Lynette Evans

Longitudinal Analyses of Family Functioning in Veterans and Their Partners Across Treatment

OBJECTIVE This study evaluated the relations between posttraumatic stress disorder (PTSD) symptoms and poor family functioning in veterans and their partners. METHOD Data were collected from Caucasian veterans with PTSD (N = 1,822) and their partners (N = 702); mean age = 53.9 years, SD = 7.36. Veterans completed the Posttraumatic Checklist Military Version (PCL-M) and, along with their partners, completed the McMaster Family Assessment Device (FAD-12). Assessments were conducted at intake into a treatment program at 3 months and 9 months posttreatment. RESULTS Structural equation models (SEMs) were developed for veterans as well as for veterans and their partners. Poor family functioning for veterans at intake predicted intrusion (β = .08), hyperarousal (β = .07), and avoidance (β = .09) at 3 months posttreatment. At 3 months posttreatment, family functioning predicted hyperarousal (β = .09) and avoidance (β = .10) at 9 months. For veterans and their partners, family functioning at intake predicted avoidance (β = .07) at 3 months, and poor family functioning at 3 months predicted intrusion (β = .09) and hyperarousal (β = .14) at 9 months. The reverse pathways, with PTSD symptoms predicting poor family functioning, were only evident with avoidance (β = .06). CONCLUSION Family functioning may play a role in treatment for veterans.

Family functioning predicts outcomes for veterans in treatment for chronic posttraumatic stress disorder

A longitudinal framework was used to examine the competing hypotheses of (a) whether family functioning predicts changes in posttraumatic stress disorder (PTSD) symptoms or (b) whether PTSD symptoms predict changes in family functioning. Veterans (N = 311) admitted to a treatment program completed a series of questionnaires at 3 time points: at intake, from intake to completion of a treatment program, and at the 6-month follow-up. Alcohol use and general mental health symptoms were also measured at intake. A cross-lagged panel model using structural equation modeling analyses indicated that family functioning was a moderate predictor of PTSD symptoms at posttreatment and at the 6-month follow-up. PTSD was not a significant predictor of family functioning across time and alcohol use, and general mental health symptoms did not affect the overall findings. Further analyses of PTSD symptom clusters indicated that the avoidance symptom cluster was most strongly related to family functioning. Targeting family relationships for treatment may be important in the future for veterans with PTSD.

Predicting posttraumatic stress disorder symptoms and pain intensity following severe injury: the role of catastrophizing

Background: A number of theories have proposed possible mechanisms that may explain the high rates of comorbidity between posttraumatic stress disorder (PTSD) and persistent pain; however, there has been limited research investigating these factors. Objective: The present study sought to prospectively examine whether catastrophizing predicted the development of PTSD symptoms and persistent pain following physical injury. Design: Participants (N = 208) completed measures of PTSD symptomatology, pain intensity and catastrophizing during hospitalization following severe injury, and 3 and 12 months postinjury. Cross-lagged path analysis explored the longitudinal relationship between these variables. Results: Acute catastrophizing significantly predicted PTSD symptoms but not pain intensity 3 months postinjury. In turn, 3-month catastrophizing predicted pain intensity, but not PTSD symptoms 12 months postinjury. Indirect relations were also found between acute catastrophizing and 12-month PTSD symptoms and pain intensity. Relations were mediated via 3-month PTSD symptoms and 3-month catastrophizing, respectively. Acute symptoms did not predict 3-month catastrophizing and catastrophizing did not fully account for the relationship between PTSD symptoms and pain intensity. Conclusions: Findings partially support theories that propose a role for catastrophizing processes in understanding vulnerability to pain and posttrauma symptomatology and, thus, a possible mechanism for comorbidity between these conditions. For the abstract or full text in other languages, please see Supplementary files under Reading Tools online

Work-family conflict and crossover in volunteer emergency service workers

Abstract A growing literature indicates that organizational and work demands place pressure on the partners and families of volunteer workers as it does on paid workers. This study evaluated a conceptual model integrating work–family conflict and stress crossover theoretical frameworks, to investigate the mechanisms by which emergency service volunteer work, specifically, predicts outcomes for the partners of volunteers. Matched data from 102 couples in which one partner was an Australian emergency services volunteer – firefighter, ambulance officer or emergency rescue volunteer – were analysed using structural equation modelling analyses. Findings suggested that one mechanism by which inter-role conflict related to partner adjustment was through elevated withdrawn marital behaviour and decreased intimacy reported by the couple, which indirectly affected partners’ distress. This finding regarding withdrawn behaviour appears to be novel and may also be applicable to paid workers. Alternative mechanisms involving role overload and angry marital behaviour were not supported. These findings extend limited research which has adapted organizational theory to understand processes affecting volunteer workers, and advance conceptual accounts of the mechanisms through which the partners and families of workers are impacted by inter-role conflict.

Families of rural volunteer firefighters

Abstract The protection of Australian rural communities from fire and other emergencies is provided mostly by volunteers. However, many fire agencies are facing concerns over falling volunteer numbers and are increasingly looking at factors potentially impacting on volunteering. Evidence suggests that family issues play a role in many volunteer resignations and could be contributing to declining volunteer numbers. Despite this, there is little research available on the families of rural volunteer firefighters and agencies have little evidence to inform strategies for supporting the families of their volunteers. In a preliminary effort to address this lack of knowledge, this review summarises the small amount of research available on rural families in general, and then volunteer firefighter families in particular. It then introduces a potentially useful model of Work–Family Conflict, which suggests that time- and strain-based pressures may be important sources of difficulty for spouses and partners balancing volunteer firefighter and family roles. This review concludes by summarising directions for future research that are important, if volunteer-based rural fire agencies are to develop policies to better support the families of their volunteers

Secondary traumatic stress in postdisaster field research interviewers

Numerous studies show that those involved in disaster response may develop posttraumatic stress disorder or experience secondary traumatic stress (STS). There are few reports about the experiences of postdisaster field research interviewers. We report findings from a follow-up study of researchers who conducted postwildfire field research interviews with residents affected by 5 severe wildfire events in Australia over the period 2009-2014. There were 33 postwildfire research interviewers who reported their experiences, and 18 of them (54.5%) described distressing interviews involving deaths, surviving severe threats to life, and destruction of houses. There were 27 (81.6%) who reported having experienced 1 or more STS symptoms on a 20-item measure. Those who conducted interviews following a multifatality wildfire event reported higher levels of STS symptoms compared with researchers whose interviews followed nonfatal wildfires. There were 21 (63.6%) researchers who reported that their interviewing experiences had positive effects on their lives. This indicates that the researcher role of gathering information so that future wildfire risk could be mitigated may have served a protective function.

An examination of the association between eating problems, negative mood, weight and sleeping quality in young women and men

The aim of this study was to determine if low mood influenced the association between eating problem symptoms and self report sleeping quality in a large group of young women and men. A group of 381 female and male undergraduate students completed a set of self-report inventories in order to test a model developed for this study observing the association between eating problems, low mood, restricted dieting, weight and self-reported sleeping quality using a path analysis model. The model that best fit the data indicated that eating problem symptoms were associated with low mood and low mood was related to sleeping quality. There was also a direct association between eating problems and sleeping quality but this was reduced by the presence of low mood in the equation. There were no other direct relationships with sleeping quality but there was an association between low mood and low weight. There were also differences reported between men and women on sleeping quality suggesting that women in this sample reported more sleeping difficulties than men. In all this research demonstrates with a large non-clinical sample the links between eating problems, mood and sleeping difficulties.

Sexual abuse, bulimic symptoms, depression and satisfaction in adult relationships.

This study explored the role of depression as a mediator between self-reported sexual abuse and bulimic symptoms. Secondly, the study examined whether there was an association between sexual abuse, bulimic symptoms, or depression and satisfaction in relationships and avoidance of sexual interactions. Women (n=297) who reported experiencing bulimic symptoms and/or depression and women who were not symptomatic completed measures on sexual abuse, bulimic symptoms, depression, satisfaction in partner relationships and avoidance of sexual interactions. A path model analysis indicated that there were direct relationships between sexual abuse and depression, depression and low satisfaction in relationships and avoidance of sexual interactions. Sexual abuse was not directly related to bulimic symptoms when depression was included in the model. Nor was sexual abuse directly related to relationship difficulties. The findings of this study support a model of non-specific pathways between sexual abuse and bulimic symptoms.