Abstract
Objective: Relying upon the military family stress model, we evaluated the associations between combat exposure, PTSD symptoms, and parental locus of control (PLOC) among mothers and fathers with history of deployment, using a multigroup analysis. Background: Few studies have investigated the correlates of deployment-related stressors for deployed mothers and none have examined perceptions of parenting efficacy. The relationship between combat exposure and PTSD symptoms may differ by gender. Method: The sample (421 fathers and 117 mothers) was selected by combining baseline data from two distinct randomized controlled trials of a parenting program for post-deployed military families: ADAPT and ADAPT 4 U (Gewirtz et al., 2018a). Results: Our analyses revealed a significant indirect effect of PTSD symptoms between combat exposure and PLOC, among deployed parents, with no gender differences in the indirect effect. Conclusion: Relationships between combat exposure, PTSD symptoms, and PLOC support a military family stress model, and highlight the need to support parents with PTSD symptoms because PTSD symptoms appear to be a mechanism through which combat exposure affects parenting beliefs and perceptions. Implications: Prevention and intervention research should focus on how parenting programs might help to reduce PTSD symptoms and improve parental perceptions of efficacy, confidence, and control.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1103-1117 |
| Number of pages | 15 |
| Journal | Family relations |
| Volume | 72 |
| Issue number | 3 |
| DOIs | |
| State | Published - Jul 2023 |
Bibliographical note
Funding Information:The largest mobilization of U.S. forces since the Vietnam war has occurred in the last 2 decades, in support of the post-9/11 Middle East conflicts focused in Iraq and Afghanistan. Women accounted for approximately 15% of the active-duty component and 18% of the Reserve component/National Guard and Reserves (NG/R; U.S. Department of Defense, 2016). Of the 2.1 million service members deployed, approximately 41% are parents (Defense Manpower Data Center, 2015). Parents who are service members face different challenges post-deployment than nonparent service members because of the immediate nature of parenting duties. Some research has examined parenting in deployed fathers, but little to no research has examined the correlates of deployment-related stressors for deployed mothers (Gewirtz et al., 2014). The military family stress model provides a theoretical framework for examining the impact of military stressors on family functioning (Gewirtz et al., 2018a). Family stress models more broadly seek to understand the family mechanisms through which different types of stressors (e.g., socioeconomic stress, marital transitions) affect parents and children. Typically, paths from external stressors to increases in parental stress or mental health symptoms, to decrements in parenting effectiveness and increased child problems are found (e.g., Elder & Caspi, 1988; Gard et al., 2020). The military family stress model examines military stressors (e.g., deployments and combat stress) and their resulting impacts on parent functioning, given the lengthy family separations, combat exposure, perceived danger, and anxiety commonly experienced by service members and families during and after deployment (Faber et al., 2008; Gewirtz et al., 2018a). The model seeks to explain the mechanisms through which external stressors affect child adjustment by considering the consequences of these stressors on parenting (Gewirtz et al., 2018b). No studies, however, have sought to understand how family stressors might differentially affect mothers and fathers. In this study, then, consistent with the military family stress model, we examine associations among combat exposure, parents' mental health, and perceptions of parenting in both deployed mothers and deployed fathers. Although most soldiers exposed to combat return without significant wounds of war, a significant minority suffer physical injuries and/or negative mental health consequences, including depression and posttraumatic stress disorder (PTSD) symptoms, substance abuse, and difficulties transitioning back to work and family life (Brown et al., 2012; Hines et al., 2014; Vasterling et al., 2010; Vogt et al., 2011). Among the negative sequelae, combat-related PTSD is by far the most studied. A significant body of literature has investigated the associations of PTSD symptoms with family functioning but relatively fewer studies have examined deployment stressors, PTSD symptoms, and perceptions of parenting among military fathers and mothers. A meta-analysis of 33 studies reported that approximately 23% of veterans returning from recent military operations met full criteria of PTSD (Fulton et al., 2015). Five factors characterize PTSD according to Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria: exposure to a traumatic or stressful event, repeated and unwanted reexperiencing of the event, hyperarousal, emotional numbing (memory impairment, diminished interest, detachment), and avoidance (including behavioral and experiential) of reminders of traumatic events (American Psychiatric Association, 2013; Ehlers & Clark, 2000). Studies have mixed research findings related to gender differences in PTSD symptoms among service members and veterans (Haskell et al., 2010; Hourani et al., 2015). Though both men and women tend to report reexperiencing, avoidance, and hyperarousal symptoms, women more typically report emotional numbing (Barnett et al., 2018; Hourani et al., 2015), while men more typically report dysphoria (Barnett et al., 2018). One study found that, overall, women military veterans show lower rates of PTSD compared with men (Haskell et al., 2010) though the researchers did not assess or control for combat exposure. Luxton et al. (2010) found that gender moderated the relationship between combat exposure and PTSD, such that among females, higher levels of combat exposure were more strongly associated with PTSD symptoms than males, and in a different study, overall higher levels of PTSD were found among female veterans than males (Tanielian et al., 2008). In contrast, other studies have shown minimal or no significant differences in the prevalence of PTSD among male and female veterans of the Afghanistan and Iraq conflicts (Rona et al., 2007; Seal et al., 2007). Similarly, a systematic review of military subgroups from Canada, the United States, and the United Kingdom found no significant gender difference in the prevalence of PTSD (Hines et al., 2014). A longitudinal study examining the influence of combat-related stressors and pre-deployment risk/protective factors on post-deployment mental health revealed that exposure to the aftermath of combat (e.g., witnessing injured/dying people) did not differ by gender, but that gender moderated the association between risk factors for PTSD (e.g., combat-related stressors, prior interpersonal victimization, lack of unit support) and post-deployment PTSD symptoms such that the relationship between the two was significantly more powerful for women than men (Polusny et al., 2014). Given inconsistent findings, examining the gender differences in PTSD symptoms among parents exposed to combat remains an important issue for further investigation. Consistent with a military family stress model, PTSD symptoms also are associated with impairments in parenting behaviors, including harsh and inconsistent parental discipline (Giff et al., 2019), as well as parental engagement and warmth (Brockman et al., 2016), but these studies have only examined fathers. Parental locus of control refers to parents' perceptions of their control, competence, and efficacy in parenting. Parental locus of control (PLOC) is an important feature of the parenting role because it is likely associated with parents' perceptions of the source of children's problems (Campis et al., 1986), may influence parenting behaviors (Solomon & Mikulincer, 1990), and is amenable to change through parenting interventions (Piehler et al., 2018). It is likely that PLOC is a proximal outcome of participation in a parenting intervention. For example, PLOC was the first parenting construct to improve following the ADAPT (After Deployment, Adaptive Parenting Tools) intervention, and it, in turn, led to changes in related constructs such as child and parent mental health (Piehler et al., 2018). Parental locus of control changes also foreshadow changes in observed parenting (Benedetto & Ingrassia, 2017). Several studies highlight the links between PLOC and parental competence, consistent discipline, and functioning, as well as parenting satisfaction (Jones & Prinz, 2005; Kokkinos & Panayiotou, 2007; Solomon & Mikulincer, 1990). However, PTSD symptoms may impair an individual's PLOC, engendering negative perceptions about the ability to effectively parent (Solomon & Mikulincer, 1990). Specifically, parents with avoidance and numbing symptoms may behave in less active, involved, and more reactive ways and/or be less responsive to the immediate demands of parenting (N. B. Smith et al., 2018). Moreover, parents experiencing symptoms of numbing may offer less attention to their children and may be more prone to inconsistent discipline and poor monitoring of their children (Creech et al., 2017; Giff et al., 2019), further impacting parenting. Although extensive studies document the role of combat exposure in PTSD symptoms, the majority of empirical studies have focused on deployed men/fathers, with limited data on deployed mothers (Gewirtz et al., 2014). Posttraumatic stress disorder is likely a central construct through which military family stress (in this case, trauma exposure) is linked to parental behavior (Gewirtz et al., 2010). Yet no studies have investigated whether combat-related PTSD is associated with impairments in perceptions of parenting/PLOC. We thus aimed to examine these relationships in the current study. We hypothesized that parents' combat exposure would be indirectly linked to their parental locus of control (PLOC) through self-reported PTSD symptoms. Deployed mothers may exhibit more challenges following deployment, given expectations that they immediately return to their traditional gender roles as primary caregivers, assuming household and parenting responsibilities (Gewirtz et al., 2014). Mothers who are able to successfully separate their distress from their parenting role may be better able to care for their children, and exhibit more sensitivity to their children following return from deployment (Gewirtz et al., 2014; Kelly et al.,1994). On the other hand, fathers may experience more difficulty transitioning back to parenting responsibilities and may be given more time to adjust to being at home, especially when their spouse remained at home during the deployment (Creech et al., 2017). Therefore, in the context of the military family stress model, we also examine potential gender differences among deployed parents in the relationships of combat exposure to PTSD symptoms and PLOC.
Funding Information:
The ADAPT study was funded by a grant from the National Institute on Drug Abuse, grant no. DA030114 to Abigail Gewirtz. The ADAPT4U study was funded by the Department of Defense; grant no. W81XWH‐1‐14‐0143 (PI: Gewirtz). Funding information
Publisher Copyright:
© 2022 The Authors. Family Relations published by Wiley Periodicals LLC on behalf of National Council on Family Relations.
Keywords
- ADAPT (After Deployment
- Adaptive Parenting Tools)
- PTSD symptoms
- combat exposure
- military deployment
- parental locus of control
- parents