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2015 HSR&D/QUERI National Conference Abstract

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3153 — Predictors and Influence of Spouse/Partner Distress Trajectories Across Deployment on Veterans' Post-deployment Mental Health

Polusny MA, Minneapolis VA Health Care System; Erbes CR, Minneapolis VA Health Care System; Arbisi PA, Minneapolis VA Health Care System; DeGarmo D, University of Oregon; Kramer MD, Minneapolis VA Health Care System; Campbell EH, Minneapolis VA Health Care System; Bangerter A, Minneapolis VA Health Care System; Vogt DS, Boston VA Healthcare System; Cutting A, Minneapolis VA Health Care System;

Objectives:
This prospective, 4-wave longitudinal study of National Guard Soldiers and their spouses/partners characterized spouse/partner distress across a deployment cycle and examined the impact of family well-being on Veterans' mental health following deployment.

Methods:
1,020 Soldiers-spouse/partner dyads completed valid and reliable measures of risk and resilience factors (i.e., personality, individual and family stressors, social support) and mental health (depression, anxiety and alcohol misuse) before Soldiers' deployment to Iraq or Afghanistan. A multi-step mail survey procedure was used to collect follow-up measures from spouse/partners at Month 3 (n = 750, 74% response rate) and Month 9 (n = 707, 70% response rate) of deployment, and from Soldiers/Veterans (n = 535, 53%) and spouse/partners (n = 608, 60%) 3-months post-deployment.

Results:
Latent class growth analysis revealed four distinct trajectories of spouse/partner distress: low pre-deployment distress remaining stable over time (resilience); initially low distress, increasing during deployment and remained elevated post-deployment (vulnerable-risk); initially high distress, declining sharply during deployment (anticipatory distress); high, stable distress across time (chronic distress). Multinomial logistic regression was used to identify pre-deployment predictors of spouse/partner latent trajectory class membership: For vulnerable risk vs. resilient trajectory, predictors included: Soldiers' social support (aOR = 0.94) and spouse/partners' tendency towards emotional reactivity (aOR = 1.08), individual and family stressors/concerns (aOR = 1.44), and family readiness (aOR = 0.95). For chronic distress vs. resilient trajectory, predictors included: Soldiers' pre-deployment individual and family stressors/concerns (aOR = 2.12) and alcohol use (aOR = 0.68) and spouse/partners' pre-deployment tendency towards emotional reactivity (aOR = 1.11), low positive emotionality (aOR = 1.11), and disconstraint (i.e., impulsivity; aOR = 1.11), perceptions of family readiness (aOR = 0.93), and social support (aOR = 0.92). For anticipatory distress vs. resilient trajectory, predictors included: Spouse/partners' pre-deployment neuroticism (aOR = 1.07) and individual and family stressors/concerns (aOR = 1.45). Spouse/partner membership in the resilient trajectory class, characterized by low, stable distress across the deployment cycle, was a significant protective factor in Veterans' development of post-deployment distress (B = -0.12, p < .05), while spouse/partner membership in the vulnerable-risk distress trajectory was associated with greater post-deployment distress among Veterans (B = 0.13, p < .05).

Implications:
Risk/resilience factors measured prior to deployment predicted distinct patterns of spouse/partners well-being across deployment. Spouse/partner trajectories (resilience and vulnerable-risk) predicted Veterans' mental health adjustment following return from deployment.

Impacts:
This research provides systematic information that may inform development and testing of family-based interventions to enhance Veterans' resilience.