This study uses a stress process framework and person-centered methods to describe patterns of concurrent stressors across multiple domains and to associate patterns with female military spouse mental health. Background: Most military families are resilient. However, a subset of military spouses experiences adverse outcomes in the context of war-related stress. To date, a focus on military-specific stressors has largely obscured the effects of stress unrelated to military service on the well-being of military spouses. Methods: Data were drawn from a 2012 survey of 343 U.S. Army spouses, measuring intrapersonal (e.g., adverse childhood experiences), family (e.g., work-family conflict), and military stressors (e.g., cumulative deployments). Outcomes included moderate or more severe depression, anxiety, and posttraumatic stress disorder (PTSD). Results: The three-step method of latent class analysis identified three classes: low (58.86% of participants), moderate (21.62%), and high (19.52%) stress. Prevalence of mental health problems was significantly elevated in the high-stress class. In this group, 35.3%, 36.3%, and 39.5% of spouses' screenings indicated at least moderate depression, anxiety, and PTSD symptomatology, compared with 3.0%, 3.9%, and 2.7% in the low-stress group. Conclusions: Results suggest many military spouses have low stress exposure across domains and low rates of mental health symptoms. However, a subset of spouses may experience both intrapersonal and family-level risk associated with elevated rates of mental health problems. Implications: Findings highlight the critical role of nonmilitary stressors in the lives of military spouses and the
PurposeMost outcome studies of bypass surgery are limited to five years of follow-up. However, as human life expectancy has increased, analyses of more long-term outcomes are needed. The aim of this study is to evaluate 10-year outcomes of anatomical bypasses in aortoiliac occlusive disease.MethodsFrom 1996 to 2009, 92 patients (82 males and 10 females) underwent aortic anatomical bypasses to treat aortoiliac occlusive disease at Samsung Medical Center. The patients were reviewed retrospectively. Kaplan-Meier survival analyses were performed using PASW ver. 18.0 (IBM Co).ResultsA total of 72 patients (78.3%) underwent aorto-femoral bypasses (uni- or bi-femoral), 15 patients (16.3%) underwent aorto-iliac bypasses (uni- or bi-iliac), and 5 patients (5.4%) underwent aorto-iliac and aorto-femoral bypasses. The overall primary patency rates of the 92 patients were 86.2% over 5 years and 77.6% over 10 years. The 10-year limb salvage rate and overall survival rate were 97.7% and 91.7%, respectively.ConclusionThe overall patency rates of bypass graft and limb salvage rates decreased as time passed. The analysis of results after bypass surgery to treat arterial occlusive disease will be needed to extend for 10 years of follow-up.
Military spouses are an understudied population with respect to intimate partner violence (IPV) perpetration. Due to the unique demands of service members’ jobs, military couples are documented to experience particular individual, couple, and family-level risk factors that may lead to IPV perpetration. Using the frustration-aggression hypothesis and considering the possibility of mutual violence, we examined (a) the direct effects of stressful events, marital discord, and work–family conflict on IPV perpetration among military spouses and (b) the indirect effect of anger arousal between stressful events, marital discord, and work–family conflict on IPV perpetration. This study is a secondary analysis of data drawn from a survey of army spouses conducted by the Walter Reed Army Institute of Research in 2012. The sample consists of 314 female spouses of active-duty members (white 75%, enlisted 80%). After controlling for covariates (including spouse race, rank, household size, age, living distance from military installation), the direct effects of marital discord and anger on IPV perpetration were statistically significant. Also, the direct effects of marital discord and work–family conflict on anger were significant. The path model demonstrated that the indirect effects of marital discord and work–family conflict on IPV perpetration via anger were significant. Finally, most physical and verbal violence was reported to occur in the form of mutual violence with their partners. Study findings suggest that the pathway of risk factors impacting IPV might differ depending on the sources of stress. The Family Advocacy Program, military social work practitioners, and other behavioral health providers should consider domains of risk and provide support to military spouses that is specifically tailored to these risk factors. Furthermore, considering the mediating role of anger arousal in the relationship between marital discord, work–family conflict and IPV, programs to address anger might be helpful to reduce IPV among military spouse perpetrators.
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