Psychological symptoms and marital satisfaction in spouses of Operation Iraqi Freedom veterans: relationships with spouses' perceptions of veterans' experiences and symptoms

Much research has shown that spouses of combat veterans with posttraumatic stress disorder (PTSD) have higher rates of psychological and marital distress than do spouses of veterans without PTSD; however, very few studies have examined potential mechanisms of this increased vulnerability. The current study examined spouses of National Guard soldiers recently returned from deployments in Iraq. In addition to documenting elevated levels of psychological symptoms in these spouses, the authors found that spouses experienced greater symptom severity when they perceived high levels of symptoms in soldiers but the soldiers endorsed low levels of symptoms. Furthermore, spouses' marital satisfaction was negatively linked to soldiers' self-reported symptom severity only when spouses perceived that soldiers had experienced low levels of combat activity while deployed. When spouses perceived high levels of such activity, soldiers' self-reported symptoms had no relationship with spouses' marital satisfaction. These findings highlight the importance of interpersonal perceptions in intimate relationships and are consistent with the notion that uncontrollable attributions for a relative's mental health problems may provide a buffer against relationship distress. (PsycINFO Database Record (c) 2008 APA, all rights reserved).     

Mild Traumatic Brain Injury and Posttraumatic Stress Disorder in Returning Iraq and Afghanistan War Veterans: Implications for Assessment and Diagnosis

Mild traumatic brain injury (MTBI) and posttraumatic stress disorder (PTSD) are considered the “signature injuries” of combat soldiers returning from Iraq and Afghanistan. Both disorders can greatly affect the functioning of soldiers, yet the disorders often go undetected or are misdiagnosed by both military and civilian health care providers. This article provides information about MTBI and PTSD in returning combat soldiers along with implications for assessment and diagnosis.     

Impact of Peer Support on PTSD,Hope, and Functional Impairment: A Mixed-Methods Study of Child Soldiers in Nepal

The experience of child soldiers during postwar civilian reintegration is recognized as a major contributor to mental health. For some children, postwar social relations may be more important than war trauma in determining psychosocial well-being. Mixed methods incorporating epidemiology and qualitative case studies were employed to evaluate the effects of family, peer, and community relations after reintegration on psychosocial outcomes: hope, functional impairment, and post-traumatic stress disorder (PTSD). Participants were 142 child soldiers, including 9 qualitative case studies. Peer support predicted increased hope, decreased functional impairment, and decreased PTSD symptoms. Conversely, problems with peer relations predicted less hope and more PTSD symptoms. Maximizing peer support and minimizing stigma from peers should be prioritized within psychosocial reintegration programs, especially among former child soldiers with PTSD.     

Management of Post-Traumatic Stress Disorder in the Military: An Intervention Model

Military Forces are involved in combat, peacekeeping operations and disaster management. The nature of such operations include violent conflict, death of women and children, child soldiers and own forces. These traumatic circumstances can contribute to the development of post traumatic stress disorder (PTSD) in members involved. This article discusses the role and function of psychological debriefing for trauma with operational military units. It also proposes a preliminary intervention model to manage PTSD in military forces.     

Natural Disasters and Post-traumatic Stress Disorder Short-Term versus Long-Term Recovery in Two Disaster-Affected Communities1

Post-traumatic stress disorder (PTSD) in adults following disaster-precipitated family relocation was investigated in a longitudinal study of family and individual response to natural disasters. Adult participants included 78 women and 77 men in two communities. Psychosocial adjustment was measured at two points in time: at 4 months and 16 months after the disaster. Instruments used for assessing stress-related symptomatology included the Horowitz Impact of Event Scale (HIES) and the Diagnostic Interview Schedule (DIS). Major findings included: (a) levels of short-term stress symptomatology and diagnosable PTSD were substantial in both communities; (b) significant decrements in these levels occurred by 16-months postdisaster;(c) substantial gender differences (greater levels for women) were apparent in both short- and long-term PTSD response rates; and (d) patterns and levels of PTSD symptoms were different in the two communities. Findings have implications for the interpretation of PTSD within the context of family- and community-level variables.     

Citizens Coping as Soldiers: A Review of Deployment Stress Symptoms Among Reservists

The present study provides a summary of studies examining the prevalence of posttraumatic stress (PTSD) and related symptoms among reserve personnel deployed during Operations Enduring Freedom and Iraqi Freedom. The few extant studies showed that in-theater and shortly after returning from deployment, reserve and active duty personnel had similar rates of PTSD and related symptoms. Sometime after deployment, reserve personnel reported higher rates of PTSD and related symptoms than active duty personnel. A work stress model is used to develop several possible explanations of findings, having implications for practices to reduce stress symptoms among reservists and for improving research and theory of future studies examining PTSD and related symptoms among reservists.     

Ethnic Identity,Family Cohesion,and Symptoms of Post-traumatic Stress Disorder in Maltreated Youth

Post-traumatic stress disorder (PTSD) is prevalent among maltreated youth, but little empirical work exists regarding the role of ethnic identity and family cohesion as influential factors among different ethnic groups. This study included an ethnically diverse sample of adolescents affiliated with a state-administered residential facility for maltreated youth. Variables included ethnic identity and family cohesion, as well as symptoms of PTSD, depression, dissociation, and post-traumatic cognitions. The most prominent finding was that low family cohesion predicted greater PTSD symptoms, depression, dissociation, and post-traumatic cognitions. This finding was especially pronounced for multiracial youth. Results are discussed within the context of developmental pathways regarding ethnic identity development in multiracial youth.     

Suicide and War: The Mediating Effects of Negative Mood, Posttraumatic Stress Disorder Symptoms, and Social Support among Army National Guard Soldiers

The mediating effects of posttraumatic stress disorder (PTSD) symptoms, negative mood, and social support on the relationship of war experiences to suicidality were examined. The research literature suggested a sequence among study scales representing these constructs, which was then tested on survey data obtained from a sample of National Guard soldiers (N = 4,546). Results from structural equation modeling suggested that war experiences may precipitate a sequence of psychological consequences leading to suicidality. However, suicidality may be an enduring behavioral health condition. War experiences showed no direct effects on postdeployment suicidality, rather its effect was indirect through PTSD symptoms and negative mood. War experiences were, however, predictive of PTSD symptoms, as would be expected. PSTD symptoms showed no direct effect on postdeployment suicidality, but showed indirect effects through negative mood. Results also suggested that suicidality is relatively persistent, at least during deployment and postdeployment. The percentage of those at risk for suicide was low both during and after deployment, with little association between suicidality and time since returning from deployment. Additionally, few soldiers were initially nonsuicidal and then reported such symptoms at postdeployment. Implications of relationships of both negative mood and combat trauma to suicidality are discussed, as well as possible mediating effects of both personal dispositions and social support on relationships of war experiences to PTSD, negative mood, and suicidality.     

Effects of Three Sources of Social Support on Survivors' Posttraumatic Stress After the Wenchuan Earthquake

This study investigated the relationship between social support and symptoms of posttraumatic stress among adolescents who were exposed to the 2008 Wenchuan earthquake in China. The results showed that three sources of social support—support from family, support from friends, and support from significant others—have significant main effects on posttraumatic stress disorder (PTSD). Buffering effects of social support were not supported. Gender and residency were also associated with PTSD, with female adolescents and adolescents from rural areas demonstrating higher levels of PTSD than their male counterparts and adolescents from urban and township areas.     

Emotional distress and positive and negative memories from military deployment: the influence of PTSD symptoms and time

During military deployment, soldiers are confronted with both negative and positive events. What is remembered and how it affects an individual is influenced by not only the perceived emotion of the event, but also the emotional state of the individual. Here we examined the most negative and most positive deployment memories from a company of 337 soldiers who were deployed together to Afghanistan. We examined how the level of emotional distress of the soldiers and the valence of the memory were related to the emotional intensity, experience of reliving, rehearsal and coherence of the memories, and how the perceived impact of these memories changed over time. We found that soldiers with higher levels of post-traumatic stress disorder (PTSD) symptoms were more affected by both their negative and positive memories, compared with soldiers with lower levels of PTSD symptoms. Emotional intensity of the most negative memory increased over time in the group with highest levels of PTSD symptoms, but dropped in the other groups. The present study adds to the literature on emotion and autobiographical memory and how this relationship interacts with an individual’s present level of emotional distress and the passage of time.     

Buffering Effects of Benefit Finding in a War Environment

Benefit finding (BF) has been extensively examined after exposure to traumatic events. However, less research has examined BF as a buffer against the negative effects of an ongoing stressful event. Data from 1,925 U.S. Army soldiers deployed in support of Operation Iraqi Freedom (OIF) was used to examine whether BF would moderate the relationship between combat exposure and posttraumatic stress disorder (PTSD) and depression. Regression analyses revealed that BF was associated with lower levels of PTSD and depression. However, we found that BF during the combat deployment was found to moderate the combat exposure–PTSD relationship, such that the relationship was stronger when BF was low. Results are discussed in terms of BF being a form of meaning-based coping that may help soldiers adjust to the challenges of war.     

Prevalence and Correlates of Posttraumatic Stress and Postpartum Depression in Parents of Infants in the Neonatal Intensive Care Unit (NICU)

The purpose of this study was to assess the prevalence and correlates of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) in mothers and fathers, and postpartum depression (PPD) in mothers, of infants in the Neonatal Intensive Care Unit (NICU). 86 mothers and 41 fathers completed measures of ASD and of parent perception of infant medical severity 3–5 days after the infant’s NICU admission (T1), and measures of PTSD and PPD 30 days later (T2). 35% of mothers and 24% of fathers met ASD diagnostic criteria at T1, and 15% of mothers and 8% of fathers met PTSD diagnostic criteria at T2. PTSD symptom severity was correlated with concurrent stressors and family history of anxiety and depression. Rates of ASD/PTSD in parents of hospitalized infants are consistent with rates in other acute illness and injury populations, suggesting relevance of traumatic stress in characterizing parent experience during and after the NICU.     

Post-Traumatic Stress Disorder as a Consequence of a Toxic Spill in Northern California

This study examined the development of post-traumatic stress disorder (PTSD) and associated features in residents of Dunsmuir, California, following a toxic spill. Classification of PTSD was based on a cutoff score from the Impact of Event Scale. It was predicted that greater exposure to the spill would increase the risk of PTSD and associated symptoms among spill residents; that those classified with PTSD would report more symptoms than would those without PTSD and controls; and that litigants would be classified with PTSD more than would nonlitigants. Results suggest that spill residents classified with PTSD had greater levels of tension, depression, anxiety, anger, fatigue, and confusion than did spill residents without PTSD and control residents with and without PTSD. Spill residents with PTSD reported more memory problems and sleep disorders than did those without PTSD and control residents with and without PTSD. Measures of physiological arousal showed that spill residents had higher systolic blood pressure several hours after a stressful interview than did control residents without PTSD. Pulse rates several hours after a stressful interview were higher for spill residents with and without PTSD than for control residents with PTSD. Results suggest that exposed residents are at risk for developing PTSD and associated symptoms.     

Emotion Dysregulation in Comorbid Posttraumatic Stress Disorder and Substance Use Disorders: A Narrative Review

Co-occurrence of substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) is extremely common and is associated with elevated dropout and relapse rates. Given that PTSD/SUD co-occurrence rates among veterans have been found to be as high as 55?75%, it is important to identify mechanisms that may affect the interplay of both disorders. Emotion dysregulation (ED) presents a candidate mechanism that may underlie poor treatment response in co-occurring PTSD/SUD. This article proposes a transdiagnostic emotion regulation framework that considers ED conceptualized as a combination of low ability to tolerate emotional distress (low distress tolerance) and difficulties in the goal-directed use of emotion regulation strategies as a key risk factor in co-occurring PTSD/SUD. The authors review empirical findings from self-report and laboratory-based studies of ED in PTSD. They describe psychological explanations of the emotion-substance relationship and review studies documenting ED in SUDs and in co-occurring PTSD/SUD. The literature on ED in PTSD/SUD suggests that (a) patients with PTSD may resort to substances to cope with trauma-related symptoms due to ED, and (b) ED may maintain SUD symptoms and interfere with psychological treatment. Longitudinal studies on bidirectional relationships between ED and substance use in PTSD are needed, particularly research examining the course of ED in PTSD patients who use substances versus those who do not.     

Symptoms of Posttraumatic Stress Disorder and Social Support Among Children and Adolescents After the 2010 Haitian Earthquake

This study explored the prevalence of posttraumatic stress disorder (PTSD) symptoms related to social support received by the children and adolescents who survived the earthquake on January 12, 2010, in Haiti. A strategy of stratified sampling was used, and 540 children and teenagers were questioned. Questionnaires based on the PTSD Checklist, the Impact of Event Scale-Revised, and the Peritraumatic Distress Inventory, among others, were used and bivariate statistical analyses were carried out. The results showed high rates of complete and partial PTSD symptoms, with higher rates among females, and indicated the need for reinforcing social support as a resilience factor for youth.     

Complex Trauma Symptoms in Former Ugandan Child Soldiers

Children exposed to repeated interpersonal trauma often develop symptoms that exceed those documented in criteria for post-traumatic stress disorder (PTSD) and are better described with the emerging concept of developmental trauma disorder (DTD). This study examines complex trauma symptoms in a sample of 330 former Ugandan child soldiers (age 11–17 years, 49% female). Prevalence rates were 33.0% for PTSD, 36.4% for depression, and 78.2% for DTD. Whereas PTSD symptoms were significantly related to traumatic war experiences and depression, DTD symptoms were significantly associated with experiences of domestic violence, community violence, social support, and depression. Assessment tools and tailored interventions for DTD are urgently needed.     

Aftermath of Violence: Posttraumatic Stress Disorder Among Vietnam Veterans

Posttraumatic stress disorder (PTSD) frequently occurs in the aftermath of violence. A comprehensive four-phase treatment approach for Vietnam veterans with PTSD is presented. Phases in the recovery process are assessment, stabilization of symptoms, working through the trauma, and reintegration into the family and society.     

The Minnesota Multiphasic Personality Inventory-2 Restructured Form in National Guard soldiers screening positive for posttraumatic stress disorder and mild traumatic brain injury

The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2 RF) was administered to 251 National Guard soldiers who had recently returned from deployment to Iraq. Soldiers were also administered questionnaires to identify posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). On the basis of responses to the screening instruments, the National Guard soldiers who produced a valid MMPI-2 RF were classified into four groups: 21 soldiers who screened positive for PTSD only, 33 soldiers who screened positive for mTBI only, 9 soldiers who screened positive for both conditions, and 166 soldiers who did not screen positive for either condition. Results showed that the MMPI-2 RF was able to differentiate across the groups with the MMPI-2 RF specific problem scale Anxiety adding incrementally to MMPI-2 Restructured Clinical scales in predicting PTSD. Both MMPI-2 RC1 (Somatic Complaints) and MMPI-2 RF head pain complaints predicted mTBI screen but did not add incrementally to each other. Of note, all of the MMPI-2 RF validity scales associated with overreporting, including Symptom Validity-Revised (FBS-r), were not significantly elevated in the mTBI group. These findings support the use of the MMPI-2 RF in assessing PTSD in non-treatment-seeking veterans. This further suggests that a positive screen for mTBI alone is not associated with significant emotional disturbance.     

Testing the stress-buffering effects of self engagement among soldiers on a military operation

The present research examined whether self engagement moderated the stressor-strain relationship in a sample of U.S. soldiers deployed on a peacekeeping mission to Bosnia. Given that individuals were nested within groups (Army companies), we examined the relationships of interest using multilevel random coefficient models. The results of these analyses revealed that self engagement interacted with three different stressors (lower amounts of sleep, work stress, family stress) in the prediction of psychological distress. In support of self engagement as a buffer against stress, when stressors were low (high amounts of sleep, low levels of work stress, and family stress), soldiers reported relatively low levels of psychological distress and physical symptoms, regardless of whether they were engaged in or disengaged from their job. However, when stressor levels were high, soldiers who were engaged in their job reported less elevation in reports of psychological distress than soldiers who were disengaged from their job. The results are discussed in terms of the potential mechanisms by which self engagement might protect individuals from stressful circumstances.     

Posttraumatic Stress Disorder and Appetitive Aggression in Rwandan Genocide Perpetrators

The objectives of this study were to investigate rates of posttraumatic stress disorder (PTSD) and levels of appetitive aggression and potential risk factors for appetitive aggression in a sample of 200 Rwandan genocide perpetrators. Five percent of the perpetrators presented with PTSD, and high levels of appetitive aggression were common. High levels of appetitive aggression were associated with male gender, a high number of past committed offenses, and low levels of positive and elevated levels of negative religious coping. Considering the substantial extent of appetitive aggression, the reintegration of these individuals into the community should consider the inclusion of programs that restrain appetitive aggression and restore psychological functioning to facilitate a peaceful coexistence.