Resilience Hardiness and Family Support for the Severely Injured Service Member and Their Spouse

INTRODUCTION: While studies have investigated the effects of combat stress on service members, few have examined the after-effect of the severe injury on surviving service members and their families (Cozza et al, 2010; Mysliwiec, 2013). The present research examines the potential effects of resilience hardiness and family support on emotional well-being, sleep symptoms, and PTSD symptoms of severely wounded military personnel and their spouses.

METHODS: Study participants were recruited from a military medical center where service members were being treated for severe injuries. Participants were service members and their spouses (N=48) that completed questionnaires including outcomes measuring emotional well-being (WLWBI), sleep quality (PSQI-A) and PTSD (PCL) in relationship to psychological hardiness (DSR) and family support (WLWBI). ANOVAs were used to examine the effects of family support and hardiness on emotional well-being, sleep problems and PTSD symptoms (dichotomized at the median). First the total group was examined and then the wounded service members and spouses were examined separately.

RESULTS: For the total group (service members and their wives together, N=42), family support predicted positive emotional well-being (F=13.4, p < .001), as did hardiness (F=13.8, p < .001). Hardiness is also associated with fewer PTSD symptoms (F=6.9, p < .01). Neither resilience hardiness or family support predicted sleep quality. Looking at just wounded service members (n=21), only family support predicts emotional well-being (F=10.6, p < .01). For this group, family support also predicts fewer sleep problems (F=6.0,  p < .05). Finally, hardiness is the resiliency factor predicting PTSD symptoms for the wounded service members (F=7.6, p < .01). For the spouses only (n=22), significant effects were found for emotional well-being, but not for sleep problems or PTSD symptoms. Here, both family support (F=7.6, p < .01) and hardiness (F=14.8, p < .001) are associated with positive emotional well-being.

CONCLUSIONS: This is one of the first studies to examine resilience hardiness and family support among severely wounded service members and their spouses. Results point to psychological hardiness and family support as variables that can help to maintain positive well-being and minimize PTSD symptoms, especially for the wounded service members. Future work should explore the prevention value of programs seeking to strengthen family and martial relationships and increase psychological hardiness for injured military personnel.