Identifying psychological outcomes in families of Five Eyes alliance armed forces Veterans: A systematic review
Abstract: Military service can affect the psychological health and well-being of ex-service members and their families. Most research prioritizes active duty families or Veterans, with spouses/intimate partners and adult children of Veterans often overlooked. This study reviewed all previous research on the psychological health of Veteran families within the Five Eyes alliance countries of Australia, Canada, New Zealand, the United Kingdom, and the United States. It found spouses/intimate partners had higher rates of anxiety, depression, and posttraumatic stress disorder (PTSD) compared to national rates and were more likely to feel distress when their Veteran partner had mental health issues. Adult children were at higher risk for anxiety, depression, alcohol/substance misuse, and PTSD compared to national rates. Four themes identified were: personal feelings and internal emotions, Veteran-oriented, help and support, and acting as a unit. Due to the scarce available research, further studies are needed to address psychological outcomes among military Veteran families.
Abstract: Disordered eating is a prevalent and relevant health concern that remains understudied among U.S. military veterans. Avoidant/restrictive food intake disorder (ARFID) is a newly recognized feeding and eating disorder characterized by overly restrictive eating due to (a) picky eating, (b) lack of appetite, and (c) fear of aversive consequences related to eating. The Nine-Item ARFID Screen (NIAS) is a recently developed ARFID screening tool with initial validation studies demonstrating psychometric support. However, the psychometric properties of the NIAS have not been investigated in a veteran sample. To advance our understanding of ARFID screening tools that may be appropriate for use in veterans, the present study examined the factor structure of the NIAS using survey data from a large national sample of recently separated veterans (N = 1,486). Measurement invariance across key subgroups was tested in addition to exploring differential associations between the NIAS and related constructs. Results suggested that a three-factor model provided an excellent fit of the data and demonstrated scalar invariance across self-identified men and women, race and ethnicity, and sexual and gender minority (SGM) identity. Some subgroups had higher latent means on the picky eating (women, SGM, non-Hispanic Black), appetite (women, SGM), and fear (women) factors. The NIAS had some overlap with another measure of disordered eating and was moderately correlated with psychosocial impairment and mental health. Overall, the NIAS may be a useful screening tool for ARFID in veterans, given support for the three proposed subscales and equivalence across diverse identities.