Expressive Writing and Military Couple Adjustment Following Combat

1
Expressive Writing and Military Couple Adjustment
Following Combat

• James W. Pennebaker, Ph.D.
• Jenna L. Baddeley, M.A.
• The University of Texas at Austin
• In Collaboration with
• Amy Adler, Ph.D.
• LTC Paul Bliese, Ph.D.
• USAMRMC WRAIR
• 8/8/09

2
Agenda

• Background
• Research questions
• Methods
• Results
• Discussion

3
Reuniting after a deployment
4
Deployments as relationship disruptions

• Knowledge of each other (Gottman, 2002)
• Shared narrative (Berger Kellner, 1964)

5
Existing Interventions for Marital Problems

• Couples Therapy
• Underused
• Stigma (Hoge et al., 2004)
• Concerns about soldiers career (Scurfield, 2006)
• Low success rate
• Expensive

6
Expressive Writing

• Private expression
• Confrontation and organization of emotional
  upheavals
• Social communication the long ride home

7
Expressive Writing for Couples

• Longer relationships, especially if the male
  writes (Slatcher Pennebaker, 2006)
• Reduced anger and marital distress after
  infidelity (Snyder, Gordon, Baucom, 2004)

8
Research Questions

• Can expressive writing improve marital
  satisfaction in army couples?
• If either partner writes?
• If soldier writes vs. if spouse writes?
• If both partners write vs. only one partner
  writes?

9
METHODS
10
Recruitment

• Survey of couples experiences
• Fort Hood, TX
• Newspaper, Flyers, Events calendars, Radio

11
Screening

• Married
• Both 18
• Deployment
• Iraq or Afghanistan in last 18 months
• Not deploying again in next 2 months
• No major psychiatric disorder
• Not currently suicidal

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Participants

• 102 couples
• 97 husband military, wife civilian
• 4 dual military
• 1 wife military, husband civilian
• Married M7.44 years (SD 5.55, range 1 to 23
  years )
• 88.2 have children, average N2
• Childrens average age 8.44 (SD5.81).

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Participants, contd

• Deployment history
• M1.71 previous deployments to Iraq/Afghanistan
  (SD1.56, range 1-4)
• M18.75 months deployed in Iraq/Afghanistan
  (SD10.12)
• Reunited M9.30 months (SD2.31)
• Next deployment M8.52 months away (SD4.84)

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Participants, contd

• Average age 32 (SD 6.80)
• Education
• 20 high school
• 44 some college
• 35 4-year college or graduate degree
• Race/ethnicity
• 66 white, non-hispanic
• 17 hispanic
• 13 black

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Baseline Mental Health
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Conditions

• Both spouses in expressive writing group (N27)
• Both spouses in control writing group (N25)
• Soldier in expressive writing group spouse in
  control writing group (N28)
• Spouse in expressive writing group soldier in
  control writing group (N23)

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Participant arrival and sign-in
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Study protocol

• Intervention
• Group sessions (Chung Pennebaker, 2008)
• Informed consent
• Demographics, marital satisfaction (RAS
  Hendrick, 1988), aggressive behavior, mental
  health symptoms (PHQ-D Spitzer et al., 1999),
  physical symptoms (PILL Pennebaker, 1982).
• Writing exercises
• Post-writing questionnaire
• 1-month and 6-month internet follow-up

19
Writing Sessions
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RESULTS
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Reactions to Writing

• Expressive writing participants found writing
  more
• personal (M5.91 vs M4.70, p lt. 001)
• emotional (M5.92 vs M4.26, p lt .001)
• meaningful (M5.16 vs M4.41, p lt .003)

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Soldiers and spouses writing
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Example Personality changes

• "it's been hard for me to get back to the person
  that my wife fell in love with and that is
  putting a huge amount of stress in our
  relationship. My change has caused a change in my
  wife to deal with who I am now. So it seems that
  neither of us are the same people we fell in love
  with due to all my deployments... how do I get
  back to who I used to be?" -soldier

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Examples Future deployments

• "It's hard to unwind and relax and enjoy your
  family when you constantly worry about the next
  deployment it's like a countdown. soldier
• "I am worried about him going back next year. I
  feel like deployments are a black cloud over our
  heads. We can't make any plans for ourselves or
  our family. -spouse

25
Changes in Marital Satisfaction
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Changes in Marital Satisfaction
27
Changes in Marital Satisfaction
28
Changes in Yelling
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DISCUSSION
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Why is it good when soldiers write?

• Gender?
• Mens writing ? relationship improvement
  (Slatcher Pennebaker, 2006 data)
• Being a soldier?
• Trained to suppress emotions
• I have to be focused during a deployment and
  emotional stress will get in the way and distract
  me. That can be deadly in the theater. Emotional
  detachment seems to be the only way out of that
  and get my head back in the game.

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Participants comments on the study

• Insights
• I think it was an eye opener as far as looking
  at it through my wifes perspective, allowed me
  to realize a lot of things about her and myself.
  
• Outlet for expression
• I think this writing sessions are a great outlet
  for feelings that we dont feel comfortable
  sharing with our spouses...
• Importance
• I hope that better tools will be developed for
  re-integration. We need them. This research is
  very important. Thank you!

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Summary

• Deployments and reunions are stressful for
  soldiers and spouses
• When soldiers do expressive writing
• marital satisfaction increases
• yelling decreases
• Intervention implication
• Expressive writing for soldiers with booster
  sessions

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Acknowledgements
Amy Adler, Ph.D., and LTC Paul Bliese, Ph.D., of
the U.S. Army Medical Research and Materiel
Command Research Assistants Sonia Hart, Lisa
Sperle, Katherine Kugay, Alex Petak, Ricardo
Santos, Thomas Woodard Coding Sandra Pahl,
Jasmine Bjork-Regan
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Thank You

• James W. Pennebaker, Ph.D.
• The University of Texas at Austin
• http//www.psy.utexas.edu/pennebaker/
• pennebaker_at_mail.utexas.edu
• 512-232-2781
• Jenna L. Baddeley, M.A.
• The University of Texas at Austin
• http//homepage.psy.utexas.edu/homepage/students/B
  addeley/jenna_at_mail.utexas.edu
• 512-608-1303