Lester Patricia, Stein Judith A, Saltzman William, Woodward Kirsten, MacDermid Shelley W, Milburn Norweeta, Mogil Catherine, Beardslee William
UCLA Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Los Angeles, CA 90024, USA.
Mil Med. 2013 Aug;178(8):838-45. doi: 10.7205/MILMED-D-12-00502.
Family-centered preventive interventions have been proposed as relevant to mitigating psychological health risk and promoting resilience in military families facing wartime deployment and reintegration. This study evaluates the impact of a family-centered prevention program, Families OverComing Under Stress Family Resilience Training (FOCUS), on the psychological adjustment of military children. Two primary goals include (1) understanding the relationships of distress among family members using a longitudinal path model to assess relations at the child and family level and (2) determining pathways of program impact on child adjustment. Multilevel data analysis using structural equation modeling was conducted with deidentified service delivery data from 280 families (505 children aged 3-17) in two follow-up assessments. Standardized measures included service member and civilian parental distress (Brief Symptom Inventory, PTSD Checklist-Military), child adjustment (Strengths and Difficulties Questionnaire), and family functioning (McMaster Family Assessment Device). Distress was significantly related among the service member parent, civilian parent, and children. FOCUS improved family functioning, which in turn significantly reduced child distress at follow-up. Salient components of improved family functioning in reducing child distress mirrored resilience processes targeted by FOCUS. These findings underscore the public health potential of family-centered prevention for military families and suggest areas for future research.
以家庭为中心的预防性干预措施已被提议用于减轻面临战时部署和重新融入的军人家庭的心理健康风险,并促进其恢复力。本研究评估了一项以家庭为中心的预防计划——“压力下的家庭克服家庭恢复力训练”(FOCUS)对军人子女心理调适的影响。两个主要目标包括:(1)使用纵向路径模型评估儿童和家庭层面的关系,以了解家庭成员之间的苦恼关系;(2)确定该计划对儿童调适产生影响的途径。利用结构方程模型对来自280个家庭(505名3至17岁儿童)的匿名服务提供数据进行了两次随访评估,并进行了多层次数据分析。标准化测量包括军人和文职父母的苦恼(简明症状量表、创伤后应激障碍检查表-军事版)、儿童调适(长处与困难问卷)以及家庭功能(麦克马斯特家庭评估工具)。军人父母、文职父母和儿童之间的苦恼存在显著关联。FOCUS改善了家庭功能,进而在随访时显著降低了儿童的苦恼。在减少儿童苦恼方面,家庭功能改善的显著组成部分反映了FOCUS所针对的恢复力过程。这些发现强调了以家庭为中心的预防措施对军人家庭的公共卫生潜力,并提出了未来研究的方向。