Gender Differences in OEF/OIF Veterans’ Partnerships and PTSD Symptomology

OEF/OIF 退伍军人伙伴关系中的性别差异和 PTSD 症状

• 批准号: 9189031
• 负责人: Holly Beth Laws
• 金额: --
• 依托单位: VA CONNECTICUT HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-10-01 至 2018-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9189031
• 关键词: Address; Affect; Area; Attention; Behavior; Caring; Cereals; Characteristics; Clinical; Conflict (Psychology); Couples; Data Analyses; Development; Disclosure; Distress; Divorce; Eligibility Determination; Emotional; Evaluation; Family; Family Relationship; Family Research; Family member; Family psychotherapy; Female; Freedom; Gender; General Population; Goals; Health Personnel; Healthcare; Holly; Individual; Intervention; K-Series Research Career Programs; Laws; Life; Link; Marriage; Measurement; Measures; Mental Depression; Mental Health; Mentors; Mentorship; Meta-Analysis; Military Personnel; Outcome; Patient Self-Report; Pattern; Personal Satisfaction; Persons; Policies; Post-Traumatic Stress Disorders; Process; Provider; Psychotherapy; Publishing; Recovery; Reporting; Research; Research Design; Research Personnel; Resources; Self Disclosure; Services; Social support; Spouses; Symptoms; Time; Training; Training Activity; Trauma; Treatment outcome; Veterans; Woman; Work; career; cohort; combat; coping; emotional disclosure; expectation; experience; gender difference; health care service utilization; health related quality of life; improved; intimate partner violence; male; meetings; men; novel; operation; psychosocial; screening; social; symptomatology; tool; treatment adherence

Research has shown that Veterans experience better clinical outcomes and are more consistently engaged in mental health treatment when their families are involved in their mental health care. While recent changes in Department of Veterans Affairs (VA) policy place greater emphasis on family involvement in Veterans' mental health care, rates of family psychotherapy provision remain low (under four percent) and have not increased as a proportion of total mental health care service use. More troubling, rates of family psychotherapy for female Veterans are declining as a proportion of service use, despite preliminary evidence that women may benefit most from family involvement. The proposed project will identify patterns of behaviors within marital and cohabitating partnerships that support Veterans' recovery from PTSD and successful family reintegration post-deployment, paying particular attention to gender differences in these associations. Further understanding of the basic processes within partnerships that facilitate or hinder Veterans' reintegration will help providers more effectively engage families in Veterans' mental health care. The proposed mentored career development award (CDA-1) application details a two-year plan that will provide training to advance candidate Dr. Holly Laws toward a career as an independent researcher at the VA. The project aims to identify patterns of behavior within marital and cohabiting partnerships that are related to male and female Veterans' recovery from PTSD and successful family reintegration as they separate from military service. To accomplish this goal, Dr. Laws will leverage her expertise in dyadic (or two-person) multilevel data analysis and will integrate training in three new areas: 1) VA family research and psychotherapy initiatives, 2) gender differences in Veterans' experiences, and 3) PTSD course, treatment, and evaluation. Mentors expert in these areas will guide Dr. Laws' training activities, provide project mentorship, and support her professional development as an early career VA family researcher. Research that includes both Veterans and their partners is only beginning to be conducted regularly, with a majority of prior research relying on Veterans' self-reports of their relationships and well-being. This means that VA clinicians have a mandate to include Veterans' families members (most often spouses or partners) in their mental health care, with only limited research indicating how partners' unique characteristics and perspectives can help Veterans' mental health treatment. Further, there are no published studies that compare the partnerships of female Veterans to those of male Veterans. The proposed study aims to address these two gaps in the current research on Veteran couples by examining how relationship qualities such as distress, trauma disclosure, and conflict relate to PTSD symptoms and family reintegration in Veterans after discharge from military service. The specific contributions of this project are twofold. First, it will differentiate partnership processes as reported by Veterans from those reported by their partners. By disentangling these perspectives, findings can be used to inform Veteran- and partner-specific intervention and engagement strategies in couples' psychotherapy. Second, this project will identify gender differences in how relationship qualities relate to male Veterans' versus female Veterans' well- being. Results from the proposed work will inform a CDA-2 proposal to apply these findings in the development of an evaluation and screening tool that incorporates gender-specific information to meet the differential family engagement needs of male versus female Veterans. A more fine-grained understanding of how processes within partnership relate to the well-being of male and female Veterans could inform targeted psychosocial interventions to change maladaptive patterns within partnerships, or to reinforce those associated with Veterans' improved well-being.

研究表明，退伍军人经历更好的临床结果， 当他们的家人参与他们的精神卫生保健时，他们从事精神卫生治疗。虽然最近 退伍军人事务部（VA）政策的变化更加强调家庭参与 退伍军人的精神卫生保健，家庭心理治疗提供率仍然很低（低于4%）， 在精神卫生保健服务使用总量中所占比例没有增加。更令人不安的是， 尽管有初步证据表明，女性退伍军人的心理治疗在服务使用中的比例正在下降， 女性可以从家庭参与中获益最多。拟议的项目将确定行为模式 在婚姻和同居伙伴关系中，支持退伍军人从创伤后应激障碍和成功的家庭中恢复 在部署后重返社会方面，特别注意这些协会中的性别差异。进一步 了解伙伴关系中促进或阻碍退伍军人重返社会的基本程序， 帮助提供者更有效地让家庭参与退伍军人的心理健康护理。 拟议的辅导职业发展奖（CDA-1）申请详细介绍了一项两年计划，该计划将 提供培训，以促进候选人博士冬青法律走向职业生涯作为一个独立的研究人员在退伍军人事务部。 该项目旨在确定婚姻和同居关系中的行为模式， 男性和女性退伍军人从创伤后应激障碍中恢复过来， 服兵役。为了实现这一目标，Laws博士将利用她在二人（或两人） 多层次的数据分析，并将在三个新的领域整合培训：1）VA家庭研究和心理治疗 倡议，2）退伍军人经历的性别差异，3）PTSD过程，治疗和评估。 这些领域的专家导师将指导Laws博士的培训活动，提供项目指导和支持 她作为退伍军人事务部早期家庭研究员的职业发展。 包括退伍军人和他们的伴侣在内的研究才刚刚开始定期进行， 大多数先前的研究依赖于退伍军人对他们的关系和幸福的自我报告。这 这意味着退伍军人管理局临床医生有一个任务，包括退伍军人的家庭成员（最常见的配偶或 只有有限的研究表明，伴侣的独特特征如何影响他们的心理健康。 和观点可以帮助退伍军人的心理健康治疗。此外，没有发表的研究表明， 将女性退伍军人的伴侣关系与男性退伍军人的伴侣关系进行比较。 这项拟议中的研究旨在解决目前对退伍军人夫妇研究中的这两个空白， 研究关系质量，如痛苦，创伤披露和冲突与创伤后应激障碍的关系 退伍军人退伍后的症状和家庭重新融合。的具体贡献 这个项目是双重的。首先，它将区分退伍军人报告的伙伴关系进程和 他们的伴侣报告说。通过解开这些观点，研究结果可以用来告知退伍军人， 伴侣特定的干预和参与策略在夫妇的心理治疗。第二，该项目将 确定关系质量如何与男性退伍军人和女性退伍军人的健康相关的性别差异- 存在拟议工作的结果将为CDA-2提案提供信息，以便在开发中应用这些发现 评估和筛选工具，其中包括针对性别的信息，以满足不同家庭的需求， 男性与女性退伍军人的参与需求。更精细地理解流程 与男女退伍军人的福祉有关的伙伴关系可以为目标的心理社会提供信息， 采取干预措施，改变伙伴关系中不适应的模式，或加强与伙伴关系有关的模式， 改善退伍军人的福利。