Military service personnel experience high rates of PTSD, depression, and drug and alcohol use on return from Middle East Conflicts. Their families are also challenged by deployment, with a realignment of family roles, co-parenting and other stressors, resulting in high rates of child and spouse adjustment problems. Thus, post-deployment realignment and renegotiation of family roles, and re-engagement in daily family life represents a powerful transition. The manner in which this realignment, reintegration and re-engagement unfolds has powerful effects on the subsequent adjustment of service members, spouses and children. This research will develop and implement a behavior observation coding system of family interaction during post- deployment family reintegration of service personnel returning from Middle East conflicts. Two key patterns of family interaction are targeted in the coding system: reactivity-coercion, and withdrawal-avoidance. These patterns are hypothesized: (a) to be positively associated with the problems of service members and their spouses and children during the initial post-deployment period, and to disrupt skilled parenting and family problem solving, and (b) to negatively influence the long-term trajectories of parenting, family problem solving, and psychosocial adjustment of service members and their spouses and children. This study will use data from a funded NIDA RCT assessing the impact of a post-deployment parenting intervention (PMTO- ADAPT) relative to services as usual on observed parenting skills and family problem solving, and on the adjustment of service members, their spouses and children over a 24 month period. The hypotheses will be tested in a longitudinal-experimental design by examining whether changes in service and family members'adjustment and in parenting and family problem solving engendered by PMTO-ADAPT are mediated by changes in the rates of reactivity-coercion and withdrawal-avoidance. Service members'baseline adjustment will be tested as a moderator of these intervention effects. Identification and validation of the two key family interaction patterns will provide critical information needed to create, adapt and implement effective family interventions to meet the unique issues and needs of returning military service members and their families.
This research creates an observational method to measure the post-deployment impact of military service members'PTSD and alcohol and drug use on family functioning, and the role of family functioning on service members'and family members'longer-term adjustment. It will provide information needed to formulate and deliver family-based interventions needed to meet the unique needs of service members and their families.