Publication year
2009
Citation Title
Family problems among recently returned military veterans referred for a mental health evaluation.
Journal Name
Journal of Clinical Psychiatry
Journal Volume
70
Issue Number
2
Page Numbers
163-170
DOI
10.4088/JCP.07m03863
Summary
Recent research suggests that psychiatric distress and combat trauma may result in poorer family functioning for Service members. Interviews with recently returned Veterans from Iraq and Afghanistan were used to assess the association between psychiatric distress and family reintegration problems post-deployment. Results indicate that psychiatric distress, particularly depression and anxiety, influence family reintegration for returning Service members.
Key Findings
Veterans with more depressive and posttraumatic distress symptoms were more likely to report feeling like a visitor in their home (40%) or that their children are afraid of them and act distant toward them (25%).
Over 50% of Veterans reported mild to moderate domestic violence at home and 4.4% acknowledged that there has been an injury to their partner or the Veteran at least once.
Roughly 75% of Veterans reported some type of family conflict in the past week, over 50% reported marital discord, and approximately 66% reported that family conflict occurs on a weekly basis.
Family problems were more prevalent among Veterans with scores indicating provisional diagnoses for depression and anxiety.
Implications for Program Leaders
Offer post-deployment support groups for Service members and their families focused on reintegrating the Service member into family life
Engage Service members and their partners in classes working to decrease domestic violence and teach emotional regulation skills
Tailor support groups and workshops to families with a Service members experiencing psychiatric symptoms, particularly depression and anxiety
Implications for Policy Makers
Promote the development of preventative programs to help Service members and their families with family reintegration post-deployment
Continue to support programs that help prevent domestic violence and that provide help to Service members with psychiatric symptoms
Promote the development of education programs for Service members post-deployment regarding psychiatric symptoms and family reintegration
Methods
Primary care physicians located at the Philadelphia Veterans Affairs Medical Center referred Veterans who received a behavioral health evaluation.
Surveys were administered via telephone and assessed depressive symptoms, alcohol misuse, anxiety, posttraumatic stress disorder, panic disorder, psychosis, and mania.
Participants were also assessed regarding family difficulties post-deployment using family readjustment and domestic abuse measures.
Statistical analyses examined associations between depressive and posttraumatic depressive disorder symptoms and family adjustment problems.
Participants
Participants were Veterans who served in Iraq or Afghanistan after 2001 (n=199).
The Veteran sample included men and women, 89.5% and 10.5% respectively, and had an average age of 32.7 years old.
The sample was 53.3% White, 32.2% Black, 22% Multiracial, and 4% Asian American.
Limitations
This study used a clinically referred sample of Veterans, and therefore may not be relevant to the general population of Veterans post deployment.
Due to the cross-sectional research method, the direction of effects between psychiatric symptoms and family problems cannot be determined.
All data were gathered via self-report of the Veteran and did not include partners or former partners, even when assessing for domestic violence, which can increase chances of self-report bias.
Avenues for Future Research
Include Veterans who are not clinically referred in efforts to generalize the results to the overall population of Veterans reintegrating into family life after deployment
Conduct a longitudinal study to better understand the direction of effects between psychiatric distress and family problems
Gather data from partners and other family members in order to decrease self-report bias regarding psychiatric distress and domestic violence
Focus
Multiple Branches
Target Population
Population Focus
Abstract
Existing evidence suggests that military veterans with mental health disorders have poorer family functioning, although little research has focused on this topic. OBJECTIVE: To test whether psychiatric symptoms are associated with family reintegration problems in recently returned military veterans. DESIGN: Cross-sectional survey of a clinical population. Respondents who were referred to behavioral health evaluation from April 2006 through August 2007 were considered for the survey. SETTING: Philadelphia Veterans Affairs Medical Center, Pa. PARTICIPANTS: 199 military veterans who served in Iraq or Afghanistan after 2001 and were referred for behavioral health evaluation from primary care (mean age = 32.7 years, SD = 9.1). MAIN OUTCOME MEASURES: Measures included the Mini-International Neuropsychiatric Interview for psychiatric diagnoses, the 9-item Patient Health Questionnaire for depression diagnosis and severity, and screening measures of alcohol abuse and illicit substance use. A measure of military family readjustment problems and a screening measure of domestic abuse were developed for this study. RESULTS: Three fourths of the married/cohabiting veterans reported some type of family problem in the past week, such as feeling like a guest in their household (40.7%), reporting their children acting afraid or not being warm toward them (25.0%), or being unsure about their family role (37.2%). Among veterans with current or recently separated partners, 53.7% reported conflicts involving "shouting, pushing, or shoving," and 27.6% reported that this partner was "afraid of them." Depression and posttraumatic stress disorder symptoms were both associated with higher rates of family reintegration problems. CONCLUSIONS: Mental health problems may complicate veterans' readjustment and reintegration into family life. The findings suggest an opportunity to improve the treatment of psychiatric disorders by addressing family problems.
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