The Role of Natural Support Systems in the Post-deployment Adjustment of Active Duty Military Personnel

This study examined the relations among three different types of naturally occurring social support (from romantic partners, friends and neighbors, and unit leaders) and three indices of service member well‐being (self reports of depressive symptoms, satisfaction with military life, and perceptions of unit readiness) for service members who did and did not report negative experiences associated with military deployment. Data were drawn from the 2011 Community Assessment completed anonymously by more than 63,000 USAF personnel. Regression analyses revealed that higher levels of social support was associated with better outcomes regardless of negative deployment experiences. Evidence of moderation was also noted, with all forms of social support moderating the impact of negative deployment experiences on depressive symptoms and support from unit leaders moderating the impact of negative deployment experience on satisfaction with military life. No moderation was found for perceptions of unit readiness. Subgroup analyses revealed slightly different patterns for male and female service members, with support providing fewer moderation effects for women. These findings may have value for military leaders and mental health professionals working to harness the power of naturally occurring relationships to maximize the positive adjustment of service members and their families. Implications for practices related to re‐integration of post‐deployment military personnel are discussed.     

A Review of “The Transgender Child: A Handbook for Families and Professionals”

The program described in the present article focused on service member parents and their teenage children participating in camps together. The scope of the project was to provide an opportunity for military personnel who recently returned from deployment to reconnect with an adolescent after an extended absence due to deployment. The camps used the Campfire Curriculum, which included experiential learning, team-building experiences and nightly campfire programs from the Blue to You curriculum for military families. Open-ended responses from parent participants suggested that time together with their children, interacting with fellow service members and their kids, sharing stories, and opportunities for camaraderie were especially important and meaningful.     

Virtual reality goes to war: a brief review of the future of military behavioral healthcare

Numerous reports indicate that the incidence of posttraumatic stress disorder (PTSD) in returning OEF/OIF military personnel is creating a significant healthcare challenge. These findings have served to motivate research on how to better develop and disseminate evidence-based treatments for PTSD. Virtual Reality delivered exposure therapy for PTSD has been previously used with reports of positive outcomes. This article details how virtual reality applications are being designed and implemented across various points in the military deployment cycle to prevent, identify and treat combat-related PTSD in OIF/OEF Service Members and Veterans. The summarized projects in these areas have been developed at the University of Southern California Institute for Creative Technologies, a U.S. Army University Affiliated Research Center, and this paper will detail efforts to use virtual reality to deliver exposure therapy, assess PTSD and cognitive function and provide stress resilience training prior to deployment.     

Everything Here is Fine: Protective Buffering by Military Spouses During a Deployment

To minimize potential distractions for deployed military service members (SMs), some nondeployed romantic partners have reported engaging in protective buffering, or intentionally withholding information or concerns to protect their deployed partner. This study assessed the associations of protective buffering and psychological distress and marital satisfaction for military couples during and after deployment. Additionally, the study explored whether protective buffering was related to SM reports of being distracted during deployment by family matters. A total of 54 couples provided data before, during, and after an Army deployment. In multilevel models, higher protective buffering by partners was associated with higher psychological distress and lower marital satisfaction for both SMs and partners during, but not after, deployment. Additionally, partners reported frequent use of protective buffering during deployment; however, protective buffering was not significantly correlated with family related distraction for SMs during deployment. Limitations and implications of these findings are discussed.     

Deployment‐Related Benefit Finding and Postdeployment Marital Satisfaction in Military Couples

Extensive research has evaluated potential negative effects of military deployments on romantic relationships. Comparatively few studies have examined potential positive effects of such deployments. In stressful situations, benefit finding (BF) has been found to be linked with better functioning on both individual and interpersonal levels. This study reports on deployment‐related BF in a sample of 67 male service members (SMs) who deployed at least once since 9/11/2001 and their wives. Couples completed measures of marital satisfaction at baseline (an average of 1 year postdeployment) and follow‐up 4–6 months later. At follow‐up, SMs also provided data on symptoms of posttraumatic stress, and both partners provided reports of deployment‐related BF. Multivariate path analysis controlling for SMs' PTSD symptom severity revealed that wives' BF was positively associated with increases in SMs' relationship satisfaction. These findings suggest that wives' responses to deployment may be more influential than SMs' responses to deployment on military couples' relationships. This pattern indicates that support for spouses during deployments is essential; furthermore, such support should include an emphasis on trying to facilitate personal growth in spouses.     

Military Marriages: The Aftermath of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) Deployments

An examination of how members of military marriages were affected by and adapted to OIF/OEF deployment found three themes: communicating to stay connected, emotional and marital intimacy, and managing change. The findings demonstrate the nuanced and subtle nature of deployment-related challenges. While open and frequent communication was important in the adaptation process, communication was not synonymous with transparency. Unshared stories created a void that prevented couples from confiding in and supporting their partners. Although wives maintained their marriages by restraining sexual desires and over-extending their responsibilities post-deployment, these behaviors had a negative effect on marital quality. Clinical and research implications are discussed.     

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.     

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.     

A Longitudinal Study of Partners of Deployed Personnel From the Netherlands' Armed Forces

We examined the longitudinal relationships among work–family conflict, general life stress, social isolation, and psychological distress of partners of deployed military personnel. Regression analyses revealed that psychological distress experienced in early stages of deployment predicted psychological distress at later stages of deployment. After controlling for the effects of earlier psychological distress, partners who reported higher levels of work–family conflict and social isolation reported higher levels of psychological distress, particularly within that stage of the deployment cycle. Finally, we found that reports of life stress influenced psychological distress experiences before deployment but not at any other time in the deployment cycle.     

The Influence of Spirituality and Religion on Coping for Combat‐Deployed Military Personnel

A paucity of research exists examining the role of spirituality/religion (S/R) as a protective factor for combat‐deployed military personnel. The purpose of this study is to (a) define the underlying structure of items from an author‐developed instrument measuring coping, beliefs, and support; and (b) examine how S/R affiliation, activities, and practices affect coping responses for 279 combat‐deployed military personnel. Significant predictors of coping included support, age, Christian affiliation, and frequency of S/R practices. The authors found that beliefs, S/R practices prior to deployment, previous combat deployments, and first deployment were not significant predictors of coping. Implications for counselors and future research are addressed.     

Long-Term Trajectories and Service Needs for Military Families

The deployment of US military personnel to recent conflicts has been a significant stressor for their families; yet, we know relatively little about the long-term family effects of these deployments. Using data from prior military service eras, we review our current understanding of the long-term functioning and needs of military families. These data suggest that overseas deployment, exposure to combat, experiencing or participating in violence during war deployment, service member injury or disability, and combat-related post-traumatic stress disorder (PTSD) all have profound impacts on the functioning of military families. We offer several recommendations to address these impacts such as the provision of family-centered, trauma-informed resources to families of veterans with PTSD and veterans who experienced high levels of combat and war violence. Recent efforts to address the needs of caregivers of veterans should be evaluated and expanded, as necessary. We should also help military families plan for predictable life events likely to challenge their resilience and coping capacities. Future research should focus on the following: factors that mediate the relationship between PTSD, war atrocities, caregiver burden, and family dysfunction; effective family-centered interventions that can be scaled-up to meet the needs of a dispersed population; and system-level innovations necessary to ensure adequate access to these interventions.     

Moderating Effect of Marital Status on the Association Between Combat Exposure and Post-Deployment Mental Health in Canadian Military Personnel

For military personnel, there are positive and negative aspects of marriage, which may contribute to mental health during times of high stress. The present study investigated the relationship of marital status with three mental health outcomes (general mental health, posttraumatic stress disorder [PTSD], depression) among 14,624 Canadian military personnel recently deployed in support of the mission in Afghanistan. Greater combat exposure was associated with poorer postdeployment mental health, but marital status was, on its own, only slightly associated with PTSD. Marital status significantly moderated the relationship between combat exposure and mental health: For both single and married participants, mental health declined as combat exposure increased, but this association was stronger for married members. This association could be due to the additional familial demands that married personnel may face upon their return from deployment or to the stresses associated with poor marital satisfaction. Overall, results suggest that the relationship between marital status and mental health after deployment is complex and may vary according to other factors.     

A Psychological Support for Peacekeeping Soldiers and their Families: A Preliminary Model

Being a military family can be challenging, and the demands placed on soldiers and their families can become very complex. Military deployments are part of a soldier's military career that cannot be avoided and have the potential to influence military families directly. Separation within a military family is an inherent consequence of military deployments. Military deployments consist of various phases. Each phase has unique emotional and psychological challenges attached to it. These challenges can significantly influence every member in the military family. It is therefore imperative that the military, soldier and military families be sensitized around these phases and their unique challenges. A model is proposed to empower military families in the face of deployment.     

Associations of Stress Exposures and Social Support With Long-Term Mental Health Outcomes Among U.S. Iraq War Veterans

The long-term mental health effects of war-zone deployment in the Iraq and Afghanistan wars on military personnel are a significant public health concern. Using data collected prospectively at three distinct assessments during 2003–2014 as part of the Neurocognition Deployment Health Study and VA Cooperative Studies Program Study #566, we explored how stress exposures prior, during, and after return from deployment influence the long-term mental health outcomes of posttraumatic stress disorder (PTSD), depression, anxiety disorders, and problem drinking. Longer-term mental health outcomes were assessed in 375 service members and military veterans an average of 7.5 years (standard deviation = 1.0 year) after the initial (i.e., “index”) Iraq deployment following their predeployment assessment. Anxiety disorder was the most commonly observed long-term mental health outcome (36.0%), followed by depression (24.5%), PTSD (24.3%), and problem drinking (21.0%). Multivariable regression models showed that greater postdeployment stressors, as measured by the Post-Deployment Life Events scale, were associated with greater risk of depression, anxiety disorders, and problem drinking. Anxiety disorder was the only outcome affected by predeployment stress concerns. In addition, greater postdeployment social support was associated with lower risk of all outcomes except problem drinking. These findings highlight the importance of assessing postdeployment stress exposures, such as stressful or traumatic life events, given the potential impact of these stressors on long-term mental health outcomes. This study also highlights the importance of postdeployment social support as a modifiable protective factor that can be used to help mitigate risk of long-term adverse mental health outcomes following war-zone exposure.     

Military children and families: strengths and challenges during peace and war

Throughout history, military children and families have shown great capacity for adaptation and resilience. However, in recent years, unprecedented lengthy and multiple combat deployments of service members have posed multiple challenges for U.S. military children and families. Despite needs to better understand the impact of deployment on military children and families and to provide proper support for them, rigorous research is lacking. Programs exist that are intended to help, but their effectiveness is largely unknown. They need to be better coordinated and delivered at the level of individuals, families, and communities. Research and programs need to take a comprehensive approach that is strengths based and problem focused. Programs for military children and families often focus on the prevention or reduction of problems. It is just as important to recognize their assets and to promote them. This article reviews existing research on military children and families, with attention to their strengths as well as their challenges. Issues in need of further research are identified, especially research into programs that assist military children and families. Military children and families deserve greater attention from psychology.     

The Army National Guard in OIF/OEF: Relationships among combat exposure,postdeployment stressors,social support,and risk behaviors

With the continued operations in Iraq and Afghanistan, studies of the prevalence of posttraumatic stress disorder and related symptoms are now common. However, lacking is how these symptoms relate to precipitating conditions and the mitigating effects of social support on these symptoms. This is particularly relevant for reserve military personnel, who have been shown to be greater at-risk for postdeployment problems. The present study examined questionnaire data obtained from Army National Guard (ARNG) units immediately after their return from deployment to Iraq and Afghanistan during 2010 (N = 4329 soldiers in 50 units). Findings showed few soldiers displayed risk behaviors (i.e., daily alcohol use, use of illicit drugs, suicide thoughts, and physically threatening others) during and after deployment. Those most likely to have more postdeployment risk behaviors were also those who showed more risk behaviors during deployment. A substantial percentage of soldiers reported combat exposure, postdeployment negative emotions, and postdeployment loss of a personal relationship. These reported outcomes were all related to increased risk behaviors after deployment. The buffering effect of social support on postdeployment risk behaviors was equally evident when data were examined individually and when grouped by unit memberships. Implications of findings for future research, practice, and policies are discussed.     

National Guard Couples Communicating During Deployment: The Challenge of Effective Connection

Communication during a combat deployment has changed significantly in current times. Couples can now communicate with each other frequently and through multiple modes. Despite this greater availability of communication options, there remain unanswered questions related to how healthy deployment communication is best achieved between couples, particularly regarding navigating the uncertainty of deployment. In this qualitative study, we report on the experiences of 31 National Guard couples who endured a combat deployment in support of Operation Enduring Freedom. Couples were interviewed three months after the soldier returned from deployment. Through the lens of relational turbulence theory, we provide a conceptual framework related to effective and non-effective deployment communication, along with structural communication barriers in the military that may negatively affect the mental well-being of partners. Finally, we provide recommendations to guide couples through these difficult deployments.

     

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.     

The psychosocial impact of caregiving in dementia and quality of life: a systematic review and meta-synthesis of qualitative research

ABSTRACT

Objective: A systematic meta-synthesis of qualitative studies was conducted to interpret and synthesise findings from studies investigating the experiences, quality of life, and psychosocial impact of caregiving on adult informal caregivers of people with dementia.

Design: The meta-synthesis was conducted according to the principles of meta-ethnography.

Results: Fourteen studies describing the experiences of 265 informal caregivers were reviewed. The meta-synthesis elicited the following themes: (1) understanding and making sense of the dementia diagnosis, changing symptoms, and the caregiver role; (2) coping strategies, psychological facilitators and rewards of caregiver role; (3) challenges of caring for a person with dementia and their behaviour; (4) caregivers' relationships with care-recipient and other informal caregivers; and (5) caregivers’ experiences of formal support services and material resources.

Conclusion: Our findings highlight the need for a person-centred approach to care planning that also accounts for the needs of the informal caregiver to promote better caregiver well-being and quality of life. Caregivers’ emotional support, coping, resilience, need for information and respite care and adjustment to caregiver identity should be reviewed as part of the care package for the person with dementia.     

The impact of individual trauma symptoms of deployed soldiers on relationship satisfaction.

Research traditionally has focused on the development of individual symptoms in those who experienced trauma directly but has overlooked the interpersonal impact of trauma. The current study reports data from 45 male Army soldiers who recently returned from a military deployment to Iraq (Operation Iraqi Freedom) or Afghanistan (Operation Enduring Freedom) and their female spouses/partners. The results indicated that increased trauma symptoms, particularly sleep problems, dissociation, and severe sexual problems, in the soldiers significantly predicted lower marital/relationship satisfaction for both soldiers and their female partners. The results suggest that individual trauma symptoms negatively impact relationship satisfaction in military couples in which the husband has been exposed to war trauma.