Examining Within- and Between-Family Associations of Military Fathers’ PTSD Symptoms and Child Psychosocial Functioning

• In Event: Parenting After Trauma: Addressing the Effects of PTSD on the Family

Abstract

Recent research has highlighted the importance of disentangling within- and between-family effects in statistical models to clarify theory and intervention development (Curran & Bauer, 2011; Zhang & Zyphur, 2015). Differential features of such effects may be particularly important in understanding the relationship between service member/veteran (SM/V) posttraumatic stress disorder (PTSD) and child psychosocial functioning in military families. Although research has demonstrated links between PTSD and child outcomes (see review, Creech & Misca, 2017), less is known about whether these relationships reflect “between-family” differences across families as a whole, or “within-family” trajectories of change over time. Moreover, little research has evaluated the role of specific PTSD symptom clusters or potential bi-directional relationships between PTSD and child functioning (although most assume that parental PTSD leads to future child problems, it is feasible that child problems could create stress that exacerbates a parent’s PTSD). The current study addresses these gaps in a sample of 120 Army families with a young child.

These families consisted of male Army soldiers who deployed within the last 2 years, female civilian spouses, and at least one child between 3 and 4 years old. At each of 4 time points (spaced approximately 6 months apart), fathers completed the PTSD Checklist – Military Version (PCL), and mothers completed the Strengths and Difficulties Questionnaire (SDQ) in relation to their youngest child above the age of 2 (Mage = 3.41, SD = 0.49 at Time 1). We used random intercepts cross-lagged panel modeling (RI-CLPM; Hamaker et al., 2015), which decomposes observed scores into (a) stable, between-family differences modeled as random intercepts and (b) within-family processes, which represent concurrent and prospective associations among deviations from one family member’s mean with deviations from another family member’s mean. Similar to traditional CLPM, the within-family portion of the model included stability paths for the PTSD and SDQ variables, concurrent covariances between PTSD and SDQ, and prospective cross-lag paths from PTSD to SDQ and from SDQ to PTSD. All parallel paths were constrained to be equal across time (see Figure 1). Separate models used severity of total PTSD symptoms, and then severity of each of the four PTSD symptom clusters independently.

Results are shown in Table 1. Regarding within-family results, there was a significant, positive covariance of child problems with concurrent severity of SM avoidance and SM reexperiencing. Only PTSD symptoms of avoidance showed a significant positive prospective relationship with child problems in the cross-lag paths, indicating that when a father’s mean avoidance score was higher than usual for him, the mean SDQ score for the child was higher than usual for that child at the next time point. All between-family associations were non-significant.

Results suggest important links between the specific PTSD symptoms of reexperiencing and avoidance with child outcomes at the within-family level. In particular, greater levels of avoidance in fathers (compared to their own typical levels) related to subsequent increases in child difficulties. Further approaches such as this can inform us about whether targeting PTSD-related avoidance in parents may improve child functioning over time.

Authors

• Sarah Giff, George Mason University
  Presenting Author

• Keith D Renshaw, George Mason University
  Non-Presenting Author

• Elizabeth S Allen, University of Colorado Denver
  Non-Presenting Author