Traumatization, Marital Adjustment, and Parenting among Veterans and Their Spouses: A Longitudinal Study of Reciprocal Relations

• Author: Yafit Levin,Rahel Bachem,Zahava Solomon
• DOI: http://doi.org/10.1111/famp.12257
• Published date: 01 December 2017
• Date: 01 December 2017

Traumatization, Marital Adjustment, and Parenting

among Veterans and Their Spouses: A Longitudinal

Study of Reciprocal Relations

YAFIT LEVIN*

,†

RAHEL BACHEM

‡

ZAHAVA SOLOMON*

,†

Despite considerable research on secondary traumatization, the ramifications of veter -

ans’ and their wives’ posttraumatic stress symptoms (PTSS) for the family system remain

largely uninvestigated. Beginning to fill this gap, the current study aims to investigate the

reciprocal relations between both spouses’ PTSS and marital adjustment, and the implica-

tions these bear for their parental functioning. Two hundred and twenty-five Israeli veter-

ans (mean age =58.62, SD =7.6) from the 1973 Yom Kippur War and their wives (mean

age =58.28, SD =5.79) were examined at two points in time: 30 (T1) and 35–37 years

after the war (T2). Analysis included longitudinal actor–partner interdependence model-

ing and sequential mediation analyses. The results show that higher PTSS among the

wives at T1 predicted higher PTSS among husbands at T2, and vice versa, and predi cted

their husbands’ marital adjustment at T2. Moreover, wives’ PTSS at T1 had a significant

effect on parental overinvolvement of both parents at T2, but neither their PTSS no r their

husbands’ PTSS had an impact on positive parenting. In the intrapersonal domain, better

marital adjustment at T1 predicted positive parenting among both spouses in subsequent

measurement. Interpersonally, wives’ lower marital adjustment at T1 predicted husbands’

higher parental functioning, but not vice versa. Furthermore, marital adjustment medi-

ated the association between PTSS and positive parenting for both spouses. The results

emphasize the detrimental ramifications of war trauma on the interpersona l domains in

veterans’ families. Hence, both marital and parental consequences of trauma should be

considered in clinical family interventions.

Keywords: W ar Trauma; Posttraumatic Stress; Secondary Traumatization; Marital

Adjustment; Parenting; Actor–Partner Interdependence Model

Fam Proc 56:926–942, 2017

INTRODUCTION

It is widely recognized that war trauma has detrimental effects on veterans’ mental

health particularly manifesting in posttraumatic stress symptoms (PTSS), character-

ized by symptoms such as intrusive thoughts, negative cognitions and moods, hyper-

arousal, and avoidance (American Psychiatric Association, 2013) that often undermine

*Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.

†

I Core Research Center for Mass Trauma, Tel Aviv University, Tel Aviv, Israel.

‡

Psychopathology and Clinical Intervention Unit, Department of Psychology, University of Zurich, Zurich,

Switzerland.

Correspondence concerning this article should be addressed to Yafit Levin, Bob Shapell School of Social

Work, Tel Aviv University, Tel Aviv 69978, Israel. E-mail: ohanayaf@gmail.com.

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Family Process, Vol. 56, No. 4, 2017 ©2016 Family Process Institute

doi: 10.1111/famp.12257

interpersonal functioning (Monson, Taft, & Fredman, 2009). Moreover, war experienc es

not only impact the lives of veterans themselves but also impact their sign ificant others,

potentially causing loved ones to show a variety of mental and interpersonal problems

(Monson et al., 2009). Secondary traumatization (ST) describes people in close contact

with a traumatized person who may indirectly display PTSS, similar to those exhibited by

the trauma survivor (Figley, 1995). The Diagnostic and Statistical Manual of Mental

Disorders (American Psychiatric Association, 2013) specifies that indirect exposure to

traumatic events can be considered traumatic, suggesting that in specific cases veterans’

spouses might suffer from PTSS (Monson et al., 2009).

As people traverse from the status of bachelors to that of family members, they typically

take up two important social roles: first, that of a marital partner, and gradually, that of a

parent. In the aftermath of trauma, the functioning in and quality of both domains are

affected (Catherall, 2005). Veterans’ hyperarousal and irritability, for instance, may give

rise to outbursts that generate conflict and decrease conflict-resolution capacities (Miller

et al., 2013). Avoidance symptoms, specifically emoti onal numbing, may impede intimacy

and marital communication and thus contribute to relationship dysfunction (Monson

et al., 2009). However, the complex interplay between war trauma and both its marital

and parental ramifications remains under-investigated.

While past research has attended to the symptomatic ramifications of war trauma

among veterans and their wives separately, as far as we know, no study offers examina-

tion of the reciprocal relationship of PTSS, marital relationship, and parenting among vet-

erans and their wives as dyads, and not in a longitudinal design. Further, numerous

studies have demonstrated that one of the most prominent factors contributing to the

development of PTSS in wives of combat veterans concerns their husbands’ symptomatol-

ogy (Al-Turkait & Ohaeri, 2008), yet they neglect to address the reverse direction. The cur-

rent study aims to fill these gaps in the literature.

Marital Adjustment Following War Traumatization

The use of the term “marital adjustment” in the current study refers to the subjective

perception of several aspects of the marital relationship: satisfaction, consensus, cohesion,

and affection (Spanier, 1976). Research has shown that marital adjustment and mental

state of both marital partners are interrelated (Proulx, Helms, & Buehler, 2007).

The reciprocal relations bear potential relevance for the unique context of families

wherein one spouse suffers from direct war induced traumatization and the other from a

secondary reaction. However, most studies have found that the association between com-

bat exposure and marital maladjustment have been mediated by the veteran’s PTSS

severity (Sayers, Farrow, Ross, & Oslin, 2009), while neglecting the reciprocal processes

between partners. The current study is innovative in this respect as it assesses the impact

of the wives’ ST on both partners’ psychological and interpersonal status.

Parenting Following War Traumatization

Parenting may also be affected by PTSS, yet little attention has been devoted to the

effects of war trauma on parenting. One cross-sectional study has revealed a negative rela-

tionship between PTSS severity and parenting satisfaction among Vietnam combat veter-

ans with young children (Samper, Taft, King, & King, 2004). Similarly, studies focusing

on veterans’ parenting capacities indicate that veterans suffering from combat-induced

stress reactions show negative self-perceptions of their paternal abilities and reduced sat-

isfaction from their parental roles and functioning (Samper et al., 2004; Solomon, Debby-

Aharon, Zerach, & Horesh, 2011). Furthermore, studies on Holocaust survivors have

found that survivors oscillated between fear of intimacy and the need to compensate and

Fam. Proc., Vol. 56, December, 2017

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