ATLANTA — Significant others and family members experience posttraumatic stress disorder at rates that exceed those of military service members of current and previous wars, according to a study.
Using the most conservative estimates on the Psychopathology Checklist, 56 of 273 partners, parents, siblings, and other family members studied had PTSD, Brenda Nash, Ph.D., said in an interview at her poster during the annual meeting of the International Society for Traumatic Stress Studies.
This 21% rate is more than three times the reported 6% PTSD prevalence among Afghanistan veterans and well above the 13% rate reported for Iraq War veterans (U.S. Army Med. Dept. J. 2008;July-September:7-17). The prevalence is also more than twice the 9.4% estimate for the general adult population (J. Traum. Stress 2003;16:495-502).
“I'm surprised at the degree of the finding,” Dr. Nash said. “We never expected it would be twice as high.”
A lack of recognition and services to address their mental health symptoms may explain this higher rate of PTSD, compared with military personnel, Dr. Nash said. “My hypothesis is that rates are so much higher because … we prepare our troops before they leave but we don't prepare [their] families.”
Military training facilities and VA and community health centers should screen and treat significant others and family members for PTSD, added Dr. Nash, of Spalding University, Lexington, Ky.
Family members of deployed military personnel “typically don't have support, and they do all the work at home,” Dr. Nash said. Also, they may feel guilty about their symptoms, compared with what their family member might be experiencing, she added.
Lead author Rebecca K. Stahl, Dr. Nash, and their colleagues recruited participants through Yahoo and MSN forums for significant others of military service members. The participants completed a stressor-specific PTSD checklist and provided demographic information through an online survey.
They ranked degree of 17 possible PTSD symptoms on a scale from 1 (not at all) to 5 (extremely). Sleep issues, concentration, isolation, irritability/anger, and feeling upset at being reminded of the military service member's trauma were cited most often. “They see images [of the war] on TV,” Dr. Nash said.
People were diagnosed with PTSD if they had a total checklist score of 50 or more, combined with moderate or higher endorsement of certain DSM-IV TR symptoms: at least one reexperiencing symptom, three avoidance symptoms, and two hyperarousal symptoms. With this dual definition, 55 (20%) of significant others were diagnosed with PTSD.
The study cohort included significant others of service members deployed to Iraq, Afghanistan, Vietnam, Korea, and World War II.
Further investigation of PTSD in significant others is warranted, Dr. Nash said. If the findings are replicated, it would lend credence to inclusion of a vicarious trauma diagnosis in the DSM-5, Dr. Nash said.