Preventing Military Post-Deployment Adjustment Problems: Key Family Processes

描述（由申请人提供）：军事服务人员从中东冲突返回后，创伤后应激障碍，抑郁症，毒品和酒精使用率很高。她们的家庭还面临着调动的挑战，家庭角色的重新调整、共同养育子女和其他压力因素，导致子女和配偶适应问题的比例很高。因此，部署后家庭角色的重新调整和重新谈判以及重新参与日常家庭生活是一个有力的过渡。这种重新调整、重返社会和重新参与的方式对服役人员、配偶和子女随后的调整产生了强大的影响。本研究将发展并实作一套行为观察编码系统，以观察从中东冲突中返国的服务人员在部署后与家人重新融合时的家庭互动。两个关键模式的家庭互动的目标是在编码系统：反应-胁迫，和回避。这些模式是假设的：（a）在部署后的最初阶段，与服务人员及其配偶和子女的问题呈正相关，并破坏熟练的养育和家庭问题解决，（B）对服务人员及其配偶和子女的养育、家庭问题解决和心理社会调整的长期轨迹产生负面影响。本研究将使用来自受资助的NIDA RCT的数据，评估部署后育儿干预（PMTO-ADAPT）相对于常规服务对观察到的育儿技能和家庭问题解决的影响，以及对服务成员，其配偶和子女在24个月内的调整。假设将在一个实验室实验设计中进行测试，通过检查是否在服务和家庭成员的调整，并在养育和家庭问题的解决所产生的PMTO-ADAPT的变化介导的反应，胁迫和退出，避免率的变化。服务成员的基线调整将作为这些干预效果的调节器进行测试。确定和验证两个关键的家庭互动模式将提供关键信息，以创建，调整和实施有效的家庭干预措施，以满足返回的军人及其家庭的独特问题和需求。

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.