Multiple Deployments and Combat Trauma: Do Homefront Stressors Increase the Risk for Posttraumatic Stress Symptoms?

Authors
Interian, A. Kline, A. Janal, M. Glynn, S. Losonczy, M.
Publication year
2014
Citation Title
Multiple deployments and combat trauma: Do homefront stressors increase the risk for posttraumatic stress symptoms?
Journal Name
Journal of Traumatic Stress
Journal Volume
27
Issue Number
1
Page Numbers
90-97
DOI
10.1002/jts.21885
Summary
This study examined the role of homefront stressors (such as family or occupational problems) in postraumatic stress disorder (PTSD) symptoms prior to and after a new Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) deployment for 196 U.S. National Guard Soldiers. A pattern of chronic homefront stressors both pre- and post-deployment was associated with a higher risk of post-deployment PTSD symptoms.
Key Findings
Homefront stressors included marital problems, divorce/marital separation, problems with children, loss of job or business, and serious financial problems. Homefront stressors prior to the new deployment (Time 1) and post-deployment stressors (Time 2) predicted post- deployment PTSD symptoms.
When examined together, pre-deployment homefront stressors no longer significantly predicted post-deployment PTSD symptoms.
Soldiers with both pre- and post-deployment homefront stressors showed the greatest risk of PTSD.
Implications for Program Leaders
Develop services to address both pre- and post-deployment homefront stressors
Host classes for Service members and their families that teach coping skills related to relationship functioning, parenting, financial well-being and occupational functioning
Offer workshops during reintegration to help families and Service members adjust to the Service member’s return, especially when the deployment has included combat exposure
Implications for Policy Makers
Continue to support programs that help military families address homefront stressors and increase family readiness
Continue to support programs that address the unique challenges faced by deployed Service members and their families
Recommend partnerships among military-based and community-based programs to help military families feel more comfortable participating in services and accessing resources that are not on installations
Methods
National Guard Soldiers filled out surveys prior to (Time 1) and after (Time 2) a 2008-2009 OEF/OIF deployment; only those who completed both surveys and experienced a deployment between Time 1 and Time 2 were included in these analyses.
Measures of post traumatic stress symptoms, homefront stressors, previous (to Time 1) noncombat trauma, warzone stressors, unit cohesion (at Time 2), and military preparedness (at Time 1) were assessed.
Statistical analyses examined relationships between demographic and military characteristics with Time 2 PTSD symptoms and Time 1 and Time 2 homefront stressors, to explore how sample characteristics and homefront stressors explained Time 2 PTSD symptoms.
Participants
Participants included 196 National Guard Soldiers who had previously deployed for OEF/OIF and were preparing for a new deployment in 2008-2009.
The sample was predominately male (86%) and 57% were ages 26-35 years, while 31% were 40 years old and older. Almost half of the sample was married (47%) and 38% were never married; 53% had no children.
Among the sample, 42% were White, 26% were Black, and 24% were Latino/Latina.
Ninety-one percent of the participants had one previous OEF/OIF deployment, while 10% had more than one previous OEF/OIF deployment.
Limitations
The sample consists only of National Guard Service members and findings may not generalize to other military branches.
Attrition and lack of matching between Time 1 and Time 2 surveys could have biased the results.
The time frame after deployments previous to Time 1 was inconsistent with some occurring four years prior.
Only self-report measures of PTSD symptoms were used instead of a more rigorous clinical interview.
Avenues for Future Research
Conduct longitudinal studies focusing on the post-deployment period and homefront stressors may help assess the bidirectionality of homefront stress and PTSD symptoms
Replicate these findings with Active Duty Service members from multiple service branches
Gather data from military families to better understand their experiences during deployment and reintegration
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 Branch
Military Component
Abstract
Multiple deployments are common among military personnel who served in Operation Enduring Freedom and Operation Iraqi Freedom and are associated with greater posttraumatic stress symptoms (PTSS). Homefront stressors (i.e., family, occupational problems) resulting from deployments may increase the risk of PTSS. Moreover, with multiple deployments, a new deployment may occur while still experiencing homefront stressors from previous tours. This prospective study assessed whether homefront stressors from a previous tour increased the risk of PTSS after a new deployment. It also examined the effects of homefront stressors at postdeployment. Survey data were obtained from U.S. National Guard soldiers with previous deployments prior to (Wave 1) and after (Wave 2) a new deployment to Iraq (N = 196). Homefront stressors reported at Wave 1 (? = .154, p = .015) and Wave 2 (? = .214, p = .002) were both significantly predictive of PTSS at postdeployment, even after adjusting for warzone stressors, predeployment PTSS, and other variables. A pattern of chronic homefront stressors (i.e., homefront stressors at pre- and postdeployment) was associated with higher levels of PTSS at postdeployment (? = .220, p = .002). Service members with multiple deployments are at greater risk for PTSS if deployed with homefront stressors from previous tours and/or face these stressors at postdeployment.
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