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Risk and Resilience Factors in Families Under Ongoing Terror Along the Life Cycle. CONTEMPORARY FAMILY THERAPY 2015. [DOI: 10.1007/s10591-015-9356-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Hobfoll SE, Stevens NR, Zalta AK. Expanding the Science of Resilience: Conserving Resources in the Aid of Adaptation. PSYCHOLOGICAL INQUIRY 2015; 26:174-180. [PMID: 27069335 PMCID: PMC4826077 DOI: 10.1080/1047840x.2015.1002377] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Stevan E Hobfoll
- Department of Behavioral Sciences, Rush University Medical Center
| | | | - Alyson K Zalta
- Department of Behavioral Sciences, Rush University Medical Center; Department of Psychiatry, Rush University Medical Center
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53
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Mogil C, Hajal N, Garcia E, Kiff C, Paley B, Milburn N, Lester P. FOCUS for Early Childhood: A Virtual Home Visiting Program for Military Families with Young Children. CONTEMPORARY FAMILY THERAPY 2015; 37:199-208. [PMID: 26543320 DOI: 10.1007/s10591-015-9327-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Catherine Mogil
- UCLA Semel Institute for Neuroscience and Human Behavior, Nathanson Family Resilience Center, 760 Westwood Plaza, Room A8-153, Los Angeles, CA 90095
| | - Nastassia Hajal
- UCLA Semel Institute for Neuroscience and Human Behavior, Nathanson Family Resilience Center, 760 Westwood Plaza, Room A8-153, Los Angeles, CA 90095
| | - Ediza Garcia
- UCLA Semel Institute for Neuroscience and Human Behavior, Nathanson Family Resilience Center, 760 Westwood Plaza, Room A8-153, Los Angeles, CA 90095
| | - Cara Kiff
- UCLA Semel Institute for Neuroscience and Human Behavior, Nathanson Family Resilience Center, 760 Westwood Plaza, Room A8-153, Los Angeles, CA 90095
| | - Blair Paley
- UCLA Semel Institute for Neuroscience and Human Behavior, Nathanson Family Resilience Center, 760 Westwood Plaza, Room A8-153, Los Angeles, CA 90095
| | - Norweeta Milburn
- UCLA Semel Institute for Neuroscience and Human Behavior, Nathanson Family Resilience Center, 760 Westwood Plaza, Room A8-153, Los Angeles, CA 90095
| | - Patricia Lester
- UCLA Semel Institute for Neuroscience and Human Behavior, Nathanson Family Resilience Center, 760 Westwood Plaza, Room A8-153, Los Angeles, CA 90095
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54
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Promoting Protective Factors and Strengthening Resilience. ADVANCES IN CHILD ABUSE PREVENTION KNOWLEDGE 2015. [DOI: 10.1007/978-3-319-16327-7_9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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55
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Griffin GD, Charron D, Al-Daccak R. Post-traumatic stress disorder: revisiting adrenergics, glucocorticoids, immune system effects and homeostasis. Clin Transl Immunology 2014; 3:e27. [PMID: 25505957 PMCID: PMC4255796 DOI: 10.1038/cti.2014.26] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Revised: 10/05/2014] [Accepted: 10/05/2014] [Indexed: 11/09/2022] Open
Abstract
This review focuses on post-traumatic stress disorder (PTSD). Several sequelae of PTSD are partially attributed to glucocorticoid-induced neuronal loss in the hippocampus and amygdala. Glucocorticoids and adrenergic agents cause both immediate and late sequelae and are considered from the perspective of their actions on the expression of cytokines as well as some of their physiological and psychological effects. A shift in immune system balance from Th1 to Th2 dominance is thought to result from the actions of both molecular groups. The secretion of glucocorticoids and adrenergic agents is commonly induced by trauma or stress, and synergy between these two parallel but separate pathways can produce long- and short-term sequelae in individuals with PTSD. Potential therapies are suggested, and older therapies that involve the early effects of adrenergics or glucocorticoids are reviewed for their control of acute symptoms. These therapies may also be useful for acute flashback therapy. Timely and more precise glucocorticoid and adrenergic control is recommended for maintaining these molecular groups within acceptable homeostatic limits and thus managing immune and brain sequelae. Psychotherapy should supplement the above therapeutic measures; however, psychotherapy is not the focus of this paper. Instead, this review focuses on the probable molecular basis of PTSD. Integrating historical findings regarding glucocorticoids and adrenergic agents into current research and clinical applications returns the focus to potentially life-changing treatments. Autologous adoptive immune therapy may also offer utility. This paper reports clinical and translational research that connects and challenges separate fields of study, current and classical, in an attempt to better understand and ameliorate the effects of PTSD.
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Affiliation(s)
- Gerald D Griffin
- TJ Long School of Pharmacy and Health Sciences, University of the Pacific , Stockton, CA, USA
| | - Dominique Charron
- Laboratoire 'Jean Dausset' Histocompatibilite'-Imuunogenetique, Hospital Saint-Louis , Paris, France
| | - Rheem Al-Daccak
- CR1-HDR, INSERM UMRS-940, Hospital Saint-Louis , Paris, France
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56
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Marek LI, D’Aniello C. Reintegration Stress and Family Mental Health: Implications for Therapists Working with Reintegrating Military Families. CONTEMPORARY FAMILY THERAPY 2014. [DOI: 10.1007/s10591-014-9316-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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57
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Sun XY, Kong LM, Zhang QJ, Tao FY, Ma AG, Liu Y, Gao YF, Tu DH, Bai XH, Su WJ, Wang LJ, Lu F, Song WD, Zhang XZ, Meng XZ, Wang YN, Xie HB, Zhou XD, Zhang LY. The Chinese Mental Resilience Scale and its psychometric properties. J Health Psychol 2014; 21:1383-93. [PMID: 27357924 DOI: 10.1177/1359105314554474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
This study aimed to develop a Chinese Mental Resilience Scale. A total of 2500 healthy participants, in two representative samples of the Chinese population, were administered the scale. Exploratory factor analysis, confirmatory factor analysis, and correlation analysis were used to obtain the relevant coefficients and verify the reliability and validity of the scale. Five factors were extracted: willpower, family support, optimism and self-confidence, problem solving, and interpersonal interaction, plus a lying subscale, which together accounted for 54 percent of the total variance. The Chinese Mental Resilience Scale demonstrated good psychometric properties. It can be used to evaluate the mental resilience level of general Chinese population.
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Affiliation(s)
- Xin-yang Sun
- No. 102 Hospital of Chinese People’s Liberation Army, People’s Republic of China
- Second Military Medical University, People’s Republic of China
| | - Ling-ming Kong
- No. 102 Hospital of Chinese People’s Liberation Army, People’s Republic of China
| | - Qi-jun Zhang
- Hospital of 92919 Military Unit, People’s Republic of China
| | - Feng-yan Tao
- Tichen Nursing College, People’s Republic of China
| | - Ai-guo Ma
- Naval Command College, People’s Republic of China
| | - Yun Liu
- Fuyang Third People’s Hospital, People’s Republic of China
| | - Yu-fang Gao
- Women and Children Health Care Hospital, People’s Republic of China
| | - De-hua Tu
- City Central Hospital, People’s Republic of China
| | - Xiang-hui Bai
- International Mongolian Medicine Hospital, People’s Republic of China
| | - Wei-ji Su
- 92899 Military Unit, People’s Republic of China
| | - Li-jie Wang
- No. 107 Hospital, People’s Republic of China
| | - Fang Lu
- Rehabilitation Sanitarium, People’s Republic of China
| | | | | | | | - Yi-niu Wang
- Retired Cadre Association, People’s Republic of China
| | - Hong-bo Xie
- 65328 Military Unit, People’s Republic of China
| | | | - Li-yi Zhang
- No. 102 Hospital of Chinese People’s Liberation Army, People’s Republic of China
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58
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Finley EP. EMPOWERING VETERANS WITH PTSD IN THE RECOVERY ERA: ADVANCING DIALOGUE AND INTEGRATING SERVICES. ANNALS OF ANTHROPOLOGICAL PRACTICE 2014. [DOI: 10.1111/napa.12028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Smith-Osborne A, Felderhoff B. Veterans' informal caregivers in the "sandwich generation": a systematic review toward a resilience model. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2014; 57:556-584. [PMID: 24611766 DOI: 10.1080/01634372.2014.880101] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Social work theory advanced the formulation of the construct of the sandwich generation to apply to the emerging generational cohort of caregivers, most often middle-aged women, who were caring for maturing children and aging parents simultaneously. This systematic review extends that focus by synthesizing the literature on sandwich generation caregivers for the general aging population with dementia and for veterans with dementia and polytrauma. It develops potential protective mechanisms based on empirical literature to support an intervention resilience model for social work practitioners. This theoretical model addresses adaptive coping of sandwich- generation families facing ongoing challenges related to caregiving demands.
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Affiliation(s)
- Alexa Smith-Osborne
- a Center for Clinical Social Work , University of Texas at Arlington , Arlington , Texas , USA
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60
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Dissemination of family-centered prevention for military and veteran families: adaptations and adoption within community and military systems of care. Clin Child Fam Psychol Rev 2014; 16:394-409. [PMID: 24129478 DOI: 10.1007/s10567-013-0154-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In response to the needs of military families confronting the challenges of prolonged war, we developed Families OverComing Under Stress (FOCUS), a multi-session intervention for families facing multiple deployments and combat stress injuries adapted from existing evidence-based family prevention interventions (Lester et al. in Mil Med 176(1): 19-25, 2011). In an implementation of this intervention contracted by the US Navy Bureau of Medicine and Surgery (BUMED), FOCUS teams were deployed to military bases in the United States and the Pacific Rim to deliver a suite of family-centered preventive services based on the FOCUS model (Beardslee et al. in Prev Sci 12(4): 339-348, 2011). Given the number of families affected by wartime service and the changing circumstances they faced in active duty and veteran settings, it rapidly became evident that adaptations of this approach for families in other contexts were needed. We identified the core elements of FOCUS that are essential across all adaptations: (1) Family Psychological Health Check-in; (2) family-specific psychoeducation; (3) family narrative timeline; and (4) family-level resilience skills (e.g., problem solving). In this report, we describe the iterative process of adapting the intervention for different groups of families: wounded, ill, and injured warriors, families with young children, couples, and parents. We also describe the process of adopting this intervention for use in different ecological contexts to serve National Guard, Reserve and veterans, and utilization of technology-enhanced platforms to reach geographically dispersed families. We highlight the lessons learned when faced with the need to rapidly deploy interventions, adapt them to the changing, growing needs of families under real-world circumstances, and conduct rigorous evaluation procedures when long-term, randomized trial designs are not feasible to meet an emergent public health need.
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61
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Paley B, Lester P, Mogil C. Family systems and ecological perspectives on the impact of deployment on military families. Clin Child Fam Psychol Rev 2014; 16:245-65. [PMID: 23760926 DOI: 10.1007/s10567-013-0138-y] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The scope of sustained military operations in Iraq and Afghanistan has placed great demands on the Armed Forces of the United States, and accordingly, military families have been faced with deployments in more rapid succession than ever before. When military parents fulfill occupational duties during wartime, military children and families face multiple challenges, including extended separations, disruptions in family routines, and potentially compromised parenting related to traumatic exposure and subsequent mental health problems. Such challenges can begin to exert a significant toll on the well-being of both individuals and relationships (e.g., marital, parent-child) within military families. In order to respond more effectively to the needs of military families, it is essential that mental health clinicians and researchers have a better understanding of the challenges faced by military families throughout the entire deployment experience and the ways in which these challenges may have a cumulative impact over multiple deployments. Moreover, the mental health field must become better prepared to support service members and families across a rapidly evolving landscape of military operations around the world, including those who are making the transition from active duty to Veteran status and navigating a return to civilian life and those families in which parents will continue to actively serve and deploy in combat zones. In this article, we utilize family systems and ecological perspectives to advance our understanding of how military families negotiate repeated deployment experiences and how such experiences impact the well-being and adjustment of families at the individual, dyadic, and whole family level.
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Affiliation(s)
- Blair Paley
- Department of Psychiatry and Biobehavioral Sciences, Nathanson Family Reslience Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
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62
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Saltzman WR, Pynoos RS, Lester P, Layne CM, Beardslee WR. Enhancing family resilience through family narrative co-construction. Clin Child Fam Psychol Rev 2014; 16:294-310. [PMID: 23797387 DOI: 10.1007/s10567-013-0142-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We draw upon family resilience and narrative theory to describe an evidence-based method for intervening with military families who are impacted by multiple wartime deployments and psychological, stress-related, or physical parental injuries. Conceptual models of familial resilience provide a guide for understanding the mechanics of how families respond and recover from exposure to extreme events, and underscore the role of specific family processes and interaction patterns in promoting resilient capabilities. Leading family theorists propose that the family's ability to make meaning of stressful and traumatic events and nurture protective beliefs are critical aspects of resilient adaptation. We first review general theoretical and empirical research contributions to understanding family resilience, giving special attention to the circumstances, challenges, needs, and strengths of American military families. Therapeutic narrative studies illustrate the processes through which family members acquire meaning-making capacities, and point to the essential role of parents' in facilitating discussions of stressful experiences and co-constructing coherent and meaningful narratives. This helps children to make sense of these experiences and develop capacities for emotion regulation and coping. Family-based narrative approaches provide a structured opportunity to elicit parents' and children's individual narratives, assemble divergent storylines into a shared family narrative, and thereby enhance members' capacity to make meaning of stressful experiences and adopt beliefs that support adaptation and growth. We discuss how family narratives can help to bridge intra-familial estrangements and re-engage communication and support processes that have been undermined by stress, trauma, or loss. We conclude by describing a family-based narrative intervention currently in use with thousands of military children and families across the USA.
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Affiliation(s)
- William R Saltzman
- Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA.
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63
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Howell KH, Kaplow JB, Layne CM, Benson MA, Compas BE, Katalinski R, Pasalic H, Bosankic N, Pynoos R. Predicting adolescent posttraumatic stress in the aftermath of war: Differential effects of coping strategies across trauma reminder, loss reminder, and family conflict domains. ANXIETY STRESS AND COPING 2014; 28:88-104. [DOI: 10.1080/10615806.2014.910596] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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64
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Interian A, Kline A, Janal M, Glynn S, Losonczy M. Multiple deployments and combat trauma: do homefront stressors increase the risk for posttraumatic stress symptoms? J Trauma Stress 2014; 27:90-7. [PMID: 24464407 DOI: 10.1002/jts.21885] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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 (β = .154, p = .015) and Wave 2 (β = .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 (β = .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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Affiliation(s)
- Alejandro Interian
- VA New Jersey Health Care System, East Orange, New Jersey, USA; Rutgers, The State University of New Jersey, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
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65
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Gewirtz AH, Zamir O. The impact of parental deployment to war on children: the crucial role of parenting. ADVANCES IN CHILD DEVELOPMENT AND BEHAVIOR 2014; 46:89-112. [PMID: 24851347 DOI: 10.1016/b978-0-12-800285-8.00004-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
It is estimated that approximately 2 million children have been affected by military deployment, yet much of what is known about the adjustment of children experiencing a parent's combat deployment has emerged only within the past 5-10 years. The extant literature on associations of parental deployment and children's adjustment is briefly reviewed by child's developmental stage. Applying a family stress model to the literature, we propose that the impact of parental deployment and reintegration on children's adjustment is largely mediated by parenting practices. Extensive developmental literature has demonstrated the importance of parenting for children's resilience in adverse contexts more generally, but not specifically in deployment contexts. We review the sparse literature on parenting in deployed families as well as emerging data on empirically supported parenting interventions for military families. An agenda for future research in this area is proffered.
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66
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Taft CT, Howard J, Monson CM, Walling SM, Resick PA, Murphy CM. “Strength at Home” Intervention to Prevent Conflict and Violence in Military Couples: Pilot Findings. ACTA ACUST UNITED AC 2014. [DOI: 10.1891/1946-6560.5.1.41] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In this article, we report on a pilot study of Strength at Home-Couples (SAH-C), a 10-session cognitive-behavioral couples-based group intervention designed to prevent intimate partner violence (IPV) in military couples. The primary purposes of this pilot study were to determine feasibility of recruiting, retaining, and assessing SAH-C participants in addition to those participating in a comparison Supportive Therapy (ST) group-based couples intervention. Recruitment was challenging for this pilot study and we report on several barriers to recruitment as well as “lessons learned” for enhancing recruitment and overall intervention efforts. Preliminary pilot data were promising with respect to reductions and prevention of IPV in those receiving the SAH-C intervention. Initial results for the secondary intervention targets were less favorable for the SAH-C intervention, with effect sizes suggesting a trend in which relationship satisfaction increased more in the ST intervention.
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67
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Kaplow JB, Layne CM, Saltzman WR, Cozza SJ, Pynoos RS. Using multidimensional grief theory to explore the effects of deployment, reintegration, and death on military youth and families. Clin Child Fam Psychol Rev 2013; 16:322-40. [PMID: 23760905 PMCID: PMC4651441 DOI: 10.1007/s10567-013-0143-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
To date, the US military has made major strides in acknowledging and therapeutically addressing trauma and post-traumatic stress disorder (PTSD) in service members and their families. However, given the nature of warfare and high rates of losses sustained by both military members (e.g., deaths of fellow unit members) and military families (e.g., loss of a young parent who served in the military), as well as the ongoing threat of loss that military families face during deployment, we propose that a similar focus on grief is also needed to properly understand and address many of the challenges encountered by bereaved service members, spouses, and children. In this article, we describe a newly developed theory of grief (multidimensional grief theory) and apply it to the task of exploring major features of military-related experiences during the phases of deployment, reintegration, and the aftermath of combat death--especially as they impact children. We also describe implications for designing preventive interventions during each phase and conclude with recommended avenues for future research. Primary aims are to illustrate: (1) the indispensable role of theory in guiding efforts to describe, explain, predict, prevent, and treat maladaptive grief in military service members, children, and families; (2) the relevance of multidimensional grief theory for addressing both losses due to physical death as well as losses brought about by extended physical separations to which military children and families are exposed during and after deployment; and (3) a focus on military-related grief as a much-needed complement to an already-established focus on military-related PTSD.
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Affiliation(s)
- Julie B Kaplow
- Department of Psychiatry and Depression Center, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI 48109-5765, USA.
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68
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Lester P, Stein JA, Saltzman W, Woodward K, MacDermid SW, Milburn N, Mogil C, Beardslee W. Psychological health of military children: longitudinal evaluation of a family-centered prevention program to enhance family resilience. Mil Med 2013; 178:838-45. [PMID: 23929043 PMCID: PMC4020707 DOI: 10.7205/milmed-d-12-00502] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Family-centered preventive interventions have been proposed as relevant to mitigating psychological health risk and promoting resilience in military families facing wartime deployment and reintegration. This study evaluates the impact of a family-centered prevention program, Families OverComing Under Stress Family Resilience Training (FOCUS), on the psychological adjustment of military children. Two primary goals include (1) understanding the relationships of distress among family members using a longitudinal path model to assess relations at the child and family level and (2) determining pathways of program impact on child adjustment. Multilevel data analysis using structural equation modeling was conducted with deidentified service delivery data from 280 families (505 children aged 3-17) in two follow-up assessments. Standardized measures included service member and civilian parental distress (Brief Symptom Inventory, PTSD Checklist-Military), child adjustment (Strengths and Difficulties Questionnaire), and family functioning (McMaster Family Assessment Device). Distress was significantly related among the service member parent, civilian parent, and children. FOCUS improved family functioning, which in turn significantly reduced child distress at follow-up. Salient components of improved family functioning in reducing child distress mirrored resilience processes targeted by FOCUS. These findings underscore the public health potential of family-centered prevention for military families and suggest areas for future research.
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Affiliation(s)
- Patricia Lester
- UCLA Semel Institute for Neuroscience and Human Behavior,
760 Westwood Plaza, Room A8-154, Los Angeles, CA 90024
| | - Judith A. Stein
- UCLA Semel Institute for Neuroscience and Human Behavior,
760 Westwood Plaza, Room A8-154, Los Angeles, CA 90024
| | - William Saltzman
- UCLA Semel Institute for Neuroscience and Human Behavior,
760 Westwood Plaza, Room A8-154, Los Angeles, CA 90024
| | - Kirsten Woodward
- United States Bureau of Navy Medicine and Surgery,
2300 E Street NW, Building 6, Washington, DC 20372-5300
| | - Shelley W. MacDermid
- Military Family Research Institute at Purdue
University, Hanley Hall, Room 210, 1202 W. State Street, West Lafayette, IN
47907-2055
| | - Norweeta Milburn
- UCLA Semel Institute for Neuroscience and Human Behavior,
760 Westwood Plaza, Room A8-154, Los Angeles, CA 90024
| | - Catherine Mogil
- UCLA Semel Institute for Neuroscience and Human Behavior,
760 Westwood Plaza, Room A8-154, Los Angeles, CA 90024
| | - William Beardslee
- Children's Hospital Boston, Harvard Medical School,
21 Autumn Street, Suite 130.2, Boston, MA 02215
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69
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Murphy RA, Fairbank JA. Implementation and Dissemination of Military Informed and Evidence-Based Interventions for Community Dwelling Military Families. Clin Child Fam Psychol Rev 2013; 16:348-64. [DOI: 10.1007/s10567-013-0149-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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70
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Family-Centered Care for Military and Veteran Families Affected by Combat Injury. Clin Child Fam Psychol Rev 2013; 16:311-21. [DOI: 10.1007/s10567-013-0141-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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71
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Abstract
The wars in Afghanistan and Iraq have been challenging for US uniformed service families and their children. Almost 60% of US service members have family responsibilities. Approximately 2.3 million active duty, National Guard, and Reserve service members have been deployed since the beginning of the wars in Afghanistan and Iraq (2001 and 2003, respectively), and almost half have deployed more than once, some for up to 18 months' duration. Up to 2 million US children have been exposed to a wartime deployment of a loved one in the past 10 years. Many service members have returned from combat deployments with symptoms of posttraumatic stress disorder, depression, anxiety, substance abuse, and traumatic brain injury. The mental health and well-being of spouses, significant others, children (and their friends), and extended family members of deployed service members continues to be significantly challenged by the experiences of wartime deployment as well as by combat mortality and morbidity. The medical system of the Department of Defense provides health and mental health services for active duty service members and their families as well as activated National Guard and Reserve service members and their families. In addition to military pediatricians and civilian pediatricians employed by military treatment facilities, nonmilitary general pediatricians care for >50% of children and family members before, during, and after wartime deployments. This clinical report is for all pediatricians, both active duty and civilian, to aid in caring for children whose loved ones have been, are, or will be deployed.
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72
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Green S, Nurius PS, Lester P. Spouse Psychological Well-Being: A Keystone to Military Family Health. JOURNAL OF HUMAN BEHAVIOR IN THE SOCIAL ENVIRONMENT 2013; 23:10.1080/10911359.2013.795068. [PMID: 24415897 PMCID: PMC3885258 DOI: 10.1080/10911359.2013.795068] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Understanding predictors of military spouse psychosocial vulnerability informs efforts to assess, identify, and support at-risk spouses and families. In this analysis we test the effects of family stress and strain on military spouse psychological health, using a sample of female civilian spouses (n=161). Regression findings confirm expectations of the significant contribution of family stressors, strain, and resources in explaining variation in spouses' psychological health, controlling for deployment and socioeconomic factors. Identifying the effects of family stress on military spouse psychological health supports the need for family-centered interventions and prevention programs.
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Affiliation(s)
- Sara Green
- University of Washington, School of Social Work, Seattle, Washington, USA
| | - Paula S Nurius
- University of Washington, School of Social Work, Seattle, Washington, USA
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Kleim B, Ehring T, Scheel C, Becker-Asano C, Nebel B, Tuschen-Caffier B. Bewältigungsverhalten in Notfallsituationen aus klinisch-psychologischer Perspektive. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2012. [DOI: 10.1026/1616-3443/a000155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Ziel des vorliegenden Beitrags ist es, eine aktuelle Übersicht zu Annahmen und Befunden zu geben, die Hinweise darauf geben, welche Reaktionen bzw. welches Verhalten für die Bewältigung von Notfällen oder traumatischen Erlebnissen hilfreich bzw. gesundheitsförderlich sind. Ließen sich konkrete Aspekte von Bewältigungsverhalten während traumatischer Situationen identifizieren, die besonders adaptiv in Bezug auf die psychische bzw. psychobiologische Anpassung sind, so könnte dieses Wissen perspektivisch zur Entwicklung von Präventions- und Trainingsmaßnahmen genutzt werden. Der Beitrag beschreibt einleitend Traumareaktionen, psychische Traumafolgestörungen und deren Prävalenzraten und gibt eine knappe Übersicht über Prädiktoren für psychische Störungen in Folge traumatischer Erlebnisse. Im Unterschied zu dem Beitrag von Becker-Nehring, Witschen und Bengel (in diesem Heft) fokussiert unser Beitrag vor allem auf die Posttraumatische Belastungsstörung als Traumafolgestörung und auf Bewältigungsverhalten während einer Notfallsituation. Bewältigungsverhalten während und nach einer traumatischen Situation kann zum Teil auch im Forschungslabor experimentell untersucht werden, indem z. B. Methoden der Virtuellen Realität genutzt werden. Dies ist ein weiterer Fokus des Beitrags.
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Affiliation(s)
- Birgit Kleim
- Universität Zürich und Freiburg Institute for Advanced Studies (FRIAS), Universität Freiburg
| | | | - Corinna Scheel
- Freiburg Institute for Advanced Studies (FRIAS), Universität Freiburg
- Universität Freiburg, Institut für Psychologie, Abt. für Klinische Psychologie und Psychotherapie
| | | | - Bernhard Nebel
- Freiburg Institute for Advanced Studies (FRIAS), Universität Freiburg
| | - Brunna Tuschen-Caffier
- Freiburg Institute for Advanced Studies (FRIAS), Universität Freiburg
- Universität Freiburg, Institut für Psychologie, Abt. für Klinische Psychologie und Psychotherapie
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Abstract
This article reviews and reflects on studies that have explored the effects of war on children around the world. Most are cross-sectional and based on self-reports. They describe a range of mental health problems, related to dose effects and to the negative impact of being a victim or witness of violent acts, threats to and loss of loved ones, prolonged parental absence, and forced displacement. The more recent the exposure to war, and the older the child, the higher was the likelihood of reported posttraumatic stress disorder symptoms. Especially vulnerable to long-term emotional distress were child soldiers, children who were raped, and children who had been forcibly displaced. In adulthood, war-traumatized children displayed significantly increased risks for a wide range of medical conditions, especially cardiovascular diseases. Among protective factors that moderated the impact of war-related adversities in children were a strong bond between the primary caregiver and the child, the social support of teachers and peers, and a shared sense of values. Among the few documented intervention studies for children of war, school-based interventions, implemented by teachers or locally trained paraprofessionals, proved to be a feasible and low-cost alternative to individual or group therapy. More longitudinal research with multiple informants is needed to document the trajectories of risk and resilience in war-affected children, to assess their long-term development and mental health, and to identify effective treatment approaches.
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Maholmes V. Adjustment of Children and Youth in Military Families: Toward Developmental Understandings. CHILD DEVELOPMENT PERSPECTIVES 2012. [DOI: 10.1111/j.1750-8606.2012.00256.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Valerie Maholmes
- Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health
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Gibbons SW, Barnett SD, Hickling EJ. Family stress and posttraumatic stress: the impact of military operations on military health care providers. Arch Psychiatr Nurs 2012; 26:e31-9. [PMID: 22835755 DOI: 10.1016/j.apnu.2012.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Revised: 03/06/2012] [Accepted: 04/01/2012] [Indexed: 11/18/2022]
Abstract
This study uses data from the 2005 Department of Defense Survey of Health-Related Behaviors Among Military Personnel to examine relationships between family stress and posttraumatic stress symptoms across 4 subgroups of Operation Iraqi Freedom-deployed (i.e., war in Iraq) or Operation Enduring Freedom-deployed (i.e., war in Afghanistan) active-duty military service members. Results suggest the following: (a) the greatest positive correlation of family stressors with posttraumatic stress symptoms was found within the military health care officer group, and (b) these military health care officers differed in family stressors mediating posttraumatic stress with divorce and financial problems accounting for significant and unique portions of the variance. Implications for care of service members and their families are discussed.
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Affiliation(s)
- Susanne W Gibbons
- Uniformed Services University of the Health Sciences, Graduate School of Nursing, Bethesda, MD 20814, USA.
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77
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Masten AS, Narayan AJ. Child development in the context of disaster, war, and terrorism: pathways of risk and resilience. Annu Rev Psychol 2011; 63:227-57. [PMID: 21943168 PMCID: PMC5858878 DOI: 10.1146/annurev-psych-120710-100356] [Citation(s) in RCA: 381] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This review highlights progress over the past decade in research on the effects of mass trauma experiences on children and youth, focusing on natural disasters, war, and terrorism. Conceptual advances are reviewed in terms of prevailing risk and resilience frameworks that guide basic and translational research. Recent evidence on common components of these models is evaluated, including dose effects, mediators and moderators, and the individual or contextual differences that predict risk or resilience. New research horizons with profound implications for health and well-being are discussed, particularly in relation to plausible models for biological embedding of extreme stress. Strong consistencies are noted in this literature, suggesting guidelines for disaster preparedness and response. At the same time, there is a notable shortage of evidence on effective interventions for child and youth victims. Practical and theory-informative research on strategies to protect children and youth victims and promote their resilience is a global priority.
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Affiliation(s)
- Ann S Masten
- Institute of Child Development, University of Minnesota, Minneapolis, 55455, USA.
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