Publication year
2007
Citation Title
Psychological distress and burden among female partners of combat veterans with PTSD
Journal Name
The Journal of Nervous and Mental Disease
Journal Volume
195
Issue Number
2
Page Numbers
144-151
DOI
10.1097/01.nmd.0000254755.53549
Summary
Caring for a loved one with posttraumatic stress disorder (PTSD) can be stressful and a large burden on caretakers. Relationships between Veteran PTSD symptoms and partner perceived threat, mental health, treatment involvement, burden, and distress were examined in partners of Veterans receiving outpatient Veterans Affairs (VA) PTSD treatment. Partners reported very high levels of distress and burden, especially those with lower self-efficacy and partnered with Veterans with high PTSD symptoms.
Key Findings
Partners of Veterans with PTSD reported high levels of distress, and rated anxiety, depression, somatic symptoms, and overall psychological distress as high as or higher than 90% of people.
Many partners reported suicidal ideation (15%) and felt physically threatened by their Veterans (60%).
Partners who were less involved in Veteran treatment and who perceived more emotional, physical, or relationship threat had the highest levels of psychological distress.
The largest caretaker burden was felt by partners with low self-efficacy, high Veteran treatment involvement, high perceived threat, and high PTSD symptom severity of their Veteran.
Implications for Program Leaders
Educate Service members about healthy communication techniques and mental health resources in order to prevent physical harm or abuse toward partners
Offer workshops that teach self-care skills for military partners
Provide support groups for military partners caring for Service members with PTSD
Implications for Policy Makers
Encourage the incorporation of partners into the planning of Veteran mental health care
Continue to support programs that provide education, resources, and social support for caretaker partners of Service members with PTSD
Recommend education about the stressors and burdens of Service members’ partners and caretakers for professionals working with military families
Methods
Veterans and their partners were recruited from two VA outpatient PTSD treatment groups via information sheets provided at a clinic visit, with 89% agreeing to participate.
Veterans completed a PTSD symptom measure; partners completed questionnaires about involvement in treatment and their own and their Veteran’s mental health and distress.
Relationships between partner psychological distress, Veteran symptoms and severity, partner perceived threat to self, partner treatment involvement, and partner burden were examined.
Participants
Participants included 89 cohabitating female partners (M = 52, SD = 5.8) of Veterans with PTSD.
Partners were primarily White (51%) and married (92%).
A significant minority of partners had received mental health treatment in the past six months (28%).
Limitations
Without measures of Veteran and partner distress, adjustment, or mental health symptoms prior to the development of Veterans’ PTSD, the direction of effects cannot be inferred.
Because all Veterans were male and attending treatment, results may not generalize to other populations of Veterans with PTSD.
Veterans and partners who agreed to participate may have differed from those who did not participate, including differences in PTSD severity or partner distress and burden.
Avenues for Future Research
Examine whether programs that reduce partner burden or increase self-efficacy result in more positive outcomes (e.g., symptom reduction, relationship satisfaction) for Service members
Explore whether including Service members’ partners or other family members in mental health treatment planning improves partner burden, treatment adherence, or symptom reduction
Compare partner burden and distress between partners of Active Duty and Veteran Service members with PTSD
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Psychological distress among cohabitating female partners of combat Veterans with posttraumatic stress disorder (PTSD) was examined in a cross-sectional study using a modified version of the Health Belief Model. A convenience sample of 89 cohabitating female partners of male Veterans in outpatient PTSD treatment was interviewed by telephone using a structured interview. Partners endorsed high levels of psychological distress with elevations on clinical scales at or exceeding the 90th percentile. Severe levels of overall psychological distress, depression, and suicidal ideation were prevalent among partners. Multivariate analyses revealed that perceived threat, recent mental health treatment, and level of involvement with Veterans predicted global partner psychological distress. Partner burden was predicted by partner self-efficacy, perceived threat, barriers to mental health treatment, and partner treatment engagement. These findings are compelling since they demonstrate that partners of Veterans with combat-related PTSD experience significant levels of emotional distress that warrant clinical attention. Psychological distress and partner burden were each associated with a unique combination of predictors, suggesting that although these constructs are related, they have distinct correlates and potentially different implications within the family environment. Future research should examine these constructs separately using causal modeling analyses to identify modifiable targets for interventions to reduce psychological distress among partners of individuals with PTSD.
Abstract Document
Attach