Military Couples Experiences with Service-Related Conditions

Background & Purpose:

The challenges and struggles encountered by military service members related to service related conditions (SRC) such as Traumatic Brain Injury (TBI) and Posttraumatic Stress Disorder (PTSD) extend beyond the individual, often creating significant disturbances in the service member's support network.  These challenges can have especially profound effects on couples, further compounding the unique circumstances that can accompany military service (e.g. prolonged separations, disruptions in family roles, frequent relocations).  Increasing attention is being given to the military couple as a critical point of intervention for addressing the needs of both service members and their partners, but we continue to have a limited understanding of the experiences that confront these couples. 

Methods:

This study utilizes a mixed-methods design to explore the experiences and needs that these couples encounter.  To accomplish this, secondary data was analyzed that was collected from a couples retreat for military couples affected by an SRC and semi-structured qualitative interviews were conducted with a cohort of retreat participant couples.

Pre and post intervention data was collected from 156 intervention participants across eight retreat cohorts, including service members and their partners from various locations in a mid-Atlantic state.  Surveys consisted of two instruments: a health and wellbeing scale, based on the 12-Item Short Form Health Survey (SF-12) to assess how much participant’s symptoms of PTSD or TBI (or their partner’s symptoms) and emotional state interfered with their general health and functioning; and the Revised Dyadic Adjustment Scale (RDAS), used to examine the quality of relationship dynamics between participant couples.  To examine this data, descriptive statistics were calculated, paired sample t-tests were conducted, and an intraclass correlation coefficient was calculated to determine the level of agreement between couples’ scores on the RDAS, a measure of their respective perceptions of the relationship. 

Interviews were conducted with 11 participants from the most recent retreat, representing 7 different couples.  Interview questions related to their experiences and needs as couples affected by a SRC.   Thematic analysis was utilized to determine emergent categories that were salient across couples.

Results:

Descriptive statistics from the two instruments yielded valuable insights into dimensions of wellbeing and relational functioning that present both strengths and challenges to these couples. We were not able to detect a significant change on either measure post-intervention; however, we did find a significant improvement in the intraclass correlation coefficient (pre 0.740, post 0.936) indicating a strong congruence of couples’ responses on the RDAS, especially post intervention. 

Three thematic continuums emerged from the qualitative analysis: a continuum between confrontational or avoidant approaches to problem-solving and communication, a continuum between feeling connected or isolated from their support networks, and finally a continuum between being understood or misunderstood by significant others in their lives. 

Conclusions & Implications:

Couples involved in this study provided insights into how an SRC can affect both intra- and interpersonal dynamics of wellbeing and relational functioning.  This information is valuable for social workers seeking to intervene and support the wellness of military families affected by these conditions.