Posttraumatic Stress Disorder and Current Relationship Functioning Among World War II Ex-Prisoners of War

Authors
Cook, J. M. Riggs, D. S. Thompson, R. Coyne, J. C. Sheikh, J. I.
Publication year
2004
Citation Title
Posttraumatic stress disorder and current relationship functioning among World War II ex-prisoners of war.
Journal Name
Journal of Family Psychology
Journal Volume
18
Issue Number
1
Page Numbers
36-45
DOI
10.1037/0893-3200.18.1.36
Summary
World War II (WWII) ex-Prisoners of War (POW) living in California participated in this study examining the association of posttraumatic stress disorder (PTSD) with the quality of intimate relationships. Marital functioning was within a range expected for persons without traumatic exposure, however, ex-POWS with PTSD reported poorer adjustment and communication with their partners and more difficulties with intimacy compared to those without PTSD.
Key Findings
This sample of WWII ex-POWs had a level of relationship satisfaction comparable to the general population.
WWII ex-POWs with PTSD were three times more likely to score in the maritally distressed range than those without PTSD, experienced more problems on every measure of intimate relationship functioning, and yet the mean relationship quality scores of those with PTSD were in the non-distressed range.
Emotional numbing PTSD symptoms had a unique, independent deleterious effect on relationship functioning.
Implications for Program Leaders
Consider outreach efforts to Service members and their spouses who may be experiencing psychological distress or relationship difficulties
Design activities specifically to meet the needs and challenges of older Service members and their partners
Educate couples who have a history of trauma before deployment on positive coping skills
Implications for Policy Makers
Encourage the development and continuation of programs that can promote resilience in Service members, their partners, and children
Continue to support programs for identification and prevention of domestic violence in military families
Recommend training for community providers to educate them about unique factors that contribute to marital strain for military couples
Methods
Members of the American Ex-Prisoner of War Association who were currently living in California were sent an initial survey in the mail; responders with a spouse or domestic partner were sent a follow-up survey.
The initial survey included questions about demographics, military experience, physical well-being, use of mental health care, severity of POW trauma and PTSD symptoms; the follow-up survey included assessments of psychological distress, PTSD symptoms, and relationship quality.
Only WWII ex-POWs living with partners who had completed both surveys’ data were included in the outcome analyses, but sample characteristics were reported for the entire sample.
Statistical analyses were used to compare average level of relationship satisfaction, examine the contribution of PTSD symptom clusters to difficulties in relationships, and explore the relationships between scales.
Participants
Three hundred thirty-one WWII partnered military ex-POWs constitute the outcome sample (100% male); 545 WWII ex-POWs constituted the demographic sample (100% male).
Of the 545 WWII ex-POWs, average age was 80 years (SD = 3.30), the sample was 86% White, 46% Army, 42% Air Force, 8% Navy, 4% Marines, 68% had more than high school education, 74% were married or partnered, 16% were widowed, 7% were divorced/separated, and average number of children was 2.80 (SD = 2.00).
Fifty-eight percent were held captive in the European Theater, the remainder were in the Pacific Theater. The average length of internment was 21 months (SD = 16.40).
Limitations
It is unknown how the sample differed how the sample differed from other WWII ex-POWs.
The results may be biased by increased mortality of those with PTSD or decreased likelihood of belonging to the organization.
All data were self-reported and may be subject to recall and/or social desirability biases.
Avenues for Future Research
Include partners’ perspectives about relationship functioning in subsequent studies
Evaluate the most effective interventions used in this population, focusing on couples’ interventions
Conduct studies that compare relationship satisfaction among Service members and their spouses over time, especially as mental health symptoms fluctuate
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 the association of posttraumatic stress disorder (PTSD) with the quality of intimate relationships among present-day male World War II ex-prisoners of war (POWs). Ex-POWs had considerable marital stability; those with PTSD were no less likely to be in an intimate relationship. Ex-POWs in an intimate relationship who had PTSD (N=125 ) were compared with ex-POWs in a relationship who did not have PTSD (N=206). Marital functioning was within a range expected for persons without traumatic exposure. Yet, over 30% of those with PTSD reported relationship problems compared with only 11% of those without PTSD. Ex-POWs with PTSD reported poorer adjustment and communication with their partners and more difficulties with intimacy. Emotional numbing was significantly associated with relationship difficulties independent of other symptom complexes and severity of PTSD. Implications for clinical practice are discussed.
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