Research Proposal on "Domestic Violence in Veterans With PTSD"

Research Proposal 10 pages (3169 words) Sources: 8 Style: APA

[EXCERPT] . . . .

Tens of thousands of combat veterans returning from the war on terrorism in Iraq and Afghanistan are experiencing the effects of their traumatic experiences in ways that have contributed to an increased incidence of domestic violence. Although many of these combat veterans seek out marital counseling therapy, others continue down a path of self-destructive behaviors and many relationships end up in divorce or through suicide. Given the current push to send even more troops to the Middle East to help prosecute the war in Afghanistan, it is reasonable to suggest that these trends will not reverse themselves in the near future. It is therefore vitally important to identify the extent of the problem and a set of best practices that clinicians can use to help these combat veterans make the readjustments needed to live a meaningful and fulfilling life after their return. To this end, this study seeks to determine whether veterans who suffer from post traumatic stress disorder who seek couples therapy have a higher level of domestic violence than veterans without PTSD who seek couples therapy.

The Incidence of Domestic Violence in Combat Veterans with PTSD

Introduction

To date, more than 5,100 soldiers have died fighting the war on terrorism in Operation Iraqi Freedom in Iraq and Operation Enduring Freedom in Afghanistan (Faces of the fallen, 2009). These grim statistics, though, do not reflect the other toll exacted by armed conflicts in the form of the trauma it can cause those who wear the uniform of the armed forces of the United States is these far-flung regions of the world. Faced with a population that contains insurgents as well as friends, and the potential for death as a result of undetectable improvised explosive devices, it is difficult for most American sitting in the comfort of their own homes to imagine the terror that these combat troops face on daily basis. In fact, the suicide rate among returning veterans has reached inordinately high levels and clinicians and military officials alike are seeking answers to what is causing this reaction by those who have participated in these wars in the Middle East and what can be done to reverse this ugly trend. It is little wonder, as well, that combat veterans of this area of the world have experienced more than their fair share of posttraumatic stress disorder (PTSD), a potentially debilitating condition that may be responsible in large part for the current high suicide rate among these returning combat veterans. It is also not surprising that many of the combat veterans who suffer from PTSD also experienced problems in their marital and family relationships in ways that contribute to a higher incidence of domestic violence.

Statement of the Problem

Domestic violence rates among active-duty servicemen, couples seeking relationship therapy, and Vietnam veterans with and without posttraumatic stress disorder (PTSD) have been shown to be higher than those from the general population; however, there remains a paucity of timely and relevant studies concerning couples who seek relationship therapy in which the veteran has PTSD to explore how these relationships compare with other couples (Sherman, Sautter, Jackson, Lyons & Han, 2006). According to Howard and Rheem (2009), "Combat-related trauma can be particularly detrimental to marital and other intimate relationships. Marital instability is present at higher rates in combat veterans. Veterans with post traumatic stress disorder (PTSD) and their spouses report significantly higher rates of impaired relationship functioning than those without PTSD" (p. 21). Because of the established relationship between the existence of PTSD and an elevated risk for violence among these couples, the treatment-seeking behavior, and the relationship distress, those couples who consult marital counselors for relationship therapy represent a particularly vulnerable population (Sherman et al., 2006). Therefore, identifying the respective levels of domestic violence among those combat veterans who suffer from PTSD compared to those combat veterans who do not represents a timely and important enterprise which is discussed further below.

Review of Related Literature

The military has learned a number of valuable lessons from its experiences in the world wars and the wars in Korea and Vietnam in the 20th century. Unlike veterans returning from deployment to combat areas in these conflicts, the armed forces attempt to provide active duty military personnel with the information and training they will need to help make the transition from combat duty to life in the United States and perhaps civilian life more seamless and less traumatic. In this regard, Fennell and Fennell (2002) note that, "Active duty military personnel and spouses have all completed a series of activities preparing them for reunion prior to the actual event. Thus, the active duty families have a cognitive sense of what to expect. The cognitive awareness of many of the issues is helpful, but does not by itself make the reconstitution of the family painless" (p. 1).

Indeed, combat veterans who return to their homes and families may encounter some unexpected problems besides just readjusting to a lifestyle where an unseen enemy is not trying to kill them and their comrades. For instance, Mabray, Bell and Bray (2009) recently reported that, "When soldiers return home, marital therapy is often needed to reintegrate. Common issues include lack of trust due to possible extramarital affairs, financial issues and disagreements about how money was spent, the returning soldier having difficulty thinking in terms of 'we' instead of 'I,' and the spouse who was left at home becoming more independent during deployment and having difficulty relinquishing duties" (p. 33). These issues may contribute to yet other problems, including veterans believing they no longer enjoy a space in their own homes or with their families, exaggerated expectations on the part of the veteran's spouse to contribute more than the veteran's fair share of the marital responsibilities because he or she was forced to "go it alone" for so long and wants a break from these tasks, elevated demands on the spouse's time and attention to the detriment of the relationships that were forged during the soldier's absence, and unrealistic expectations on the part of the returning soldier that things will be the same as when he or she was deployed (Mabray et al., 2009).

Not only do many returning veterans experience problems with their spouses, they can also have problems reestablishing meaningful relationships with their children. According to Mabray et al., "Soldiers coming back from deployment also face challenges in dealing with their children. Some have expectations that things will be the same, and are often confused when their children feel resentment towards them, seem distant or afraid, or do not show the same respect as before" (p. 32). Moreover, the child or children involved may have grown emotionally attached to the mother or father who stayed at home during the soldier's absence, and the return event may spawn new fears concerning the potential for future separations as well (Mabray et al., 2009). Clearly, these marital conflicts and familial problems can even be further exacerbated when the returning combat veteran experiences the potentially debilitating effects pf PTSD (Mabray et al., 2009).

Studies have shown time and again that combat veterans with PTSD display increased rates of anger compared to combat veterans who do not suffer from PTSD, findings that lend support to the notion that anger is a concomitant of PTSD instead of the combat experience itself; these higher rates of displayed anger can be manifested in hostile behavior (Sherman et al., 2006). For example, the results of a study of Vietnam combat veterans suffering from PTSD found that there was a higher incidence of hostility and increased hostile behaviors in interpersonal interactions compared to veterans who did not suffer from PTSD veterans or those subjects who served as community controls (Beckham, Roodman, Barefoot, Haney, Helms, Fairbank, et al., 1996). Likewise, a study by Rosenbaum and Leisring (2003) found that traumatic experiences can have a significant impact on the subsequent development of aggression in relationships, a finding the authors suggest "is not surprising given the evidence for a relationship between post-traumatic stress disorder (PTSD), anger, and aggression in other populations" (p. 7). According to Rosenbaum and Leisring, "Studies with PTSD samples suggest that PTSD is related to anger dysregulation as well as to relationship violence. Combat veterans with PTSD had more difficulty controlling anger than both combat veterans without PTSD and noncombat veterans with other psychiatric diagnoses" (p. 8). In addition, veterans who suffer from PTSD have been shown to exhibit increased levels of hostility and physically aggression toward their wives compared to veterans who did not suffer from PTSD (Rosenbaum & Leisring, 2003).

Not surprisingly, such elevated hostility and aggression levels can result in increased violence in their domestic relationships. For instance, Riggs, Byrne, Weathers, and Litz (1995) determined that almost two-thirds (63%) of those veterans who sought assistance for PTSD had reported being aggressive with their partners during the previous year. Likewise, Byrne and Riggs (1996) analyzed 50 volunteer Vietnam combat veterans and their partners and determined that nearly half (42%) of the male participants had been physically… READ MORE

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