Transcript Impact of PTSD on Children and Families (5)

Impact of Post Traumatic Stress
Disorder on Children and Families
Malaysia Gresham, LICSW, BCD
William Satterfield, Ph.D.
LCDR, US Public Health Service
LCDR, US Public Health Service
Special Assistant to the
Senior Policy Analyst
United States Surgeon General
Office of the Assistant Secretary of Defense for Health Affairs
United States Department of Health and Human Services
Force Health Protection & Readiness
June 20, 2012
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Outline
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Scope of the problem
Factors related to impact on families/children
Impact of Post Traumatic Stress
Disorder (PTSD) on children
Impact on relationships
Intervention
Resources
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Scope of the Problem
• Presidential Initiative – “Strengthening Our Military
Families: Meeting America’s Commitment”
– Priority #1 – Enhance the overall well-being and
psychological health of the military family
• National Leadership Summit on Military Families
– Priority #3 – Strengthen the Department’s ability to
provide for the psychological well-being of military
personnel and their families (with a particular focus
on the health of children in these families)
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Scope of the Problem
• Over 2 million Service members have deployed
– As many as 1 in 5 with post-traumatic stress or
depression (Rand 2008)
– Prevalence of PTSD between 5-15%
• 55% of Service members are married
– Approximately 700,000 military spouses
• 40% have 2+ children
– Over 700,000 children have experienced parental
deployments
• 220,000 had parent deployed at single time (Jan 2011)
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Factors Related to Impact
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Preparation/pre-exposure
Pre-existing Mental Health concerns
Development age
Strength of relationships
Communication
Community/social support
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Impact of Parent PTSD on Children
• Re-experiencing Symptoms
– Nightmares, flashbacks, physical/emotional reactivity
– Impact: Confusion, fear, anxiety, perceive environment as unsafe
and unpredictable
• Avoidance Symptoms
– Avoidance of activities, emotional numbing, withdrawal
– Impact: Loss of intimacy, interpreted as lack of caring
• Hyper-arousal Symptoms
– Sleep disruption, irritability, exaggerated startle
– Impact: Overprotective parenting, low frustration tolerance,
increased risk for violence
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Impact of Parent PTSD on Children
• Increased risk for behavioral, academic, and
interpersonal problems
• May be viewed by parents as more depressed,
anxious, aggressive, hyperactive
• Impact of physical/emotional well-being
– Children – deployment-related emotional difficulties
• 11% increase in outpatient visits for behavioral health issues*
• 18% increase in behavior disorders*
• 19% increase in stress disorders*
*Among a group of 642,397 children 3- to 8-years old
with a military parent deployed
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Impact on Relationships
• Those with PTSD 2X as likely to divorce; 3X more likely to
divorce two or more times
– 4X greater likelihood of marital distress
– 2nd highest diagnosis associated with marital distress
• Increased incidence of intimate partner violence
• Poorer communication
• Increased incidence of sexual dysfunction
• Partners with PTSD
– May be less self-disclosing and less expressive
– Have more anxiety related to intimacy
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Impact on Relationships
• Impact of PTSD on partners:
– Lower subjective well-being
– Somatic complaints
– Neurotic symptoms – up to 50% of partners (N=376)
reported feeling “on the verge of a nervous
breakdown”
– Depression
– Sleep problems
– Poor social relations and support
– Caregiver burden
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Recommendations/Intervention
• Couples therapies
– Cognitive-Behavioral Conjoint Therapy
– Emotion-Focused Therapy
• Pre-deployment preparation
• Psycho-educational intervention
• Supportive interventions
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Resources
• Office of Military Community Outreach (Military
Community and Family Policy)
– Military OneSource (www.militaryonesource.mil)
– Military HOMEFRONT (www.militaryhomefront.dod.mil)
• Defense Center of Excellence for Psychological
Health and Traumatic Brain Injury
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24/7 Outreach Center
Sesame Street Workshop
Family and Friends of Service members Handbook
Real Warriors Campaign
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Resources
• Deployment Health Clinical Center (www.pdhealth.mil)
– One-week educational program for family members of
Service members with PTSD
• Center for the Study of Traumatic Stress
(www.cstsonline.org)
• AfterDeployment.org
• FOCUS Program (Families OverComing Under
Stress) (www.focusproject.org)
• National Center for PTSD (www.ptsd.va.gov)
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Implications for Response Teams
• Pre-existing mental health conditions have impact on responses
during traumatic events and subsequent post-traumatic
symptoms
• Understanding family dynamics can improve prevention and
intervention efforts
• Disaster response personnel are vulnerable to traumatic
exposure and development of PTSD
– Self-aid/buddy care
– Seeking professional intervention
• Training needs
– Listen, Protect, Connect
– Psychological first aid
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Questions
Questions?