Research on Children in Miliary Families: The Impact of Parental Family Deployment and Reintegration on Child and Family Functioning

Cincinnati Childrens Hosp Med Ctr, Cincinnati OH

Investigators

Abstract

DESCRIPTION (provided by applicant): The impact of combat-related PTSD (crPTSD) on the veteran and his/her family is considerable. Although there is a national priority to involve the entire family system in the care of veterans,1,2,67 no studies to date have explored how targeting all aspects of a family system may improve the quality of family functioning (in addition to the expected alleviation of crPTSD symptoms for the individual veteran). This study is a collaboration between the Cincinnati Veteran's Administration Medical Center, the University of Cincinnati, and Cincinnati Children's Hospital Medical Center. Eighty-four veterans diagnosed with crPTSD from the Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) campaigns and their partner will be randomly assigned to one of two treatment groups: (1) cognitive-behavioral conjoint therapy that contains an embedded parent management training (PMT) module (CBCT-PMT), or (2) CBCT without the parent management training module (CBCT only). The veteran's custodial children (ages 5-11) will participate in the study by completing separate behavior rating scales at pre-treatment, immediate post-treatment, and three-month post-treatment. This study will address an important question as it pertains to maximizing treatments for crPTSD: do veterans assigned to the CBCT-PMT group yield greater reductions in PTSD symptoms and greater gains in quality of family functioning (i.e., family satisfaction, parental well-being, reduction in child externalizing behaviors) than veterans assigned in the CBCT group? Treatments that focus on the entire family system has been shown to yield significantly higher effect sizes on improved veteran and family functioning in comparison to individual therapies that target only one subsystem (i.e., the patient-partner dyad). Thus, our working hypothesis, supported by our pilot data, is that targeting all elements within the family system will yield significantly higher effect sizes for CBCT-PMT than CBCT (only), in terms of PTSD symptom reduction, positive changes in both the partner relationship and positive changes in parent-child relationships (including reduced child problem behaviors). The magnitude of these between-group effect size differences will continue to be realized at 3- month post-treatment, which will further demonstrate the stability of benefits to veterans in the CBCT-PMT group, as well as their family members.