Experiences of intimate partner violence and valued living among women veterans: The role of self-efficacy.

Predominantly cross-sectional research suggests that self-efficacy may play an important role in women's psychological health after experiencing intimate partner violence (IPV). However, few studies have examined these associations over time or with respect to broader aspects of psychological well-being. Valued living, which reflects behavioral engagement within personally important life domains, represents a key aspect of well-being that may be negatively impacted by experiences of IPV. Participants were 190 women veterans who completed three web-based surveys. We examined whether IPV experiences at Time 1 were associated with valued living at Time 3 (i.e., 4 years after Time 1) through self-efficacy at Time 2 (i.e., 3 years after Time 1). We separately examined overall, psychological, physical, and sexual IPV and investigated lifetime and recent (i.e., past 6 months) IPV experiences for each subtype. Separate path analysis models indicated that lifetime overall, ß = -.10, 95% CI [-.19, -.02]; psychological, ß = -.08, 95% CI [-.17, -.001]; physical, ß = -.10, 95% CI [-.18, -.01]; and sexual, ß = -.11, 95% CI [-.22, -.01], IPV experiences were indirectly associated with less valued living through less self-efficacy, whereas the indirect effect only emerged for recent physical IPV, ß = -.26, 95% CI [-.50, -.02], but not for recent overall, psychological, or sexual IPV. These findings suggest that experiencing IPV is associated with less self-efficacy and valued living, which highlights the importance of providing early psychosocial interventions to enhance well-being among individuals managing the effects of experiencing IPV.

From posttraumatic stress symptoms to suicidal ideation among military veterans: Pathways founded on meaning in life and gratitude.

Military veterans experience higher rates of suicidal ideation compared to nonveteran populations. Importantly, suicidal ideation often precedes and predicts fatal and nonfatal suicide attempts, and thus it is critical to better understand factors that increase risk for suicidal ideation to inform suicide prevention efforts in this population. One key predictor of suicidal ideation is exposure to traumatic experiences and their sequelae, particularly posttraumatic stress symptoms (PTSS). However, little work has explored how deficits in well-being contribute to this association among veterans. We tested two aspects of well-being-meaning in life and gratitude-as potential mechanisms underlying the pathway from PTSS to suicidal ideation among 7,388 men and women veterans who recently separated from service. A parallel mediation analysis revealed significant paths from more severe PTSS to more frequent suicidal ideation through diminished meaning in life, B = 0.005, SE = 0.001, 95% CI [0.004, 0.007], and gratitude, B = 0.001, SE = 0.001, 95% CI [< 0.001, 0.002]. Gender differences were also observed. Although the results related to meaning in life appeared to replicate across gender, pathways involving gratitude differed among men and women. Overall, our findings suggest that helping veterans build meaning and appreciation in everyday life may be a proactive and holistic approach to suicide prevention.

Development and validation of the Moral Outcomes of Relationship Aggression Scale: A measure of moral distress following intimate partner violence perpetration.

Research with military veterans has established that distress may arise in response to perpetrating violent behaviors that violate individuals' moral beliefs. To date, no studies have similarly examined morally-related cognitive and emotional responses specifically among intimate partner violence (IPV) perpetrators. However, research on moral cognitions and emotions in response to IPV perpetration may inform understanding of the behavior and potential mechanisms for intervention. In the current series of four studies, we used classical test theory to develop a measure of moral distress following IPV perpetration that focuses on thoughts about the actions (assimilated cognitions), thoughts about the self due to one's actions (accommodated cognitions), and emotions experienced due to one's actions (moral emotions). Items were developed and tested among two samples of undergraduate students, and psychometric properties of the final measure were confirmed among two community samples. The final measure consists of three subscales consisting of five items each. Results demonstrate support for internal consistency and test-retest reliability, convergent, discriminant, and incremental validity, and factor structure. This measure can be used in future research designed to examine how individuals respond to their IPV perpetration, and to study the implications this may have for long-term outcomes and behavioral change.

Consequences of PTSD for the work and family quality of life of female and male U.S. Afghanistan and Iraq War veterans.

PURPOSE: Although it is well established that combat-related PTSD can lead to reduced quality of life, less is known about the relative effect of PTSD on different aspects of former service members' post-military readjustment. Moreover, research on female veterans' reintegration experiences is limited. This study aimed to document the work and family quality of life of post-9/11 male and female veterans and evaluate the gender-specific impact of PTSD on veterans' work and family outcomes. METHODS: A national sample of 524 post-9/11 veterans completed mailed surveys as part of a longitudinal study. Descriptive and regression-based analyses were gender-stratified and weighted to enhance representativeness to the larger population. RESULTS: With a few notable exceptions, the majority of post-9/11 U.S. veterans reported high work and family quality of life. PTSD was not associated with either employment or relationship status; however, it did predict poorer work and family functioning and satisfaction for both men and women, with the most consistent negative effects on intimate relationships. Several gender differences were found, primarily with respect to work experiences. CONCLUSIONS: Although most post-9/11 veterans appear to be doing well in both their work and family lives, results support the need for interventions that can mitigate the negative effect of PTSD and other associated mental health conditions on several aspects of work and family quality of life. Findings contribute to research suggesting both similarities and differences in the post-military readjustment of male and female post-9/11 veterans and underscore the need for additional consideration of the unique work-related challenges women experience following military service.

PTSD Symptom Cluster Severity Predicts Momentary Emotion Dynamics During Couple Conversations.

This study investigated the associations between momentary emotion dynamics and posttraumatic stress disorder (PTSD) symptoms. Using a sample of 61 couples (N = 122 individuals) in which all individuals were trauma exposed and at least one partner screened positive for PTSD, we examined the intra- and interpersonal regulation of vocally encoded emotional arousal (fundamental frequency [f0]) and how these momentary emotion regulatory patterns relate to specific PTSD symptoms during two couple conversations: one designed to elicit conflict and one to elicit intimacy. PTSD symptoms were assessed using a gold standard clinical interview. In both conversations, higher reexperiencing symptoms were associated with greater emotional inertia (i.e., more resistance to change in emotional state following deviation from one's emotional equilibrium), and higher avoidance symptoms were associated with less emotional inertia (i.e., quicker return to emotional equilibrium). In the intimacy conversations, individuals also responded to their partners' arousal. Furthermore, individuals whose partners exhibited higher emotional numbing symptoms exhibited more emotional inertia, suggesting that emotion regulation may be a function of both one's own and one's partner's PTSD symptoms. Attending to the interpersonal context of emotion dynamics during PTSD treatment may enhance outcomes.

Responsivity to Interviewer during Interview-Based Assessment of Physical Intimate Partner Violence.

Objective: Interview assessments of intimate partner violence (IPV) may provide more accurate behavior frequency estimates than self-report questionnaires. However, concerns have been raised about whether participants underreport IPV during interviews due to an emotional response to the interviewer. Method: Participants were 42 mixed gender community couples (83 individuals) in which at least one partner endorsed physical IPV perpetration or victimization in their relationship. We examined whether participants were emotionally responsive to the interviewer during an interview about physical IPV. Responsivity was defined as the extent to which participants' emotional arousal, indexed by vocal fundamental frequency (f0), was predicted by interviewers' emotional arousal at the previous talk turn on a moment-by-moment basis. We then examined whether participants' responsivity predicted interview-based reporting of IPV relative to their own self-report on an IPV measure and to the highest other available report (including partner report). Results: Repeated measures actor-partner interdependence models conducted in a multi-level modeling framework indicated that, on average, participants were responsive to interviewers' emotional arousal, even when controlling for responsivity to their own arousal, and that responsivity varied across participants. However, participants' responsivity to interviewer arousal did not significantly predict reporting of IPV perpetration or victimization during the interview relative to their own self-report or to the highest other available report. Conclusions: Participants are emotionally responsive to interviewer arousal, but this responsivity does not appear to reduce interview-based reporting of IPV relative to self-report, supporting the utility of IPV interviews in clinical and research settings.

In vivo defensive behaviors, fear, and attention bias to physical and negative evaluation threats.

Aggressive behavior is a major public health issue for which there are few efficacious treatments. Although much of information processing is automatic, there are few studies of early-stage decoding biases (e.g., attention bias to threat) and aggressive behavior, potentially resulting in missed opportunities for identifying targets of intervention. Previous studies are limited by indirect measures of attention bias and little consideration of proximal factors like state fear, which organizes perception and motivates defensive behaviors. We used laboratory methods (i.e., eye-tracking, idiographic mood induction, and the Point Subtraction Aggression Paradigm), to examine the association between attention bias to physical and negative evaluation threat and in vivo defensive responding (i.e., aggression and escape) and the potential moderating role of state fear among 74 undergraduate students. As predicted, attention bias to threat was positively associated with in vivo aggression. Fear did not potentiate aggression or modify the relationship between attentional bias to threat and aggression; however, in the fear condition, greater attentional bias to threat was associated with less escape behavior. Findings add to the sparse literature identifying early-stage decoding processes as possible risk factors of aggression and suggest a need for additional research on freeze behavior in response to threat and provocation.

U.S. Military Veterans' Health and Well-Being in the First Year After Service.

INTRODUCTION: This study examined the health and well-being of U.S. veterans during the first year after military service and tested several hypotheses regarding differences in veterans' well-being over time, across life domains, and based on sex, military rank, and deployment history. METHODS: A national sample of 9,566 veterans was recruited from a roster of all separating U.S. service members in the fall of 2016. Veterans' status, functioning, and satisfaction with regard to their health, work, and social relationships were assessed within 3 months of separation and then 6 months later. Analyses were completed in 2019. RESULTS: Health concerns were most salient for newly separated veterans, with many veterans reporting that they had chronic physical (53%) or mental (33%) health conditions and were less satisfied with their health than either their work or social relationships. By contrast, most veterans reported relatively high vocational and social well-being and only work functioning demonstrated a notable decline in the first year following separation. Enlisted personnel reported consistently poorer health, vocational, and social outcomes compared with their officer counterparts, whereas war zone-deployed veterans reported more health concerns and women endorsed more mental health concerns compared with their nondeployed and male peers. CONCLUSIONS: Although most newly separated veterans experience high vocational and social well-being as they reintegrate into civilian life, findings point to the need for additional attention to the health of separating service members and bolstered support for enlisted personnel to prevent the development of chronic readjustment challenges within this population.

Prospective, dyadic links between posttraumatic stress disorder symptoms and family violence in the early years of parenthood.

Cross-sectional research has suggested that posttraumatic stress disorder (PTSD) symptom severity may be an important predictor of family violence perpetration; however, causal inference is limited by the absence of studies designed to prospectively predict family violence by PTSD symptoms. In the current study, PTSD symptoms were assessed among 250 trauma-exposed heterosexual couples 10 months after having their 1st child. The number of acts of psychological and physical intimate partner aggression (IPA) and parent-to-child aggression (PCA) that occurred during the past year was assessed at 10 and 24 months postpartum to account for stability in family violence perpetration when prospectively predicting perpetration. Longitudinal actor-partner interdependence models revealed that women's and men's PTSD symptoms positively predicted increases in the frequency of their own perpetration of psychological and physical IPA as well as psychological PCA. Additionally, partners' PTSD symptoms prospectively predicted psychological and physical IPA perpetration but not psychological or physical PCA perpetration, suggesting that partners' PTSD symptoms may directly impact dyadic processes during incidents of IPA but may not generally affect the family environment in a way that potentiates all forms of aggression. No significant gender differences were revealed. Overall, results of the current study largely support existing research and theory while clarifying inconsistencies that have emerged when examining cross-sectional associations. Further, the current results highlight the potential utility of PTSD treatment as an avenue for aggression prevention and intervention efforts during the early parenting years. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Development and Validation of a Tool to Assess Military Veterans' Status, Functioning, and Satisfaction with Key Aspects of their Lives.

BACKGROUND: We developed and validated the Well-Being Inventory (WBI) to address the need for a tool that can provide a comprehensive assessment of key aspects of military veterans' lives. This multidimensional instrument assesses status, functioning, and satisfaction with regard to vocation, finances, health, and social relationships. METHODS: Two large multi-phase studies (Study 1 Ns = 301, 286; Study 2 Ns = 9,566, 7,342) were conducted to develop and validate this tool among military veterans. RESULTS: Confirmatory factor analyses supported the proposed factor structure, with separate factors observed for all scales except the health functioning scale, which was best represented as three factors rather than a single factor. Cronbach's alphas were satisfactory, with an average alpha of 0.86. Most WBI measures discriminated among individuals with and without mental health conditions and demonstrated expected declines among those with a new mental health condition. CONCLUSIONS: This study provides initial evidence for the reliability, validity, and sensitivity to change of the WBI. This tool can be used to provide insight into areas in which military veterans would benefit from additional support and inform efforts to promote the well-being of this population. Given its broad focus, it may also prove useful with other civilian populations.

Conceptualizing and Measuring Mental Illness Stigma: The Mental Illness Stigma Framework and Critical Review of Measures.

Although the last decade has seen a proliferation of research on mental illness stigma, lack of consistency and clarity in both the conceptualization and measurement of mental illness stigma has limited the accumulation of scientific knowledge about mental illness stigma and its consequences. In the present article, we bring together the different foci of mental illness stigma research with the Mental Illness Stigma Framework (MISF). The MISF provides a common framework and set of terminology for understanding mechanisms of mental illness stigma that are relevant to the study of both the stigmatized and the stigmatizer. We then apply this framework to systematically review and classify stigma measures used in the past decade according to their corresponding stigma mechanisms. We identified more than 400 measures of mental illness stigma, two thirds of which had not undergone any systematic psychometric evaluation. Stereotypes and discrimination received the most research attention, while mechanisms that focus on the perspective of individuals with mental illness (e.g., experienced, anticipated, or internalized stigma) have been the least studied. Finally, we use the MISF to discuss the strengths and weaknesses of mental illness stigma measurement, identify gaps in the literature, and provide recommendations for future research.

The Role of PTSD, Depression, and Alcohol Misuse Symptom Severity in Linking Deployment Stressor Exposure and Post-Military Work and Family Outcomes in Male and Female Veterans.

Exposure to stressors during military deployment puts veterans at risk for reduced post-military quality of life. Stress-related mental health problems may lead to decreased well-being within work and family domains, yet few studies have explored associations in the context of gender. We examined relationships between deployment stressors and post-military functioning and satisfaction in the domains of work and family, with a focus on PTSD, depression, and alcohol misuse symptomatology as potential mediators. Participants included 522 male and female Iraq and Afghanistan War veterans assessed longitudinally. Structural equation models supported several direct and indirect pathways linking deployment stressors to work and family outcomes for both men and women. PTSD had an important role in these associations. Depression also played a significant role, particularly for women. These findings build on prior research by elucidating potential gender-specific risk, which may be applied to better tailor services to veterans' unique needs.