Preventing Military Post-Deployment Adjustment Problems: Key Family Processes

描述(由申请者提供)：军人经历了高比例的创伤后应激障碍，抑郁，以及从中东冲突归来后使用毒品和酒精。他们的家庭也面临着部署的挑战，家庭角色的重新调整、共同养育和其他压力因素，导致子女和配偶适应问题的比率很高。因此，部署后家庭角色的调整和重新谈判以及重新参与日常家庭生活是一个强有力的过渡。这一调整、重返社会和重新参与的方式对随后的服务人员、配偶和子女的调整产生了重大影响。本研究将开发和实施中东冲突回国服务人员部署后家庭重返社会期间家庭互动的行为观察编码系统。编码系统针对的是两种关键的家庭互动模式：反应-强迫和回避-回避。这些模式的假设是：(A)在部署后的最初阶段，与军人及其配偶和子女的问题呈正相关，扰乱熟练的育儿和家庭问题解决；(B)对军人及其配偶和子女的育儿、家庭问题解决和心理社会调整的长期轨迹产生负面影响。这项研究将使用NIDA资助的随机对照研究的数据，评估部署后育儿干预(PMTO-Adapt)相对于通常服务对观察到的育儿技能和家庭问题解决的影响，以及对服役人员、其配偶和子女在24个月期间的调整的影响。这些假设将通过纵向实验设计进行检验，考察PMTO-Adapt在服务和家庭成员的适应、养育和家庭问题解决方面的变化是否通过反应性-强迫和回避-回避的比率的变化来调节。服务人员的基线调整将作为这些干预效果的调节因素进行测试。查明和确认两种关键的家庭互动模式将提供所需的关键信息，以便创建、调整和实施有效的家庭干预措施，以满足退伍军人及其家属的独特问题和需要。

DESCRIPTION (provided by applicant): Military service personnel experience high rates of PTSD, depression, and drug and alcohol use on return from Middle East Conflicts. Their families are also challenged by deployment, with a realignment of family roles, co-parenting and other stressors, resulting in high rates of child and spouse adjustment problems. Thus, post-deployment realignment and renegotiation of family roles, and re-engagement in daily family life represents a powerful transition. The manner in which this realignment, reintegration and re-engagement unfolds has powerful effects on the subsequent adjustment of service members, spouses and children. This research will develop and implement a behavior observation coding system of family interaction during post- deployment family reintegration of service personnel returning from Middle East conflicts. Two key patterns of family interaction are targeted in the coding system: reactivity-coercion, and withdrawal-avoidance. These patterns are hypothesized: (a) to be positively associated with the problems of service members and their spouses and children during the initial post-deployment period, and to disrupt skilled parenting and family problem solving, and (b) to negatively influence the long-term trajectories of parenting, family problem solving, and psychosocial adjustment of service members and their spouses and children. This study will use data from a funded NIDA RCT assessing the impact of a post-deployment parenting intervention (PMTO- ADAPT) relative to services as usual on observed parenting skills and family problem solving, and on the adjustment of service members, their spouses and children over a 24 month period. The hypotheses will be tested in a longitudinal-experimental design by examining whether changes in service and family members' adjustment and in parenting and family problem solving engendered by PMTO-ADAPT are mediated by changes in the rates of reactivity-coercion and withdrawal-avoidance. Service members' baseline adjustment will be tested as a moderator of these intervention effects. Identification and validation of the two key family interaction patterns will provide critical information needed to create, adapt and implement effective family interventions to meet the unique issues and needs of returning military service members and their families.