Combat Exposure, Mental Health, and Relationship Functioning Among Women Veterans of the Afghanistan and Iraq Wars

Authors
Creech, S. K. Swift, R. Zlotnick, C. Taft, C. Street, A. E.
Publication year
2016
Citation Title
Combat exposure, mental health, and relationship functioning among women veterans of the Afghanistan and Iraq wars.
Journal Name
Journal of Family Psychology
Journal Volume
30
Issue Number
1
Page Numbers
43-51
DOI
10.1037/fam0000145
Summary
As women continue to represent a fast-growing segment of the present military and Veteran population, more research regarding their combat exposure is needed. This study examined the impacts of combat exposure, posttraumatic stress disorder (PTSD) symptoms, and alcohol misuse on family, intimate relationship, and parenting functioning of female OEF/OIF/OND Veterans.


Key Findings
Combat exposure had a direct, positive relationship with both PTSD symptoms and alcohol misuse.
Combat exposure did not have a direct relationship with family functioning; however PTSD symptoms did have a direct, negative relationship with family functioning and intimate relationship satisfaction.
Parenting confidence and satisfaction did not have a relationship with combat exposure, PTSD, or alcohol misuse, although the authors note to interpret this finding with caution due to the small subsample of respondents who were parents.
Implications for Program Leaders
Increase the level of relationship- or family-focused programming for Service members and families
Provide a parenting toolkit or resources for female Service members who return from deployment
Host mother-child social gatherings for Service members and families to nurture parental and social bonds
Implications for Policy Makers
Continue to support the professional development of professionals working with female Service members or Service members exhibiting symptoms of PTSD or alcohol misuse
Recommend regular family participation in community programs for Service members
Support programs that focus on deployed mothers and ease their transition into reintegration
Methods
A random selection of 600 female Veterans of OEF/OIF/OND were sent study information with 134 women returning at least a partial survey for a response rate of 27%.
The survey included questions for measures such as: combat exposure, PTSD symptoms, alcohol misuse, post-deployment stress exposure, family functioning and, for applicable participants, intimate relationship satisfaction and parenting confidence and satisfaction.
Analysis was conducted to explore any relationships between PTSD symptoms and alcohol misuse along with combat exposure and the family, intimate relationship, and parenting variables.
Participants
Participants’ average age was 37.11 (SD = 8.74), years of education was 16.10 (SD = 2.87), years of Active Duty service was 5.69 (SD = 5.31), and years of Guard or Reserve service was 7.33 (SD = 7.61).
The vast majority of participants (81%) were White, while 9% were Black, 4% Other, 2% Native American, 2% Asian-American and 2% Multiracial.
Most (78%) were currently in a romantic relationship, 40% had children living with them, and 28% had a child under 18 years old during last deployment.
Nearly half (49%) were Army Veterans, 31% Air Force, 19% Navy, and less than 1% Coast Guard; over half (52%) had one deployment; and the median number of years since returning from deployment was 7 years.
Limitations
The sample was fairly small, racially and geographically homogeneous, and represented a low response rate, making the findings hard to generalize, especially as the subsample of female Veterans who were parents was quite small.
There were some measures that were analyzed separatelyÑfamily and relationship functioningÑbut could be linked in the minds of respondents, which could lead to unclear findings.
The study analyzed data from one time point, which does not allow for any clear insight into causality.
Avenues for Future Research
Expand the study to reach more participants in order to increase racial and geographic diversity
Use a longitudinal approach to see how these associations change over time
Incorporate family surveys to gain an understanding of how the family unit perceives functioning in the Service member post-deployment
Design Rating
2 Stars - There are some flaws in the study design or research sample, but those flaws do not significantly threaten the ability to make conclusions based on the data.
Methods Rating
2 Stars - There are no significant biases or deficits in the way the variables in the study are defined or measures and conclusions are appropriately drawn from the analyses performed.
Limitations Rating
2 Stars - There are a few factors that limit the ability to extend the results to an entire population, but the results can be extended to most of the population.
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
This study examined associations between warzone exposures to combat with postdeployment relationship and family functioning in 134 women who deployed to the conflicts in Afghanistan and Iraq. Survey invitations were sent by mail to 600 randomly selected women who experienced recent military deployments and were residing in New England. The web-based survey included measures of combat exposure, posttraumatic stress disorder (PTSD) symptoms, alcohol misuse, postdeployment stress exposure, family functioning, intimate relationship satisfaction, and parenting. Multivariate linear regression with bootstrapping estimates of indirect effects was used to examine whether PTSD symptoms and alcohol misuse accounted for associations between women’s combat exposure and their postdeployment relationship and family functioning. Results indicated that women’s PTSD symptoms had a direct and negative effect on postdeployment family functioning and on intimate relationship satisfaction. There was no direct association between combat exposure or alcohol misuse with any of the family or relationship functioning variables, however, the indirect association from combat to postdeployment family functioning (b = ?.13, SE = 0.07, 95% confidence interval [CI]: ?33, ?.03) and intimate relationship satisfaction (b = ?.25, SE = 0.18, 95% CI: ?.79, ?.001) was significant and negative through its association with PTSD symptoms. Parenting satisfaction was significantly and negatively associated with postdeployment stress only. This study is among the first to characterize the impact of deployment experiences on women veterans’ relationship and family functioning. Findings suggest that women veterans who have been exposed to combat and who have higher levels of PTSD symptoms may benefit from relationship and family focused services after deployment
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