Mental health profiles of depressive symptoms and personal well-being among active-duty military families

Although some research has examined the mental health of individual family members in military families, additional research is needed that considers mental health among multiple members of the family system simultaneously and that characterizes subsets of families with distinct patterns. Mental health patterns of depressive symptoms and well-being in and among families were identified using latent profile analysis with a community sample of 236 military families with a service member (SM) parent, civilian partner, and adolescent. Drawing from the Family Adjustment and Adaptation Response model, we examined several military-related family demands (e.g., relocations, deployments) and capabilities (e.g., family cohesion, social support outside the family) as correlates of the family profiles. Three profiles emerged: thriving families (62.3% of the sample where all three family members reported relatively low depressive symptoms and high personal well-being), families with a relatively distressed SM (24.2%), and families with a relatively distressed adolescent (13.5%). Overall, there were no differences between the groups of families regarding military-related demands, yet there were differences between the groups regarding their capabilities, namely family cohesion and social support. In general, families in the thriving profile tended to have higher family cohesion and social support as reported by multiple family members compared to the other two profiles. Findings can inform the development of family needs assessments and tailored interventions (and intervention points) based on family profiles and current capabilities.

Use of food distribution resources among military families with young children since the COVID-19 pandemic

OBJECTIVE

The present study examined military families' use of food distribution resources and military (e.g. rank) and non-military (e.g. race/ethnicity) characteristics associated with using food distribution resources.

DESIGN

Secondary data analyses from a cross-sectional survey in the first 6 months of 2021.

SETTING

A national sample of eligible families completed an online survey.

PARTICIPANTS

8326 enlisted military families with an active duty service member in the United States Army or Air Force who applied for supplemental childcare funding distributed by National Military Family Association.

RESULTS

13·2 % of the families reported utilising a food distribution resource in the past 12 months. Those with lower financial well-being were more likely to utilise such resources. Older (OR = 1·04, 95 % CI = 1·02, 1·05, P < 0·001), single-earner (OR = 0·73, 95 % CI = 0·61, 0·89, P = 0·001) families with a lower rank (OR = 0·69, 95 % CI = 0·64, 0·75, P < 0·001) and Army affiliation (compared with Air Force) (OR = 2·31, 95 % CI = 2·01, 2·67, P < 0·001) were more likely to utilise food distribution resources. Members of certain racial/ethnic minority groups were more likely to utilise food distribution resources than White respondents (OR from 1·47 for multi-racial to 1·69 for Asians), as were families with more dependent children (OR = 1·35, 95 % CI = 1·25, 1·47, P < 0·001).

CONCLUSIONS

These results identify the extent of food distribution resource utilisation in military families with young children approximately 1 year into the COVID-19 pandemic. The results also identify characteristics associated with their use of food distribution resources. Findings are discussed with an emphasis on prevention and intervention implications for military families.

Military-related stress, self-efficacy, and anxiety: Investigating the role of marital quality in military couples

This study utilizes a stress process framework in conjunction with a crossover perspective to conceptualize how stress, specifically military-related stress, manifests within individuals and couples. An actor-partner interdependence mediation modeling approach was used in a cross-sectional sample of 243 military couples to examine whether difficulties managing military-related stress may erode one's own self-efficacy and, in turn, contribute to greater anxiety (actor effects) and/or one's partner's self-efficacy and, in turn, anxiety (partner effects). Further, the potential moderating impact of marital quality was explicated in the model to understand if greater marital quality might buffer the impact of military-related stress. There was support for the stress process model primarily regarding actor effects; fewer partner effects emerged. One's own perceptions of military-related stress, specifically higher stress, were related to lower levels of their own self-efficacy, and, consequently, higher anxiety, but military-related stress did not directly affect the partner's self-efficacy or anxiety. Both service members' and civilian spouses' marital quality had ramifications for civilian spouses' self-efficacy, specifically a buffering effect; that was not the case regarding civilian spouse effects on the military member. Findings point to specific ways in which military stressors have implications for personal well-being, the role of a strong couple relationship in buffering stress, especially for civilian spouses, and concomitant leverage points for supporting both individual and couple well-being.

Identifying Mental Health Profiles Among Adolescents Who Experienced a Recent Parental Deployment or Military-Related Family Separation

Accessing two independent samples of adolescents in military families in the United States who recently experienced parental separation (N = 573; N = 186), this study sought to identify adolescent mental health profiles indexed on multiple indicators. In other words, we asked how military adolescents fare after parental separation in terms of mental health indicators. Proximal family processes (family cohesion, conflict, and marital adjustment) were also examined in relation to mental health profiles as well as core adolescent outcomes, self-rated health, and school enjoyment. In both samples, three profiles emerged identifying similar structures of mental health profiles. Two-thirds of adolescents were in the lowest risk mental health group. Poor family cohesion and greater conflict were associated with the moderate and highest risk groups. The lowest risk group reported better health and greater school enjoyment. Family nurses and other health care professionals are encouraged to inquire about military connectedness, structural changes occurring within the family system, and family processes in relation to adolescent well-being.

The Case for Multidimensional Co-Parenting Behaviors as Sources of Chronic Stress: Understanding Pathways to Mental Health Symptomology Among Divorced and Separating Adults

The co-parenting relationship matters for postdivorce parental adjustment. This study explores the relative impact of different forms of co-parenting behaviors, coupled with an individual's psychological resources, in explaining parent mental health in recently divorced or separated parents (n = 355). A latent variable structural equation model was fit to examine pathways between dimensions of co-parenting (support, overt conflict, self-controlled covert conflict, and externally controlled covert conflict), various psychological resources (satisfaction with the divorce decree, perceived competence of the co-parent, and self-efficacy), and adverse mental health symptomology. Significant direct pathways were identified between overt co-parenting conflict and adverse mental health. Indicators of co-parenting quality were tied differentially to various resources. Indirect effects were found for both self-controlled covert conflict and overt conflict on adverse mental health symptomology through self-efficacy. Leverage points and considerations for health professionals and practitioners working with divorcing parents are discussed.

Accepting influence in military couples: Implications for couples' communication and family satisfaction

In popular relationship resources, accepting influence is regarded as a couple-level process vital for relational satisfaction. However, empirical research has demonstrated inconsistent evidence for these suppositions, with several studies identifying no associations between accepting influence and relationship outcomes, and, furthermore, several gaps in the literature remain with regard to our knowledge on accepting influence (e.g., little identified research on military couples or family outcomes). To address these gaps, a measure of perceptions of one's partner accepting influence was retrospectively created to examine accepting influence in Army couples (N = 244). With theoretical underpinnings from family systems theory, this study used an actor-partner interdependence approach to investigate the associations between partners' accepting influence and couple communication satisfaction and satisfaction with the family. Service members' perceptions of their partners' accepting influence were associated with their own outcomes, whereas civilian spouses' perceptions of partners' accepting influence were related to both partners' outcomes. Results suggest accepting influence may be an intervention point to improve couple and family outcomes.

Combat Deployment Experiences and Soldier Mental Health: Examining the Factor Structure of a Combat Experiences Scale

INTRODUCTION

Researchers and practitioners are invested in understanding how deployment experiences impact the nearly 193,000 U.S. service members who deploy in a given year. Yet, there remains a need to adequately identify salient deployment experiences through survey measurement tools and understand how differential experiences are uniquely related to mental health outcomes. Therefore, this study examined the factor structure of an established combat experiences measure from the Army Study to Assess Risk and Resilience in Service members (Army STARRS) dataset to identify underlying survey constructs that reflect nuanced deployment experiences. Then, we examined the association between diverse combat experiences and current mental health symptoms (i.e., anxiety and depressive symptoms) and the mediating role of coping.

MATERIALS AND METHODS

Data were drawn from the Army STARRS data (N = 14,860 soldiers), specifically the All Army Study component. A principal component analysis (PCA) was conducted to examine the dimensionality of the combat experiences scale, and then a path model was conducted to examine the relationships between combat experiences, coping with stress following a deployment, and mental health symptoms while controlling for relevant individual and interpersonal factors.

RESULTS

Results from the principal component analysis suggested that the Army STARRS combat experiences scale encompasses two components, specifically: "Expected combat experiences" and "Responsible for non-enemy deaths." Both "Expected combat experiences" and "Responsible for non-enemy deaths" were associated with higher levels of anxiety and depressive symptoms, respectively, and "Responsible for non-enemy deaths" was also indirectly linked to these mental health outcomes through coping with stress after deployment.

CONCLUSIONS

These findings provide insight into the dimensionality of combat experiences and offer practitioners a more nuanced understanding of how to process unique combat experiences that differentially relate to mental health symptoms.

Parental Relationship Quality and Adolescent Depressive Symptoms: Investigating The Role of Parental Warmth and Hostility in United States Military Families

Military life is characterized by regular transitions; thus, parents are positioned to serve as stable protective factors for adolescents. We investigated a theory-informed model that assessed direct and indirect relationships between parental relationship quality, parental behaviors, and adolescent depressive symptomatology using cross-sectional data of military families in the United States (US). Participant families (N = 229), recruited via convenience sampling to take a computer-based survey, included an active duty father, his spouse, and an adolescent. Mother's couple relationship quality was indirectly linked to adolescent depressive symptoms through maternal warmth. Conversely, father's couple relationship quality was indirectly linked to adolescent depressive symptoms via paternal hostility. In other words, parental couple relationship quality was indirectly related to adolescent depressive symptoms, but this relationship differed by parent (i.e., warmth for mothers and hostility for fathers). Findings were similar for adolescent boys and girls.

Coping and Mental Health Differences among Active Duty Service Members and Their Spouses with High and Low Levels of Marital Warmth

This study examined the relationship between marital warmth (e.g., openly expressing affection, supportive behaviors) and assessments of coping (i.e., challenges coping with military life and self-efficacy in the context of stress) and mental health (i.e., depressive symptoms and anxiety symptoms) in a sample of active duty men and their spouses/romantic partners (N = 234 military couples). Results from a series of multivariate analysis of variance tests indicate that service members and spouses who reported higher levels of marital warmth also reported better coping skills and mental health compared to individuals in couple relationships that demonstrated lower levels of marital warmth. Intervention and prevention implications targeting social support and marital warmth are provided.

The Buffering Effect of Relationships on Combat Exposure, Military Performance, and Mental Health of U.S. Military Soldiers: A Vantage Point for CFTs

This study examined the role of cumulative combat experiences with regard to military performance and conduct and mental health among a sample of young soldiers from the Army STARRS dataset (N = 5,283). Higher levels of cumulative combat experiences were directly related to poorer performance and conduct and a greater likelihood of anxiety, depression, and post-traumatic stress disorder (PTSD). Military performance and conduct served as a linking mechanism between combat experiences and mental health. Using moderated mediation structural equation modeling, relationship disruptions were found to exacerbate the adverse effects of combat experiences; conversely, unit cohesion buffered the impact of combat experiences. Implications for military helping professionals include identifying leverage points for intervention, particularly strengthening the social connections of service members within and outside the military.

Enhancing Relationship Skills and Couple Functioning with Mobile Technology: An Evaluation of the Love Every Day Mobile Intervention

A research-informed mobile application (app) was created to encourage and activate couples to demonstrate healthy relationship behaviors in an effort to promote relationship quality, stability, and resilience. The app, Love Every Day, is grounded in the literature on couple quality, habit formation, and family resilience, and it uses tenets of effective behavioral intervention technologies. Forty-three couples (N = 86 participants) engaged with the app across a 21-day period and completed online evaluations, which consisted of a pretest, posttest, and three weekly questionnaires. Findings suggest that the couples' app promoted high levels of engagement, such that most participants viewed the app multiple times a day and also submitted answers to daily prompts 19.8 of the 21 days (94% of the intervention). Pretest and posttest assessments suggest that participants enhanced their relationship skills and behaviors, including knowledge of their partner's general well-being, care for one's partner, partner communication, and self-efficacy to manage conflict. Participants also reported higher levels of relationship quality after engaging with the app for 21 days, including less relationship distress, greater partner cohesion, better relationship satisfaction, and more relationship confidence. Implications for self-directed modes of relationship education and promoting family resilience are discussed.

Social stressors, coping behaviors, and depressive symptoms: A latent profile analysis of adolescents in military families

We investigated the relationship between context-specific social stressors, coping behaviors, and depressive symptoms among adolescents in active duty military families across seven installations (three of which were in Europe) (N = 1036) using a person-centered approach and a stress process theoretical framework. Results of the exploratory latent profile analysis revealed four distinct coping profiles: Disengaged Copers, Troubled Copers, Humor-intensive Copers, and Active Copers. Multinomial logistic regressions found no relationship between military-related stressors (parental separation, frequent relocations, and parental rank) and profile membership. Analysis of variance results revealed significant and meaningful differences between the coping profiles and depressive symptomology, specifically somatic symptoms, depressive affect, positive affect, and interpersonal problems. Post-hoc analyses revealed that Active Copers, the largest profile, reported the fewest depressive symptoms. Accordingly, frequent use of diverse, active coping behaviors was associated with enhanced resilience. Discussion is provided regarding the promotion of adaptive coping behaviors within this developmental period and the context of military family life.

Economic pressure and health and weight management behaviors in African American couples: A family stress perspective

This study extends the family stress model by examining the influence of economic pressure on health and weight management behaviors mediated by depressive symptoms and spousal support among 506 African American married couples. The actor–partner interdependence model accounted for the interdependent nature of relationships. Findings support the family stress model; yet pathways differed slightly for husbands and wives. Economic pressure directly influenced depressive symptoms and spousal support. Spousal support was a buffer against poor health and weight management behaviors for husbands, while depressive symptoms exacerbated poor health and weight management behaviors for wives. These mechanisms have implications for practitioners who promote African American couples’ well-being.

Relationship education for stepcouples reporting relationship instability--evaluation of the Smart Steps: Embrace the Journey curriculum

Smart Steps: Embrace the Journey is a research-based educational curriculum for stepfamily couples ("stepcouples"). The curriculum is designed to build couple strengths while addressing the unique challenges of repartnering with a child or children from a previous relationship. This study evaluated the effectiveness of this curriculum with 151 individuals in relationally less stable stepcouple relationships who either engaged in the Smart Steps curriculum (n = 97) or were part of the comparison group (n = 54). This study represents methodological and conceptual advances in the study of stepfamily programs with the use of a comparison group, a racially and economically diverse sample, and a relationally at-risk population. Results indicated that those who participated in Smart Steps reported significant increases in individual empowerment, couple quality, family harmony, and parenting efficacy while these measures were unchanged for those who did not receive the program. Implications for future research and for practitioners are provided.

Exploring processes of change in couple relationship education: predictors of change in relationship quality

In the past several decades, a number of largely atheoretical individual and meta-analytic studies of couple relationship education (CRE) programs have focused on program effectiveness without considerations of how these programs work and for whom. To address this gap in the literature, the current study drew upon assumptions from social-cognitive and behavioral theories that are implicit in CRE design to assess the influence of short-term changes from pre- to posttreatment in behaviors and commitment on changes in relationship quality among a racially and economically diverse group of 2,824 individuals who participated in a CRE program. Findings from structural equation modeling indicated that the best-fitting model for both men and women was one in which changes in behaviors predicted changes in relationship quality via their influence on changes in commitment. Further, a series of moderational analyses provided some evidence to suggest that the strength of the relationships between these variables may depend to a small extent on the social address of the participants (race, income) and to a greater extent on characteristics of the CRE experience (i.e., beginning the class at lower levels of functioning, attending with a partner). Findings help us begin to understand the influences among domains of change that occur as a result of participating in a CRE program, as well as offering some useful information to practitioners on demographic and contextual moderators of program outcomes. Implications for future research on the mechanisms of change for CRE are presented.