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Roscoe RA. Narrating the Sociocultural Experience and Management of Stigma Related to Military Caregiving. HEALTH COMMUNICATION 2024:1-12. [PMID: 38818796 DOI: 10.1080/10410236.2024.2360177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
Despite accelerating the recovery and rehabilitation of wounded veterans and saving the U.S. substantial sums in avoided long-term care costs, military caregivers (MCs) are an underserved community lacking resources and support. On top of managing a variety of emotional, physical, relational, and occupational challenges, MCs experience stigma. Indeed, caregiving can be a stigmatized task, especially for military-affiliated individuals who may be expected to adhere to cultural norms of personal sacrifice and resilience in the face of adversity. The current study uses narrative inquiry to better understand the unique experiences and characteristics of MCs providing care for veterans experiencing posttraumatic stress. Specifically, this study examined MCs' narratives to uncover the sociocultural experience and management of stigma related to military caregiving. Interviews with 15 military caregivers of veterans experiencing PTS demonstrated that military caregivers experienced stigma for 1) staying in the relationship, 2) enabling the veteran, 3) mismanaging the condition, and 4) flaking on plans and relationships. In response to stigma, MCs often challenged stigma through strategies of denial or evasion of responsibility. This study contributes to communication scholarship by introducing co-stigma management and further interrogating processes related to stigma management communication. In addition, the results can inform Veteran Affairs (VA) healthcare, caregiver assistance programs, health practices, and support-seeking behaviors.
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Affiliation(s)
- Rikki A Roscoe
- Department of Communication Studies, University of Kansas
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Brickell TA, French LM, Varbedian NV, Sewell JM, Schiefelbein FC, Wright MM, Lange RT. Relationship satisfaction among spouse caregivers of service members and veterans with comorbid mild traumatic brain injury and post-traumatic stress disorder. FAMILY PROCESS 2022; 61:1525-1540. [PMID: 34859431 DOI: 10.1111/famp.12731] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 10/15/2021] [Accepted: 10/22/2021] [Indexed: 06/13/2023]
Abstract
This study examined relationship satisfaction and health-related quality of life (HRQOL) among spouse caregivers assisting service members and veterans (SMV) with comorbid uncomplicated mild traumatic brain injury (MTBI) and post-traumatic stress disorder (PTSD). Spouse caregivers (N = 205) completed the Couples Satisfaction Index (CSI), 12 HRQOL measures, and the Mayo-Portland Adaptability Inventory 4th Edition (MPAI-4). T-scores were classified as "clinically elevated" using a cutoff of ≥60T. The sample was also classified into "Satisfied" (≥13.5, n = 113, 55.0%) or "Dissatisfied" (<13.5, n = 92, 44.0%) relationship categories. Using stepwise regression analysis, Anxiety, Family Disruption, Vigilance, Emotional Support, Feeling Trapped, and MPAI-4 Adjustment were identified as the strongest predictors of CSI total scores (p < 0.001), accounting for 41.6% of the variance. Squared semi-partial correlations revealed that 18.1% of the variance was shared across all six measures, with 7.8% to 1.5% of unique variance accounted for by each measure separately. When comparing the number of clinically elevated measures simultaneously, the Dissatisfied group consistently had a higher number of clinically elevated scores compared to the Satisfied group (e.g., 3-or-more clinically elevated scores: Dissatisfied = 40.2%, Satisfied = 8.8%, OR = 6.93, H = 0.76). Caring for a SMV with comorbid TBI and PTSD can have a profound impact on the spouse caregiver's HRQOL, relationship satisfaction, and family functioning. The findings from the current study continue to support the need for family involvement in the SMV's treatment plan, but more effort is needed to integrate behavioral health treatment that focuses on the family member's own issues into military TBI and PTSD systems of care.
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Affiliation(s)
- Tracey A Brickell
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- General Dynamics Information Technology, Silver Spring, Maryland, USA
- Centre of Excellence on Post-Traumatic Stress Disorder, Ottawa, ON, Canada
| | - Louis M French
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Nicole V Varbedian
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- General Dynamics Information Technology, Silver Spring, Maryland, USA
| | - Jessie M Sewell
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- General Dynamics Information Technology, Silver Spring, Maryland, USA
| | - Faith C Schiefelbein
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- General Dynamics Information Technology, Silver Spring, Maryland, USA
| | - Megan M Wright
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- General Dynamics Information Technology, Silver Spring, Maryland, USA
| | - Rael T Lange
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- General Dynamics Information Technology, Silver Spring, Maryland, USA
- Centre of Excellence on Post-Traumatic Stress Disorder, Ottawa, ON, Canada
- University of British Columbia, Vancouver, BC, Canada
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Russin SE, Stein CH. The Aftermath of Trauma and Abuse and the Impact on Family: A Narrative Literature Review. TRAUMA, VIOLENCE & ABUSE 2022; 23:1288-1301. [PMID: 33653179 DOI: 10.1177/1524838021995990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The present narrative review examined quantitative and qualitative research on family members who support survivors of trauma or abuse. Studies included in the present review were found in peer-reviewed journal articles, available in English, published between 1980 and 2019, and focused specifically on the experiences of adult familial supporters of adult trauma and abuse survivors. A search of PsychInfo and Google Scholar identified 136 relevant articles, and analysis of their content generated the following categories: individual-level impacts (i.e., quality of psychological health, burden, secondary traumatic stress, quality of physical health, and positive impacts), interpersonal and environmental level impacts (i.e., quality of relationships with survivors, navigating environment, maltreatment and safety, and social impacts), and other experiences (i.e., social roles, needs, coping strategies, and sociocultural context). Findings indicate that the majority of existing studies examined the experiences of family members of adult survivors of military trauma. Results of the review suggest that family supporters of adult trauma and abuse survivors generally experience physical, emotional, cognitive, behavioral, social, safety, and relational impacts. Implications of review findings and directions for future research are discussed.
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Affiliation(s)
- Sarah E Russin
- Department of Psychology, 1888Bowling Green State University, OH, USA
| | - Catherine H Stein
- Department of Psychology, 1888Bowling Green State University, OH, USA
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Zhang N, Piehler TF, Gewirtz AH, Zamir O, Snyder JJ. Trait Mindfulness and Anger in the Family: A Dyadic Analysis of Male Service Members and their Female Partners. JOURNAL OF MARITAL AND FAMILY THERAPY 2020; 46:15-29. [PMID: 31081952 PMCID: PMC6851408 DOI: 10.1111/jmft.12384] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Anger-related problems have been documented among post-deployed service members who returned home, posing risks to their well-being and increasing distress in their families. Trait mindfulness (acting with awareness, nonjudging, and nonreactivity) has been associated with lower self-reported anger. Using actor-partner interdependence models, we tested the association between trait mindfulness and parental anger observed in parent-child and couple interactions. The sample consisted of 155 dyads of male National Guard/Reserve members who had been recently deployed and returned, and their female non-deployed partners. Results showed that fathers' and mothers' nonreactivity was negatively associated with their own observed anger, indicating that parents who reported higher nonreactivity exhibited lower anger. Mothers' nonreactivity was also negatively associated with observed fathers' anger in the same family such that fathers exhibited lower anger when their female partner reported higher nonreactivity. Nonreactivity facilitates emotion regulation and its cultivation may reduce anger in post-deployed military families.
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