Health Services Research & Development

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2007 HSR&D National Meeting Abstract

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National Meeting 2007

1060 — The Importance of Family Readjustment Problems among OEF-OIF Veterans Referred for Behavioral Health Evaluation

Sayers SL (Philadelphia VA Medical Center, VISN 4 MIRECC) , Farrow V (Philadelphia VA Medical Center, VISN 4 MIRECC), Ross J (Philadelphia VA Medical Center, VISN 4 MIRECC), Beswick C (Philadelphia VA Medical Center, VISN 4 MIRECC), Sippel L (Philadelphia VA Medical Center, VISN 4 MIRECC), Kane V (VISN 4 Behavioral Health), Oslin DW (Philadelphia VA Medical Center, VISN 4 MIRECC)

Objectives:
This project aimed to estimate the clinical importance of family readjustment and family conflict among psychologically distressed veterans returning from OEF-OIF conflicts.

Methods:
Veterans at the Philadelphia VA Medical Center were considered for inclusion after being referred from Primary Care to the Behavioral Health Laboratory (BHL) for evaluation. The BHL is a psychiatric evaluation service that conducts structured assessment for primary care clinicians. All patients who were reached for BHL evaluation in the past 4 months and who reported serving in the OEF-OIF conflicts were asked questions about family readjustment and family violence.

Results:
Of the 76 OEF-OIF veterans identified, none refused participation (age: M=32.5, SD=9.7). Over 40% were currently married or cohabitating; 27.6 % were recently separated or divorced, and 60.5% of all respondents reported that they had at least 1 child (M=1.9, SD=1.2). Two-thirds of the married/cohabitating veterans reported some type of family readjustment or family conflict problem occurring several times a week—35.5% felt like a guest in their household, 23.1% reported their children do not act warmly or were afraid of them, and 51.6% had disagreements about household responsibilities. About 56% of respondents with current or recently separated partners reported severe conflicts involving “shouting, pushing, or shoving”, or that this partner was “afraid of them.” Among veterans with current or former partners, the number of family problems was correlated with the severity of depressive symptoms, r=.27, p<.05; an index of more severe family conflicts was associated with depression severity, r=.46, p<.01. The existence of severe conflict was associated with an increased risk of having a major or minor depression diagnosis, chi-square=7.23, p<.01, OR=5.72 (95% CI=1.5-21.8), and Generalized Anxiety Disorder, chi-square=14.01, p<.001, OR=15.5 (95% CI=3.0-80.0).

Implications:
Family problems are prevalent among OEF-OIF veterans referred for behavioral health evaluation and these problems should be systematically assessed. The results support that family problems are associated with severity of behavioral health symptoms.

Impacts:
The prevalence of family problems and their association with behavioral health issues indicates it is important to address family-related needs of those OEF-OIF veterans experiencing psychological distress subsequent to their reentry into civilian life.