association between partners' internal stress and couple satisfaction for both partners, but not life satisfaction and couple identity. Moreover, for partners who reported a resolution to the internal problem, the negative associations of internal stress with life satisfaction, couple satisfaction, and couple identity were significantly lower than for those who did not resolve the internal problem. This study confirms the negative role of internal stress on well-being, shows the associations between internal stress and couple identity, and highlights the protective role of dyadic coping and internal problem resolution in couples' daily lives.     

Coping Options: Missing Links between Minority Group Identification and Psychological Well-Being

Using concepts from social identity theory ( Tajfel & Turner, 1979 ) and Lazarus and Folkman's (1984) cognitive theory of stress and coping we tested the capacity for group identification to foster beliefs in one's ability to cope successfully and in turn predict psychological well-being. Black American participants appraised the availability of coping options that varied by level of identity (individual, intragroup, and intergroup) as well as function of coping (problem-focused and emotion-focused). Replicating prior work, participants who were higher in racial group identification reported more positive well-being. Appraisals of individual emotion-focused and intergroup problem-focused options mediated the relationship of group identification with both self-esteem and life satisfaction. Appraisals of intergroup emotion-focused options also partially mediated the relationship between group identification and life satisfaction. Findings suggest that the relationship between minority group identification and well-being may partly be due to its influence over a person's sense that they and their group can respond effectively to disadvantage.     

Coping with the loan transition in professional association football

The present study generated a qualitative examination of male professional football players’ experiences of stress during the loan transition using the Demand Resources and Individual Effects (DRIVE) Model. Purposeful sampling was used to recruit participants (M age = 23; SD = 2.5) from various Premier League (n = 2), Championship (n = 8), and League (n = 1) clubs across the UK who have experienced a loan to another club. Guided by a critical realist philosophical orientation, semi-structured interviews were deductively developed based upon the DRIVE model to stimulate contextual discussion about the pre-transition resources (e.g. organizational support), perceived transition demands (e.g. performance pressure) and appraisals. Finally, players were asked to discuss their strategies for coping (e.g. situational coping) with loan demands and if they deemed this coping to be effective. Braun and Clarke’s (2013) thematic content analysis was utilised. Deductive thematic analysis was used to identify and evidence themes that were articulated in relation to the demands experienced, appraisals associated with such demands, and the coping strategies used to manage these demands. An inductive approach was used to code sub-themes from the data, on the basis of players’ specific experiences that had not yet been exemplified in the existing literature. This study presented loan transition demands (performance and organizational), contextual individual differences (situational coping, dispositional coping, and protective factors) and loan resources (transition preconditions and during loan) that may assist individuals’ performance and well-being. Practitioners would be advised to work with players on facilitating pre-transition resources and identify perceived demands they consider important to their transition process. Future research should seek to explore the loan transition within elite female football.     

Construct Validity of the Perceived Criticism Measure

The construct validity of the Perceived Criticism Measure (PCM) was examined in 2 studies. In Study 1, 50 community couples participated in problem-solving interactions after which they rated interaction-specific perceived criticism and their criticism of their spouses. In addition, they provided ratings of perceived criticism for their relationship overall and completed measures of psychopathology and marital satisfaction. For both husbands and wives, convergent validity was demonstrated by moderate-to-large correlations between the PCM and spouses' own ratings of their criticism for both general and interaction-specific perceived criticism. In Study 2, 37 patients with obsessive-compulsive disorder and their spouses participated in problem-solving interactions and provided ratings of marital satisfaction and general perceived criticism. Five untrained coders rated the interactions according to their own definitions of the relatives' destructive criticism of the patient. Their aggregated ratings proved strongly related to patients' PCM scores. Higher PCM scores were related to lower marital satisfaction in both Studies 1 and 2. The results of these studies are supportive of the convergent validity of the Perceived Criticism Measure. Evidence of discriminant validity was mixed.     

Health and Well-Being in Highly Cohesive Units of the U.S. Army1

A large civilian literature on the role of social support in health and well-being suggests that military units high in unit cohesion should provide their members both significant protection from physical and mental illness and high levels of job satisfaction. This hypothesis was tested with a questionnaire survey of soldiers in Special Forces “A-teams”, generally viewed as the U.S. Army's most cohesive permanent units. As predicted, A-team soldiers reported greater physical and psychological well-being and greater satisfaction with job and career than did soldiers in conventionally organized units, be they Special Forces, airborne, or mechanized infantry. The best predictors in our battery of demographic, personality, and cohesion measures were ratings of social support from and satisfaction with one's Army unit, and relatively more “internal” scores on the Rotter locus-of-control scale. From these data and extensive participant observation we conclude that unit cohesion provides the soldier considerable protection from the stresses of military life, even in peace, and that it is organizational rather than individual variables that are primarily responsible for the very high levels of cohesion and/or social support in Special Forces A-teams.     

Alzheimer's Disease: The Impact of the Family on Spouses,Offspring, and Inlaws

This article reports the findings from a study designed to identify qualities of the multigeneration family system that affected the relationship between the demands of Alzheimer's disease on the family and the health and well-being of (a) spouses, (b) offspring, and (c) offspring's spouses or “inlaws.” Members of 97 families of patients with Alzheimer's disease, recruited from four University-affiliated Alzheimer's Centers, completed detailed questionnaires and participated in a 45-minute telephone interview to assess care-strain, personal stress, appraisals of three major domains of family life (World View, Structure/Organization, and Emotion Management), and three health and well-being indices (Anxiety/Depression, Somatic Symptoms, and Well-Being). Multivariate multiple regression equations, run separately for each of the three groups of family respondents and each of the three family domains, indicated: (1) no significant associations between the severity of the elder's disease and family member health and well-being; (2) female family members reported poorer health and well-being than male family members; and (3) caregiver strain was negatively associated with family member health and well-being. Further, appraised family qualities were associated with the health and well-being of the three groups of respondents differently: directly for offspring, interactively with severity of patient disorder for inlaws, and not at all for spouses. The data suggested that some family qualities served a protective function, whereas others exacerbated the negative effects of caregiving by affecting personal health and well-being. The findings are interpreted in terms of the different roles and expectations for caregiving placed on spouses, offspring, and inlaws. It is suggested that programs of intervention for patients with Alzheimer's and other chronic diseases should focus on the multigeneration family as the context for care, rather than only on the primary caregiver.     

Ambivalence Over Emotional Expression and Psychological Weil-Being Among Rheumatoid Arthritis Patients and Their Spouses1

Associations between ambivalence over emotional expression and psychological well-being among rheumatoid arthritis patients and their spouses were investigated. Sixty-nine couples completed questionnaires assessing ambivalence over emotional expression, emotional expressiveness, psychological well-being, and strategies used in coping with arthritis. Associations between the patient's ambivalence and psychological well-being were stronger for those married to a highly ambivalent spouse, although this pattern of results was not found for spouses. Lower psychological well-being among more ambivalent spouses, and to a lesser extent patients, could be partially explained by their greater use of passive and distancing coping strategies. Results emphasize the importance of taking a dyadic approach to the study of psychological functioning among chronically ill patients and their spouses.