Family Adaptation to OIF Deployment

描述(由申请人提供)：超过210万名军人至少部署了一次，以支持持久自由行动或伊拉克自由行动(OIF)，许多当代军人家庭生活紧张。最近的部署对家庭的影响在很大程度上是未知的，尽管现有证据表明，部署会给家庭带来相当大的损失，导致心理困扰、行为问题和家庭不和。这种心理社会功能障碍可能会带来巨大的社会成本。军人伴侣/配偶占美国劳动力的很大比例，是心理健康服务的潜在受益者。同样，军人儿童的福祉和未来的生产力对社会至关重要。以前部署的研究表明，战区退伍军人创伤后应激障碍(PTSD)显著增加了家庭心理社会结局不良的额外风险。然而，关于部署前的特点、社会支持和战斗老兵创伤后应激障碍症状的过程如何影响家庭适应，特别是在最近部署的背景下，人们知之甚少。拟议工作的直接目的是检查OIF退伍军人创伤后应激障碍症状(以及症状轨迹，部署前到部署后8年)与家庭心理健康结果和家庭功能的关系。较长期的目标是利用研究结果，通过向军人/退伍军人家庭成员提供服务提供目标和预防干预措施，加强家庭心理健康对部署的适应。我们假设OIF退伍军人创伤后应激障碍，尤其是慢性创伤后应激障碍，将与较差的家庭结果相关，风险和复原力变量(例如，家庭社会 支持、退伍军人特征)将缓和退伍军人创伤后应激障碍对家庭结果的影响。这项独特的观察性研究涉及从之前跟踪调查的分散在全国各地的OIF退伍军人的家庭成员(N=380个家庭)收集初步数据，这些数据将与从神经认知部署健康研究和退伍军人管理局合作研究计划(CSP)#566收集的大量存档OIF退伍军人数据一起进行分析。OIF退伍军人数据与其他工作不同，因为它们包含自我报告问卷、访谈数据，以及在对退伍军人心理健康的纵向测量(从部署前开始)的背景下，客观的神经心理表现数据。家庭数据将包括自我报告问卷和电话采访，家庭结果与配偶/伴侣、子女和整体家庭凝聚力有关。退伍军人保护计划为联系退伍军人群体成员和访问存档的退伍军人数据提供了一个经济高效的平台。 与公共卫生相关：超过210万的服役人员至少被部署到伊拉克或阿富汗一次，许多当代军人家庭都很紧张。拟议的研究旨在更好地了解军事部署对家庭造成的心理损失，并确定可能影响家庭适应部署压力及其后果的因素，如军人自身的心理适应。由于精神障碍和心理社会功能障碍会给社会带来巨大的代价(例如，增加医疗保健利用率，增加工作中的问题)，最大限度地减少战区退伍军人家庭成员的这些问题将对公共卫生产生巨大的好处。

DESCRIPTION (provided by applicant): With over 2.1 million service members deployed at least once in support of Operation Enduring Freedom or Operation Iraqi Freedom (OIF), many contemporary military families are strained. The impact of recent deployments on the family is largely unknown, although available evidence suggests that deployments take a considerable toll on families, leading to psychological distress, behavioral problems, and family discord. Such psychosocial dysfunction likely comes with substantial societal costs. Military partners/spouses comprise a large proportion of the US workforce and are potential beneficiaries of mental health services. Likewise, the well-being and future productivity of military children are critical to society. Research from previous deployments suggests that warzone veteran posttraumatic stress disorder (PTSD) confers significant additional risk of poor psychosocial outcomes in families. Little is known, however, about how pre-deployment characteristics, social support, and the course of combat veteran PTSD symptoms influence family adaptation, especially in the context of recent deployments. The immediate aim of the proposed work is to examine associations of OIF veteran PTSD symptoms (and symptoms trajectories, pre-deployment to 8 years post-deployment) with family mental health outcomes and family functioning. The longer term goal is to use study findings to enhance family mental health adaptation to deployment by informing service delivery targets and prevention interventions among military/military veteran family members. We hypothesize that OIF veteran PTSD, especially if chronic, will be associated with poorer family outcomes, and that risk and resilience variables (e.g., family social support, veteran characteristics) will moderate the impact of veteran PTSD on family outcomes. This unique observational study involves primary data collection from the family members (N = 380 families) of previously followed nationally-dispersed OIF veterans, which will be analyzed with the large body of archived OIF veteran data collected from the Neurocognition Deployment Health Study and VA Cooperative Study Program (CSP) #566. The OIF veteran data are distinct from other efforts because they contain self-report questionnaires, interview data, and objective, neuropsychological performance data in the context of longitudinal measurement of veteran mental health (beginning prior to deployment). Family data will encompass self-report questionnaires and phone interviews, with family outcomes relevant to spouses/partners, children, and overall family cohesion. The VA CSP presents a cost-effective platform for contacting veteran cohort members and accessing archived veteran data. PUBLIC HEALTH RELEVANCE: With over 2.1 million service members having deployed at least once to Iraq or Afghanistan, many contemporary military families are strained. The proposed research is designed to better understand the psychological toll of military deployments on families and to identify factors, such as the service member's own psychological adjustment, that may influence the family's adaptation to the stress of deployment and its aftermath. Because mental disorders and psychosocial dysfunction result in significant costs to society (e.g., increased healthcare utilization, increased problems at work), the minimization of these problems in the family members of warzone veterans will have tremendous public health benefits.