Reintegration Stress and Family Mental Health: Implications for Therapists Working with Reintegrating Military Families

Predictors of reintegration adjustment among female U.S. Army spouses: A preliminary exploration

LAY SUMMARY

Little is known about how military families navigate the challenges they experience during reintegration, the period after a deployment separation when a service member returns home and families must readjust to their presence. This study considers how family risk factors such as the mental health of both partners and protective factors such as social support and participation in military-sponsored training influence family adjustment during reintegration. Military spouses who reported having more social support were likely to report that their families adjusted more quickly during reintegration. However, spouses who expressed concern about a partner’s mental health were less likely to feel prepared for reintegration and, in turn, were more likely to report that their families adjusted more slowly. The results of this study suggest that supporting military spouses in feeling more prepared for reintegration may be an important means to shorten the adjustment period after a deployment.

Posttraumatic Stress Disorder and Aggression Among Post-9/11 Veterans: The Role of Shame

Posttraumatic stress disorder (PTSD) is often accompanied by elevated aggression. PTSD and combat exposure alone do not fully explain the reliable finding of heightened aggression among trauma-exposed veterans. Shame may be an important affective feature in this relationship. The present study examined the role of shame from a social hierarchy theoretical perspective in a sample of 52 combat veterans from the post-9/11 era. Correlational analyses indicated moderately strong positive relationships among PTSD, shame, and aggression. Trait shame was found to significantly mediate the relationship between total PTSD severity and physical aggression, but not other forms of aggression. For veterans within the context of a hierarchical military culture, separation from the military and PTSD diagnosis may be very salient markers of social loss and social exclusion. Aggression may operate to reduce the negative affective experience associated with shame and to regain social standing. Findings implicate shame as an important emotional component in the relationship between PTSD and aggression.

The impact of family stressors and resources on military spouse's perception of post-deployment reunion stress

Much of the prior research on variables impacting spouses' perceptions of reunion stress have focused on individual variables and have not examined these variables within their shared context, despite the indication from some research and theory that this is a key component of understanding couple's responses to stressors. The present study examined the impact of various family stressors and resources, both independently and in conjunction with each other, on spouses' perceptions of reunion stress. To examine these variables, the present study utilized cross-sectional data from a representative sample of 1,558 military service members and their spouses participating in the Millennium Cohort Family Study. Results indicated that poorer mental health among spouses and service members was associated with increased reunion stress as reported by spouses across all models tested. In addition, stressful communication during deployment was significantly associated with spouses' perceptions of reunion stress. These results can help guide more targeted prevention and intervention efforts to decrease spouses' sense of reunion stress.

Stigma and its impact on the families of former soldiers of the German Armed Forces: an exploratory study

BACKGROUND

Military families who have a family member with a mental illness see themselves confronted with many demands. Stigmatization is one of these challenges. Stigmatization affects not only the individual who suffers from a mental illness but also other family members via stigma by association and vicarious stigma. Stigma by association occurs when mental illness stigma spills over to individuals associated with an individual with a mental illness. Vicarious stigma describes the suffering of family members when they note the impact of stigma on their relative with mental illness. As a societal phenomenon, stigma plays out in social interactions and might therefore influence the social networks of families. It is also associated with healthcare utilization.

METHOD

Narrative interviews were conducted with 15 family members (partners, spouses, parents and children) of former soldiers of the German Armed Forces with a service-induced mental illness. The transcribed interview data were analyzed using a thematic analysis approach, in which codes were formed and emerging themes were systemized. Relationships between stigma, the families' reactions to it, its effects on their social relationships and its interference with their healthcare utilization were analyzed.

RESULTS

This study provides a detailed description of how relatives of former German soldiers with mental health problems experience stigma by association and vicarious stigma. Their perceptions are shown in a model that describes stigma-related attitudes, reactions to them and their effects on the social relationships of former soldiers' families. These families felt stigmatized because of the former soldiers' mental illness (mental illness stigma) and the military context in which it occurred (former soldier stigma). They reacted with nondisclosure, anger, acceptance and self-blame. Stigma was associated with smaller and weaker social networks that were characterized by social exclusion, self-segregation and conflicts with extended family, friends and colleagues. Stigma also affected the families' healthcare utilization.

CONCLUSIONS

Urgently needed anti-stigma campaigns, particularly in the civilian context, should address the stigmatization of both mental illness and the military participation of the families affected. They should consider the needs of both former soldiers with a mental illness and their families.

Air Force Chaplains' Perceived Effectiveness on Service Member's Resilience and Satisfaction

This study examined how 3,777 active duty male United States Air Force service members' (SMs) rank and residence location moderated the associations between perceived chaplain effectiveness, SMs' resilience, family coping, marital satisfaction, and satisfaction with the Air Force (AF). A multiple-sample structural equation model was conducted with four subgroups of SMs who had received chaplain support: enlisted members living on base, enlisted members living off base, officers living on base, and officers living off base. Chaplain effectiveness was significantly related, both directly and indirectly, to SM's spirituality, resilience, family coping, marital satisfaction, and AF satisfaction. Resilience was significantly associated with increased AF satisfaction for all SMs, except for those living on base. However, living on base was found to strengthen the protective factor between family coping and relationship satisfaction. Rank was found to moderate the link between resilience and family coping. Family coping was significantly related to increased relationship satisfaction.

The Whole Family Serves: Supporting Sexual Minority Youth in Military Families

Sexual minority youth in military families have a unique set of stressors that affect their mental, emotional, and physical health. There is a pronounced gap in data addressing the specific stressors of this population and how they interact to impact the health of the adolescent. The culture of the United States military has historically been heterosexist and homophobic, propelled primarily by policies that restricted the recruitment and service of lesbian, gay, bisexual, or transgender individuals, leading to a continued secrecy around sexual orientation that may affect how sexual minority youth within the community view themselves. Homophobia, social stigma, and victimization lead to significant health disparities among sexual minority youth, and youth connected to the military have additional stressors as a result of frequent moves, parental deployment, and general military culture. Primary care providers must be aware of these stressors to provide a safe environment, thorough screening, and competent care for these adolescents.