Family functioning predicts outcomes for veterans in treatment for chronic posttraumatic stress disorder.

Abstract

A longitudinal framework was used to examine the competing hypotheses of (a) whether family functioning predicts changes in posttraumatic stress disorder (PTSD) symptoms or (b) whether PTSD symptoms predict changes in family functioning. Veterans (N = 311) admitted to a treatment program completed a series of questionnaires at 3 time points: at intake, from intake to completion of a treatment program, and at the 6-month follow-up. Alcohol use and general mental health symptoms were also measured at intake. A cross-lagged panel model using structural equation modeling analyses indicated that family functioning was a moderate predictor of PTSD symptoms at posttreatment and at the 6-month follow-up. PTSD was not a significant predictor of family functioning across time and alcohol use, and general mental health symptoms did not affect the overall findings. Further analyses of PTSD symptom clusters indicated that the avoidance symptom cluster was most strongly related to family functioning. Targeting family relationships for treatment may be important in the future for veterans with PTSD.

The efficacy of recommended treatments for veterans with PTSD: A metaregression analysis

“…The results are again not unequivocal, Walter, Kiefer, and Chard (2012) did not find any effects for personality disorders on PTSD treatment, and early childhood experiences did not predict treatment outcome (Johnson & Lubin, 1997). From a social perspective, veterans performed worse in treatment if they were socially isolated (Forbes et al, 2002), had poor functioning families, and experienced marital distress (Evans, Cowlishaw, Forbes, Parslow, & Lewis, 2010;Evans, Cowlishaw, & Hopwood, 2009). Last, organisational and treatment factors also influence outcome.…”

“…The combination formats often used the group therapy component to target other non-trauma focused themes, such as providing psychoeducation, social support, or emotional-regulation to address social isolation, impaired social functioning, and anger management issues. These issues can have detrimental effects for PTSD treatment outcome (Evans et al, 2009(Evans et al, , 2010Forbes et al, 2002Forbes et al, , 2003Forbes et al, , 2008Lloyd et al, 2014;Owens et al, 2008). We believe group therapy might augment trauma-focused therapy if used in conjunction with individual trauma-focused therapy.…”

Long-Term Trajectories and Service Needs for Military Families

“…In studies of predominantly Australian Vietnam veterans, family functioning was predictive of PTSD symptom levels during treatment and at post-treatment follow-ups (Evans et al 2009(Evans et al , 2010. The reverse was not true: PTSD symptom levels did not predict family functioning across multiple assessments, except that avoidance symptomatology was associated with poor family functioning.…”

“…Among the NVVRS female veteran subsample, lower parenting satisfaction was associated with both the avoidance/numbing and hyperarousal PTSD symptom clusters (Berz et al 2008). The importance of avoidance symptoms to family dysfunction was also highlighted in a study of Australian Vietnam veterans and in a study of Canadian peacekeepers with PTSD (Evans et al 2009;Ray and Vanstone 2009).…”

Boundary Ambiguity and Ambivalence in Military Family Reintegration

“…For instance, research continues to be published today regarding the effects of PTSD in Vietnam veterans and their family systems (e.g., Evans, Cowlishaw, & Hopwood, 2009), among many other topics. A significant increase in the amount of research around reintegration would be expected given the uniqueness of the last decade of war compared to previous conflicts, including the heightened operations tempo, a heavy reliance on reserve component service members, and more service members surviving combat but doing so with chronic mental and physical trauma (Institute of Medicine [IOM], 2010).…”