There are several studies that have been completed demonstrating that the symptoms veterans experience in relation to PTSD might have a negative impact on their family relationships, and that family relationships might also either improve or aggravate the PTSD a veteran experiences, as well as any comorbid conditions the veteran has. There are some common relationship issues veterans with PTSD experience.
Research has both examined and shown the effects of PTSD on relationships, revealing severe and pervasive negative effects on adjustment to marriage, mental health of partners, and functioning as a family in general, in some instances. Untreated PTSD and negative effects may result in issues such as family violence, compromised parenting, sexual issues, aggression, caregiver burden, and divorce.
Veterans who are male and who experience PTSD are more likely to report issues with their marriage or relationship. They are more likely to report trouble with parenting, and generally adjust to family life more poorly than veterans who do not experience PTSD. Research has demonstrated that veterans with PTSD tend to be less expressive and self-disclosing with their partners than veterans without PTSD. Veterans who have PTSD and their wives have also reported an increased sense of anxiety surrounding intimacy. Combat veterans with PTSD tend to experience more sexual dysfunction than veterans without PTSD. One suggestion made is that diminished sexual interest contributes to a decrease in adjustment and couple satisfaction.
Where impairments in the functioning of a relationship is concerned, there is a high rate of both separation and divorce among veterans; both with PTSD and without. Around 38% of Vietnam veterans who get married found themselves divorced within six months of their return from war. Overall, the divorce rate among Vietnam veterans is notably higher than for people in the general population; divorce rates are even higher for veterans who experience PTSD.
The National Vietnam Veterans Readjustment Study (NVVRS) discovered that male and female veterans who do not have PTSD tended to have relationships that were longer-lasting than veterans who did have PTSD. The rates of divorce for veterans with PTSD were two-times higher for veterans without PTSD. Veterans who did experience PTSD were three-times more likely than veterans without PTSD to marry and divorce two or more times.
Untreated Post-Traumatic Stress Disorder (PTSD) may affect the way couples interact with one-another. It has the potential to affect the mental health of partners. Generally, PTSD may have a negative impact on a veterans entire family. Male veterans with untreated PTSD are more likely to report the issues below than veterans without PTSD.
The majority of research concerning PTSD and families has been done with female partners of veterans who are male. It is important to note that the same issues may occur should the veteran with untreated PTSD be female.
Veterans with Untreated PTSD and the Mental health of Their Partners
Untreated Post-Traumatic Stress Disorder (PTSD) has the potential to affect the mental health and life satisfaction of the partners of veterans with it. A number of studies have discovered that partners of veterans with untreated PTSD, or other forms of combat stress reactions, experience a higher likelihood of developing their own mental health issues when compared to partners of veterans without PTSD or other stress reactions. In one example, the wives of Israeli veterans with PTSD were found to report more symptoms of mental health and more unsatisfying and impaired social relationships when compared with the wives of veterans who did not experience PTSD.
At least two other studies, to include the NVVRS, showed that partners of Vietnam veterans with untreated PTSD reported notably reduced satisfaction in their lives, decreased levels of happiness, and greater demoralization than Vietnam veterans who do not experience PTSD. Around 50% of the partners of veterans with untreated PTSD indicated they had felt they were, 'on the verge of a nervous breakdown.' Male partners of female Vietnam veterans with untreated PTSD reported more social isolation and poorer subjective well-being than female veterans who do not experience PTSD.
Another study, performed by Nelson and Wright, indicates that partners of veterans with untreated PTSD many times describe the difficulties they experience with their loved one's PTSD symptoms. They describe the stress they experience due to needs that remain unmet, and describe experiences of emotional and physical violence. The difficulties partners experience can be described as, 'secondary traumatization,' something that is the indirect impact of trauma on people who are in close contact with victims. The mental health symptoms partners experience may also be the results of their own experiences of trauma in relation to living with a veteran with untreated PTSD, or it may be related to a prior trauma.
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The partners of veterans with untreated PTSD face many challenges while living with the veteran. Wives of veterans with untreated PTSD often take on a larger share of tasks related to the household such as housework or bill-paying. Partners or wives also tend to do more childcare and care of the extended family in general. Wives or partners may feel that they have to take care of the veteran, as well as feeling they need to attend closely to the problems the veteran experiences. Many partners and wives are very aware of the things that can, 'trigger,' the veterans PTSD symptoms, and they try hard to decrease the effects of these triggers.
The term, 'Caregiver burden,' involves an idea that is used to describe how hard it is to provide care for a person with untreated PTSD. Caregiver burden is inclusive of practical issues such as the strain on the family's finances. Caregiver burden also includes the emotional strain on the person who is providing care for the veteran who is ill. Generally, the more severe the veteran's untreated PTSD symptoms are, the more difficult it is to provide care for the veteran, and the greater the caregiver burden.
The precise connection between the symptoms of PTSD and issues with relationships remains unknown. Some of the symptoms, such as anger and a lack of feeling or, 'numbing,' have the potential to result directly in problems with a marriage. As an example, a veteran who lacks the ability to feel happiness or love can have difficulties with acting in a loving way towards their wife or children. The expression of emotions is an essential part of becoming close to another person. An inability to experience emotions due to numbing may lead to issues with both making and keeping close relationships. Numbing might inhibit intimacy.
A study performed by Beckham, Lytle, and Feldman focused on the relationship between the severity of untreated PTSD and experiences with caregiver burden in female partners of Vietnam veterans with PTSD. As might be expected, the caregivers experienced a burden that included:
Another study, performed by Calhoun, Beckham, and Bosworth, expanded on the understanding of caregiver burden in relation to partners of veterans with untreated PTSD through inclusion of a comparison group of partners of help-seeking veterans who do not experience PTSD. The study reported that partners of veterans with untreated PTSD experienced greater caregiver burden and experienced poorer psychological adjustment than the partners of veterans who do not have PTSD. Throughout the studies, caregiver burden increased with the severity of the symptoms veterans with untreated PTSD experienced. Again – the worse a veterans symptoms of untreated PTSD, the greater the caregiver's burden.
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Due to the shortage of research examining the connection between the symptoms of untreated PTSD and intimate-relationship issues it is hard to figure out the precise relationship between them. Some of the symptoms, such as irritability, anger, and emotional numbing, might be directly related to dissatisfaction with relationships. Trouble within a relationship might facilitate the development of, or exacerbate, the course and symptoms of the untreated PTSD a veteran experiences. A lack of communication, or communication that is combative, along with divisive relationships that impede self-disclosure and the processing of emotional and traumatic items, may lead to the onset or persistence of the symptoms of untreated PTSD.
A study performed by Riggs, Byrne, Weathers, and Litz, did focus on the connection between the symptom clusters of untreated PTSD and relationships. The study focused on the connection between avoidance symptom clusters and the decrease in the ability of a person who has untreated PTSD to express emotion related to their relationship. The study results suggest that avoidance symptoms, particularly emotional numbing, interfere with the person's ability to be intimate; something that requires the expression of emotion. The study results also suggest person's with untreated PTSD who experience emotional numbing and difficulties with intimacy have trouble with both building and maintaining positive and intimate relationships.
Helping Partners and Treatment for Veterans with Untreated PTSD
Helping a partner of a veteran with untreated PTSD involves taking a first step; gathering information. Doing so helps you to gain a better understanding of what PTSD is, and the impact is has on a family. Education for the whole family about the effects of trauma on survivors and their families is another step. There are support groups, not only for veterans, but for partners, couples, and family members. Counseling is available through the Veterans Administration. There are PTSD programs available to you through Vet Centers.
Nelson and Wright suggest that effective treatment for PTSD needs to involve, 'family psychoeducation,' support groups for partners and veterans, simultaneous individual treatment, as well as either couple or family therapy. 'Psychoeducational,' groups teach coping strategies, as well as educating veterans and partners about the effects of trauma on people and families. Many times, these groups work as self-help support groups for veterans and partners.
Early research encourages the use of group treatment for female partners of Vietnam veterans with untreated PTSD. Individual therapy for veterans with PTSD and their partner is an important component of treatment, particularly if the symptoms of PTSD are prominent in both people. Family or couples therapy can be highly-effective for people whose symptoms and issues exist within a family system.
A number of researchers have started to explore the benefits of family or couples therapy for both veterans and family members. Considering recent research regarding the negative impacts of untreated PTSD on families, PTSD programs available through the Veterans Administration and Vet Centers across America are starting to offer people individual, couples, group, and family programs. Perhaps the most important message for partners is that difficulties with relationships, emotional struggles, and social troubles are common when living with a veteran with untreated PTSD. Pursuit of treatment options can improve family relationships and the mental health of individuals.
“Advancing Science and Promoting Understanding of Traumatic Stress”
Each medical center within VA has PTSD specialists who provide treatment for Veterans with PTSD. Plus, the VA provides nearly 200 specialized PTSD treatment programs. A referral is usually needed to access the specialty programs.
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