Publication year
2017
Citation Title
PTSD as a moderator of a parenting intervention for military families.
Journal Name
Journal of Family Psychology
DOI
10.1037/fam0000366
Summary
Posttraumatic stress disorder (PTSD) can be a concern for Service members and their families. This study considered the impact of PTSD on the effectiveness of a 14-week parenting intervention for Service members and their spouses. Parenting behaviors measured included problem-solving, encouragement, monitoring, positive involvement, and harsh discipline. Findings indicate that the parenting intervention was more effective for some parents than others.
Key Findings
Parents who received the parenting intervention exhibited improved overall parenting behaviors six months after the end of the intervention compared to the control group.
Mothers both with and without PTSD who received the intervention improved at similar rates; however, fathers without PTSD benefitted more from the intervention than did fathers with PTSD.
Fathers with PTSD used more harsh discipline than fathers without PTSD. Mothers had reduced monitoring when they had PTSD and also when only their spouses had PTSD.
Families with more effective parenting had higher household income, were more likely to be in dual-parent households, and had children who were older and with fewer behavioral symptoms.
Implications for Program Leaders
Provide education to Service members and their families regarding the possible impacts of PTSD on parenting, especially for fathers
Offer workshops to Service members and their spouses for practicing mindfulness, which can help improve parents' ability to regulate emotions
Combine parenting classes with pre-existing services for Service members managing PTSD
Implications for Policy Makers
Encourage the development and continuation of programs that can promote positive parenting practices in Service members who are parents
Encourage further research on the inclusion of parent mindfulness training in existing family readiness programs
Recommend education of professionals who work with Service members regarding the possible complications of PTSD with parenting behaviors, particularly for fathers
Methods
Recruitment occurred through military organizations, the Veteran's Administration, media, and word of mouth. Eligible families had at least one child 4-12 years old and at least one parent who had deployed to OIF/OEF/OND.
Participants were assessed at baseline and then randomly assigned to either the parenting intervention (ADAPT) or a control group. They were then assessed again 12 months later (6 months after completion of the intervention).
Parent-child interactions were videotaped and reviewed by coders to determine parenting behaviors.
Participants
There were 336 military families included in the study, including 314 mothers (M = 36 years old), 294 fathers (M = 38 years old), and 336 children (53% female, M = 8 years old); 272 families included both parents.
Ninety-five percent of fathers had deployed, 18% of mothers had deployed, and in 13% of families both parents deployed. No military branch or rank information was provided.
Most (84%) of the families were married with two parents, 16% were single parents, 8% were divorced, 4% were separated, the rest were never married or widowed. Most families' income was $40,000-$120,000.
Eighty-eight percent of fathers, 93% of mothers, and 86% of children identified as White. Race/ethnicity was not reported for the remaining parents, but for children, 5% were multiracial, 2% or less each were Black, Asian American, Native American, or Native Hawaiian/Pacific Islander; 10% did not answer.
Limitations
Some types of families dropped out at a higher rate than others which may have biased the data and reduced the validity of the study.
The researchers did not specify what aspects of parenting were improved or not improved in the different study groups, limiting its practical applicability.
Few families had only the mother deployed, which limits generalizability for Service members who are mothers.
No branch or rank information was given regarding the participants, so it is unclear how representative the participants were regarding that aspect of the military.
Avenues for Future Research
Provide and consider military information such as rank, branch, and amount of time in the military
Repeat the study specifically recruiting mothers who have deployed
Consider the effect of the intervention when paired with services for PTSD for Service members who meet criteria
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
The stress of multiple deployments and exposure to combat places service members at risk for posttraumatic stress disorder (PTSD), which may detrimentally affect parenting. Evidence-based parenting programs have been successful in promoting adaptive parenting practices among families exposed to stress. However, the effects of preventive interventions on parenting may vary by military parent’s PTSD. The current study includes families who participated in a randomized controlled trial of a parenting intervention for military families known as After Deployment, Adaptive Parenting Tools (ADAPT). Families were randomized to either a 14-week, group-based parenting program or a comparison group. Participants included families with 4- to 12-year-old children in which at least 1 parent deployed to Iraq or Afghanistan (N 336; 945 individuals). Structural equation modeling was used to examine parent self-reported PTSD as a potential moderator of the relationship between intent-to-treat status and effective parenting practices 12 months postbaseline while accounting for baseline effective parenting, length and number of deployments, and family demographics. Father PTSD was a significant moderator, such that the intervention was less effective for fathers who met clinical levels of PTSD. No significant moderation effects were found among mothers. These findings may have important implications for the development of future evidence-based parenting programs.
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