The Impact of Mental Health, Physical Health and Previous Deployments on the Family Functioning of Veterans

Background and Purpose: Repeated family separations during deployment as well as the physical and psychological effects of combat exposure on military personnel have been shown to impact the functioning of spousal relationships and children in military families.  Less is known about the long-term impact of these experiences on veteran families, which is increasingly relevant as large numbers of personnel retire from military service. This study examines the effects of deployment, physical and mental health among veterans on reports of child and intimate relationship problems. 

Methods: Data for these analyses were drawn from a survey of 1356 veterans in Southern California. A mixed sampling strategy was employed to identify a convenience sample of veterans who completed online or paper surveys.  Independent variables included the PHQ-15, assessing physical health, the PCL, assessing PTSD symptoms, and a dichotomous measure of deployment.  Outcome variables included dichotomous lists of typical problems service members and veterans may experience with their children (e.g. behavior, peer relationships, emotional problems) and their intimate relationships (e.g. mood changes, balancing household responsibilities, sexual problems).  Responses were summed inclusively and dichotomized to reflect the presence or absence of child or relationship problems. 

Results: Two logistic regression models were run to predict the odds of child or relationship problems, controlling for age, gender, race/ethnicity and education. The final analytic sample in the child model included 513 respondents who reported having at least one child, and 448 respondents in the relationship model who reported being married or in a serious relationship. Findings indicate physical health (OR = 1.048, 95% CI: 1.002, 1.098) and mental health (OR = 1.019, 95% CI: 1.004, 1.034) independently predicted increased odds of child problems.  Similarly, physical health (OR = 1.081, 95% CI: 1.012, 1.154) and mental health symptoms (OR = 1.043, 95% CI: 1.022, 1.065) independently predicted increased odds of relationship difficulties.  When compared directly, mental health symptoms were a stronger predictor across both models, while deployment was not a significant predictor when physical and mental health symptoms were included in models.

Conclusions and Implications: Findings indicate for children, each additional PTSD symptom was associated with a 1.9% increase in reported problems and an additional physical health symptom was associated with a 4.8% increase in problems.  For intimate relationships, each additional PTSD symptom was associated with a 4.3% increase in problems.  Similarly each additional physical health symptom was associated with an 8.1% increase in report of relationship problems. Overall PTSD symptoms were more impactful on child and relationship functioning compared to physical health symptoms, which may be do to the more ambiguous nature of mental health symptomatology.  Study limitations included a cross-sectional design and missing data which may limit generalizability. Results highlight the need for longitudinal research, which could follow families through the transition out of military service in order to clearly understand how these stressors continue to impact family functioning.  Further, findings suggest the need to continue support for military families who have experienced adverse physical and mental health outcomes beyond the service member’s transition to civilian life.