Skip to main content

Advertisement

Log in

His and Hers: The Interface of Military Couples’ Biological, Psychological, and Relational Health

  • Original Paper
  • Published:
Contemporary Family Therapy Aims and scope Submit manuscript

Abstract

Serving in the military has the capacity to influence military personnel, civilian spouses, and marriages in unique ways. The purpose of the present study was to provide dyadic insight into the interface between biological, psychological, and relational health factors for military couples. Couples were recruited through a military medical center (N = 75) in the United States and both partners were assessed on several measures of biopsychorelational health. Actor-partner interdependence models were used to predict marital quality and satisfaction in relation to each partner’s experience with distress, symptoms of depression, and heart rate variability. Results indicated that husbands’ pain predicted husbands’ and wives’ positive marital quality. Husbands’ and wives’ symptoms of depression also influenced wives’ negative marital quality. Recommendations toward the need for relational assessments and routine screenings for both partners, as well as implementation of an integrated care model are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Aitken, R. C. (1969). Measurement of feelings using visual analogue scales. Proceedings of the Royal Society of Medicine, 62, 989–993. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=4899510&site=ehost-live

  • Allen, E. S., Rhoades, G. K., Stanley, S. M., & Markman, H. J. (2010). Hitting home: Relationships between recent deployment, posttraumatic stress symptoms, and marital functioning for army couples. Journal of Family Psychology, 24, 280–288. doi:10.1037/a0019405.

    Article  PubMed Central  PubMed  Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Andres, M. (2014). Distress, support, and relationship satisfaction during military-induced separations: A longitudinal study among spouses of Dutch deployed military personnel. Psychological Services, 11, 22–30. doi:10.1037/a0033750.

    Article  PubMed  Google Scholar 

  • Asbery, E. T., & Martin, D. (2012). Military deployment and the spouse left behind. The Family Journal, 20, 45–50. doi:10.1177/1066480711429433.

    Article  Google Scholar 

  • Baptist, J., Amanor-Boadu, Y., Garrett, K., Goff, B. S. N., Collum, J., Gamble, P., & Wick, S. (2011). Military marriages: The aftermath of operation Iraqi freedom (OIF) and operation enduring freedom (OEF) deployments. Contemporary Family Therapy: An International Journal, 33(3), 199–214. doi:10.1007/s10591-011-9162-6.

    Article  Google Scholar 

  • Bevans, M., Wehrlen, L., Prachenko, O., Soeken, K., Zabora, J., & Wallen, G. R. (2011). Distress screening in allogeneic hematopoietic stem cell (HSCT) caregivers and patients. Journal of Psycho-Oncology, 20, 615–622. doi:10.1002/pon.1906.

    Article  PubMed  Google Scholar 

  • Blow, A. J., Gorman, L., Ganoczy, D., Kees, M., Kashy, D. A., Valenstein, M., & Chermack, S. (2013). Hazardous drinking and family functioning in National Guard veterans and spouses postdeployment. Journal of Family Psychology, 27, 303–313. doi:10.1037/a0031881.

    Article  PubMed  Google Scholar 

  • Chambers, S. K., Zajdlewicz, L., Youlden, D. R., Holland, J. C., & Dunn, J. (2014). The validity of the distress thermometer in prostate cancer populations. Psycho-Oncology, 23, 195–203. doi:10.1002/pon.3391.

    Article  PubMed Central  PubMed  Google Scholar 

  • Cohen, J. (1992). A power primer. Quantitative Methods in Psychology, 112, 155–159. doi:10.1037/0033-2909.112.1.155.

    Google Scholar 

  • Department of Defense. (2010). Demographics 2009: Profile of the military community. Washington, DC: Department of Defense.

    Google Scholar 

  • Dimiceli, E. E., Steinhardt, M. A., & Smith, S. E. (2010). Stressful experiences, coping strategies, and predictors of health-related outcomes among wives of deployed military servicemen. Armed Forces & Society, 36, 351–373. doi:10.1177/0095327X08324765.

    Article  Google Scholar 

  • Eaton, K. M., Hoge, C. W., Messer, S. C., Whitt, A. A., Cabrera, O. A., McGurk, D., & Castro, C. A. (2008). Prevalence of mental health problems, treatment need, and barriers to care among primary care-seeking spouses of military service members involved in Iraq and Afghanistan deployments. Journal of Military Medicine, 173, 1051–1056. doi:10.7205/milmed.173.11.1051.

    Article  PubMed  Google Scholar 

  • Ein-Dor, T., Doron, G., Solomon, Z., Mikulincer, M., & Shaver, P. R. (2010). Together in pain: Attachment-related dyadic processes and posttraumatic stress disorder. Journal of Counseling Psychology, 57, 317–327. doi:10.1037/a0019500.

    Article  PubMed  Google Scholar 

  • Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196(4286), 129–136. doi:10.1126/science.847460.

    Article  PubMed  Google Scholar 

  • Engel, G. L. (1980). The clinical application of the biopsychosocial model. American Journal of Psychiatry, 137, 535–544. doi:10.1176/ajp.137.5.535.

    Article  PubMed  Google Scholar 

  • Fincham, F. D., & Linfield, K. J. (1997). A new look at marital quality: Can spouses feel positive and negative about their marriage? Journal of Family Psychology, 11, 489–502. doi:10.1037//0893-3200.11.4.489-502.

    Article  Google Scholar 

  • Fisher, H. (2007). United States military casualty statistics: Operation Iraqi Freedom and Operation Enduring Freedom. Retrieved from: www.crs.gov

  • Fox, M., Hodgson, J., & Lamson, A. L. (2012). Integration: Opportunities and challenges for family therapists in primary care. Contemporary Family Therapy, 34, 228–243. doi:10.1007/s10591-012-9189-3.

    Article  Google Scholar 

  • Goff, B. S. N., Crow, J. R., Reisbig, A. M. J., & Hamilton, S. (2007). The impact of individual trauma symptoms of deployed soldiers on relationship satisfaction. Journal of Family Psychology, 21, 344–353. doi:10.1037/0893-3200.21.3.344.

    Article  PubMed  Google Scholar 

  • Googins, B. K. (1991). Work/family conflicts: Private lives–Public responses. NY: Auburn House.

    Google Scholar 

  • Gorman, L. A., Blow, A. J., Ames, B. D., & Reed, P. L. (2011). National guard families after combat: Mental health, use of mental health services, and perceived treatment barriers. Psychiatric Services, 62, 28–34. doi:10.1176/appi.ps.62.1.28.

    Article  PubMed  Google Scholar 

  • Green, R. G., & Harris, R. N, Jr. (1992). Spouse support, career continuance, and family life in the Reserve components: A study of members and spouses of the Virginia National Guard. Evaluation and Program Planning, 15, 427–437. doi:10.1016/0149-7189(92)90080-E.

    Article  Google Scholar 

  • Haskell, S. G., Gordon, K. S., Mattocks, K., Duggal, M., Erdos, J., Justice, A., & Brandt, C. A. (2010). Gender differences in rates of depression, PTSD, pain, obesity, and military sexual trauma among Connecticut war veterans of Iraq and Afghanistan. Journal of Women’s Health, 19, 267–271. doi:10.1089/jwh.2008.1262.

    Article  PubMed Central  PubMed  Google Scholar 

  • Haskell, S. G., Heapy, A., Reid, M. C., Papas, R. K., & Kerns, R. D. (2006). The prevalence and age-related characteristics of pain in a sample of women veterans receiving primary care. Journal of Women’s Health, 15, 862–869. doi:10.1089/jwh.2006.15.862.

    Article  PubMed  Google Scholar 

  • Hodgson, J., Lamson, A., Mendenhall, T., & Crane, R. (2014). Medical family therapy: Advanced applications. New York, NY: Springer International Publishing Co.

    Book  Google Scholar 

  • Hogan, P. F., & Seifert, R. F. (2010). Marriage and the military: Evidence that those who serve marry earlier and divorce earlier. Armed Forces & Society, 36, 420–438. doi:10.1177/0095327X09351228.

    Article  Google Scholar 

  • Holland, J. C., & Bultez, B. D. (2007). The NCCN guideline for distress management: A case for making distress the sixth vital sign. Journal of the National Comprehensive Cancer Network, 5, 1–5. Retrieved from http://www.nccn.org/professionals/physician_gls/f_guidelines.asp

  • IBM Corp. (2013). IBM SPSS statistics for macintosh (Version 22.0) [Computer software]. Armonk, NY: IMB Corp. Retrieved on March 20, 2014 from http://www-01.ibm.com/software/analytics/spss/products/statistics/downloads.html

  • Karney, B. R., & Bradbury, T. N. (1995). The longitudinal course of marital quality and stability: A review of theory, methods, and research. Psychological Bulletin, 118, 3–34. doi:10.1037/0033-2909.118.1.3.

    Article  PubMed  Google Scholar 

  • Karney, B. R., & Crown, J. S. (2007). Families under stress: An assessment of data, theory, and research on marriage and divorce in the military (Vol. 599). Santa Monica, CA: Rand Corporation.

    Google Scholar 

  • Kiecolt-Glaser, J., Bane, C., Glaser, R., & Malarkey, W. B. (2003). Love, marriage, and divorce: Newlyweds’ stress hormones foreshadow relationship changes. Journal of Consulting and Clinical Psychology, 71, 176–188. doi:10.1037/0022-006X.71.1.176.

    Article  PubMed  Google Scholar 

  • Kiecolt-Glaser, J. K., Loving, T. J., Stowell, J. R., Malarkey, W. B., Lemeshow, S., Dickinson, S. L., & Glaser, R. (2005). Hostile marital interactions, proinflammatory cytokine production, and wound healing. Archives of General Psychiatry, 62, 1377–1384. doi:10.1001/archpsyc.62.12.1377.

    Article  PubMed  Google Scholar 

  • Kiecolt-Glaser, J., & Newton, T. L. (2001). Marriage and health: His and hers. Psychological Bulletin, 127, 472–503. doi:10.1037/0033-2909.127.4.472.

    Article  PubMed  Google Scholar 

  • Lewis, M. E., Lamson, A. L., & Lesueur, B. (2012). Health dynamics of military and veteran couples: A biopsychorelational overview. Journal of Contemporary Family Therapy, 34, 259–276. doi:10.1007/s10591-012-9193-7.

    Article  Google Scholar 

  • Lewis, M. E., Lamson, A. L., & White, M. B. (2015). The State of Dyadic methodology: An analysis of the literature on interventions for military couples. Journal of Couple & Relationship Therapy (in press).

  • Lewis, M. E., Lamson, A. L., White, M. B., & Russoniello, C. (2013). Contextualizing military health and trauma: Recommendations for integrated care and couple-centered interventions. Military Behavioral Health Journal, 1(2), 167–172. doi:10.1080/21635781.2013.839923.

    Article  Google Scholar 

  • Malik, M. (1998). Heart rate variability. Current Opinion in Cardiology, 13, 36–44. doi:10.1097/00001573-199801000-00006.

    Article  PubMed  Google Scholar 

  • Mansfield, A. J., Kaufman, J. S., Marshall, S. W., Gaynes, B. N., Morrissey, J. P., & Engel, C. C. (2010). Deployment and the use of mental health services among U.S. army wives. The New England Journal of Medicine, 362, 101–109. doi:10.1016/s0084-3970(10)79336-1.

    Article  PubMed  Google Scholar 

  • Marek, L., & D’Aniello, C. (2014). Reintegration stress and family mental health: Implications for therapists working with reintegrating military families. Contemporary Family Therapy, 36(4), 443–451. doi:10.1007/s10591-014-9316-4.

    Article  Google Scholar 

  • Mattson, R. E., Paldino, D., & Johnson, M. D. (2007). The increased construct validity and clinical utility of assessing relationship quality using separate positive and negative dimensions. Journal of Psychological Assessment, 19, 146–151. doi:10.1037/1040-3590.19.1.146.

    Article  PubMed  Google Scholar 

  • McCuaig-Edge, H. J., & Ivey, G. W. (2012). Mediation of cognitive appraisal on combat exposure and psychological distress. Military Psychology, 24, 71–85. doi:10.1080/08995605.2012.642292.

    Article  Google Scholar 

  • McLeland, K. C., Sutton, G. W., & Schumm, W. R. (2008). Marital satisfaction before and after deployments associated with the global war on terror. Psychological Reports, 103, 836–844. doi:10.2466/PR0.103.7.836-844.

    PubMed  Google Scholar 

  • Menchaca, D., & Dehle, C. (2005). Marital quality and physiological arousal: How do I love thee? Let my heartbeat count the ways. The American Journal of Family Therapy, 33, 117–130. doi:10.1080/01926180590915897.

    Article  Google Scholar 

  • Miaskowski, C., Zimmer, E. F., Barrett, K. M., Dibble, S. L., & Wallhagen, M. (1997). Differences in patients’ and family caregivers’ perceptions of the pain experience influence patient and caregiver outcomes. International Association for the Study of Pain, 72, 217–226. doi:10.1016/s0304-3959(97)00037-7.

    Google Scholar 

  • Mitchell, S. E., Newell, G. K., & Schumm, W. R. (1983). Test-retest reliability of the Kansas marital satisfaction scale. Psychological Reports, 53, 545–546. doi:10.1016/j.jad.2010.01.067.

    Article  Google Scholar 

  • National Institute of Mental Health. (2015). Depression: Examining the sex/gender difference and links to other diseases. Retrieved from: http://www.nimh.nih.gov/health/topics/depression/depression-examining-the-sex-gender-differences-and-links-to-other-diseases.shtml

  • Norris, P. R., Morris, J. A., Ozdas, A., Grogan, E. L., & Williams, A. E. (2005). Heart rate variability predicts trauma patient outcome as early as 12 h: Implications for military and civilian triage. Journal of Surgical Research, 129, 122–128. doi:10.1016/j.jss.2005.04.024.

    Article  PubMed  Google Scholar 

  • Patrick, V., Hebert, C., Green, S., & Ingram, C. (2011). Integrated multidisciplinary treatment teams; a mental health model for outpatient settings in the military. Military Medicine, 176, 986–989. doi:10.7205/milmed-d-11-00070.

    Article  Google Scholar 

  • Renshaw, K. D., Rodrigues, C. S., & Jones, D. H. (2008). Psychological symptoms and marital satisfaction in spouses of Operation Iraqi Freedom veterans: Relationships with spouses’ perceptions of veterans’ experiences and symptoms. Journal of Family Psychology, 22, 586–594. doi:10.1037/0893-3200.22.3.586.

    Article  PubMed  Google Scholar 

  • Riggs, D. S., Byrne, C. A., Weathers, F. W., & Litz, B. T. (1998). The quality of the intimate relationships of male Vietnam veterans: Problems associated with posttraumatic stress disorder. Journal of Traumatic Stress, 11, 87–101. doi:10.1023/A:1024409200155.

    Article  PubMed  Google Scholar 

  • RStudio. (2012). RStudio: Integrated development environment for R (Version 0.98.1060) [Computer software]. Boston, MA. Retrieved September 17, 2014. http://www.rstudio.org/

  • Sayers, S. L., Farrows, V. A., Ross, J., & Oslin, D. W. (2009). Family problems among recently returned military veterans referred for a mental health evaluation. Journal of Clinical Psychiatry, 70, 163–170. doi:10.4088/JCP.07m03863.

    Article  PubMed  Google Scholar 

  • Schumm, W. R. (1983). Characteristics of the Kansas Marital Satisfaction scale in a sample of 79 married couples. Psychological Reports, 53, 583–588. doi:10.2466/pr0.1983.53.2.583.

    Article  Google Scholar 

  • Schumm, W. R., Bell, D. B., & Gade, P. A. (2000). Effects of a military overseas peacekeeping deployment on marital quality, satisfaction, and stability. Psychological Reports, 87, 815–821. doi:10.2466/pr0.2000.87.3.815.

    Article  PubMed  Google Scholar 

  • Schumm, W. R., Crock, R. J., Likcani, A., Akagi, C. G., & Bosch, K. R. (2008). Reliability and validity of the Kansas marital satisfaction scale with different response formats in a recent sample of U.S. army personnel. Individual Differences Research, 6, 26–37. doi:10.2466/pr0.1988.62.1.95.

    Google Scholar 

  • Schumm, W. R., & Hammond, P. M. (1986). Self-reported marital quality of military families living off-post in a midwestern community. Psychological Reports, 59, 391–394. doi:10.2466/pr0.1986.59.2.391.

    Article  Google Scholar 

  • Seymour, R. A., Simpson, J. M., Charlton, J. E., & Phillips, M. E. (1985). An evaluation of length and end-phrase of visual analogue scales in dental pain. Pain, 21, 177–185. doi:10.1016/0304-3959(85)90287-8.

    Article  PubMed  Google Scholar 

  • Smith, T. W., Cribbet, M. R., Nealey-Moore, J. B., Uchino, B. N., Williams, P. G., MacKenzi, J., & Thayer, J. F. (2011). Matters of the variable heart: Respiratory sinus arrhythmia response to marital interaction and associations with marital quality. Journal of Personality and Social Psychology, 100, 103–119. doi:10.1037/a0021136.

    Article  PubMed  Google Scholar 

  • Spitzer, R., Kroenke, K., & Williams, J. (1999). Validation and utility of a self-report version of PRIME-MD: The PHQ primary care study. Journal of the American Medical Association, 282, 1737–1744. doi:10.1001/jama.282.18.1737.

    Article  PubMed  Google Scholar 

  • Stroud, C. B., Durbin, C. E., Wilson, S., & Mendelsohn, K. A. (2011). Spillover to triadic and dyadic systems in families with young children. Journal of Family Psychology, 25, 919–930. doi:10.1037/a0025443.

    Article  PubMed  Google Scholar 

  • Tan, G., Fink, B., Dao, T. K., Herbert, R., Farmer, L. S., Sanders, A., & Gevirtz, R. (2009). Associations among pain, PTSD, mTBI, and heart rate variability in veterans of Operation Enduring and Iraqi Freedom: A pilot study. American Academy of Pain Medicine, 10, 1237–1245. doi:10.1111/j.1526-4637.2009.00712.x.

    Article  Google Scholar 

  • Warner, C. H., Appenzeller, G. N., Warner, C. M., & Grieger, T. (2009). Psychological effects of deployments on military families. Psychiatric Annals, 39, 56–63. doi:10.3928/00485713-20090201-11.

    Article  Google Scholar 

  • Warner, C. M., Warner, C. H., Breitbach, J., Rachal, J., Matusz, T., & Grieger, T. A. (2007). Depression in entry-level military personnel. Military Medicine, 172, 795–799. doi:10.7205/milmed.172.8.795.

    Article  PubMed  Google Scholar 

  • Weiss, R. L. (1980). Strategic behavioral marital therapy: Toward a model for assessment and intervention. In J. P. Vincent (Ed.), Advances in family intervention, assessment and theory (pp. 229–271). Greenwich, CT: JAI Press.

    Google Scholar 

  • Wright, L. M., Watson, W. L., & Bell, J. M. (1996). Beliefs: The heart of healing in families and illness. New York, NY: Basic Books.

    Google Scholar 

  • Zwahlen, D., Hagenbuchm, N., Jenewein, J., Carley, M. I., & Buchi, S. (2011). Adopting a family approach to theory and practice: Measuring distress in cancer patient-partner dyads with the distress thermometer. Journal of Psycho-Oncology, 20, 394–403. doi:10.1002/pon.1744.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This research and development project was conducted by East Carolina University and is made possible by a cooperative agreement that was awarded and administered by the U.S. Army Medical Research & Materiel Command (USAMRMC) and the Telemedicine & Advanced Technology Research Center (TATRC), at Fort Detrick, MD, under Contract Number: W81XWH1120221. The views, opinions and/or findings contained in this article are those of the author(s)/East Carolina University and do not necessarily reflect the views of the Department of Defense and should not be construed as an official DoD/Army position, policy or decision unless so designated by other documentation. No official endorsement should be made.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lisa J. Trump.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Trump, L.J., Lamson, A.L., Lewis, M.E. et al. His and Hers: The Interface of Military Couples’ Biological, Psychological, and Relational Health. Contemp Fam Ther 37, 316–328 (2015). https://doi.org/10.1007/s10591-015-9344-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10591-015-9344-8

Keywords

Navigation