Couple adaptation in the aftermath of men's active duty in war: The roles of attachment, empathy and dyadic coping.

The literature shows that soldiers' active duty in war can lead both to their own Post-Traumatic Stress Disorder (PTSD) and tothe Secondary Traumatization (STS) of their spouses. Previous research has also documented a significant interdependence between the severities of the twopartners’ post-traumatic distress. However, an understanding of the mechanism that stands at the base of this mutualism is lacking. The Couple Adaptation to Traumatic Stress (CATS) Model suggests that this interdependence comes about through thepartners’ predisposing factors,personalresources and couple functioning. The current research uses the CATS Model to examine the adaptation of couples in the aftermath of men'sactive duty in the Second Lebanon War.

The first aim of the current research was to examine the association between the twopartners’ adaptation, as manifested in the association of the severity of their post-traumatic symptoms, mental wellbeing and daily functioning. The second research goal was to examine how each participant’s attachment, empathy and dyadic coping contributed to his/her own adaptation. The third researchgoal was to examine how each participant’s attachment, empathy and dyadic coping contributed to his/her partner’s adaptation.

According to the theoretical literature, attachmentsecurities – as opposed toattachment insecurities – contribute to the positive perception ofthe self, the significant other, and the stressful situation. Thus, in the presence of a stressful situation, an individual's secure attachment will constitute an immunity factor both for the individual and for his/her spouse. Comprehensive research shows that anindividual’sattachment securities – as opposed to his/her attachment insecurities – positively contribute to his/her ownadaptationas well as to his/her partner’s adaptation. Asimilar pattern has been assumed to existfor the contribution of attachment styles in couple adaptation after men's active duty duringwar.

According to the theoretical literature, the way spouses perceive and respondto one another's distress signals depends on their styles of empathy. Perspective-Taking and Empathic Concern are empathy styles that prevent the individual from becoming emotionally overwhelmed by a partner’s distress; they enable an expression of empathy in a way that promotes couple adaptation. Conversely, Fantasy and Personal Distress styles of empathy undermine the individual's and spouse'sadaptation. Research in this field is scarce, but that which exists indicates that Perspective-Taking and Empathic Concern correlate with better adaptation both for the individual and for his/her partner. A reverse pattern has been found for theFantasy and Personal Distress styles of empathy. Accordingly, we assumed that these same patterns would apply tothe contribution of empathy styles in couple adaptation after men's active duty during a war.

According to the theoretical literature, the success of a couple'sadaptation following a stressful event depends not only on the individual's efforts to diminish his/her own personal distress, but also on the quality of the individual's efforts to respond to his/her  spouse's emotional needs, namely dyadic coping. Active Engagement is a style of dyadic coping that promotes adaptation through combining each partner's adaptation efforts following a stressful event. Protective Buffering and Overprotection, on the other hand, are styles that hinder capability, inhibit mutual sharing of difficulties, and therefore negatively contribute to couple adaptation. Studies have revealed that an individual’s Active Engagement style is positively associated with his/her own adaptation as well as with his/her spouse’s adaptation.  Reverse findings have been revealed for the Protective Buffering and Overprotection styles.  Similar patterns have been assumed for the contribution of dyadic coping styles in couple adaptation following men's active duty during a war.

Three hundred  couples (600 individuals), of whom the male fought in the Second Lebanon War,  participated in the current research; at the beginning of the study, all of the couples had  been in their relationships for around a year. In order to expand the range ofcouple adaptation levels, the sample was comprised of two groups. One group included 150 couples, of which the male member approached the IDF or the Ministry of Defense to requestmental assistance due to distress developed as result of his having fought in the war. The other group included 150 couples, of which the male member did not request mental assistance. While the background characteristics of males from both groups were similar, adaptationlevels of those who requested assistance were distinctly lower. Dependent variables weremeasured using the followingquestionnaires: PTSD Inventory, Mental Health Inventoryand Life Functioning Scale. Independent variables were measured using the followingquestionnaires: Experience in Close Relationships Scale, Interpersonal Reactivity Index, Ways of Giving Support, Life Events, Battlefield Stressors,and a background details questionnaire. Identical questionnaires were distributed to both thestudy's men and the study's women, aside from a battle exposure severity questionnaire which was given only to the men.

Six years after the war ended, 28% of the men in the sample and 11.3% of their spouses were found to meet all the criteria for a full diagnosis of PTSD. A higher diagnosis rate (29%) was found among the spouses of the 84 men who were diagnosed as post-traumatic in the research. The analysis of the contribution of couple resources was conducted via the APIM model, which allows an observation of the dyad as an analysis unit. First, a positive correlation was found between all of both spouses' adaptation components. A high level of anxiety or avoidance in a participant’s attachment was associated with low levels of his/her own adaptation. On the interpersonal level, avoidant attachment in women was associated with weaker adaptation in men, reflected intheir higher severity of PTSD and lower level of mental wellbeing. In contrast, men's anxiety attachment was found to correlate with weaker adaptation in women, reflected in their higher severity of STS and lower level of mental wellbeing. In addition, avoidant attachment in men was found to negatively contribute to daily functioning in women.

An observation of empathy suggested that a participant’s Personal Distress style negatively correlated with his/her own adaptation. Likewise, a participant’s higher level of Perspective-Takingand lower level of Fantasywere found to correlate with a higher level of daily functioning. On the interpersonal level, the Personal Distress style in men was found to negatively correlate with adaptation in women.

An observation of  dyadic coping suggested that a participant’s higher level of Active Engagement correlated with a higher level of his/her own adaptation, excluding the absence of an associationwithSTS in women. Likewise, Protective Bufferingin womenwas found to correlate with lower levels of their ownadaptation, reflected in their more severeSTS and lower daily functioning. On the interpersonal level,Protective Buffering in womenwas found to correlate with lower adaptation in men,reflected in their more severe PTSD and lower daily functioning.

The outstanding finding of this researchwas the extent of damage in all adaptation dimensions in women. No differences were found between men and women in terms of the way each participant’s resources contributed to his/her own adaptation.Resources that were found to contribute interpersonally were also found to do so individually, with the exception of dyadic coping in the Active Engagement and Overprotection styles. While attachmentwas found to contribute interpersonally to the adaptation of both men and women, empathy was only found to contribute interpersonally to adaptation in women,and dyadic coping was only found to contribute interpersonally to adaptation in men.

 The findings regarding resources contribution reveal thatpartners may contribute, for better or worse, to one another's adaptation following men'sactive duty in war. The same resources seem to explain, in different ways, the mechanism of men'sadaptation following the traumatic experience of war and the mechanism of transmitting their distress to their female partners.As for theoretical implications, this research contributes to the understanding of the systematic processes of couple adaptation. Furthermore, the findings contribute to the theoretical understanding of the unique role that attachment, empathy and dyadic coping play in couple adaptation following men's active duty in war. This contribution is unique especially due to the scarcity of research in the field using analysis of a dyadic method. These findings support the theoretical conjecture that an intimate relationship provides strong therapeutic potential. In future research,an examination of the role of additional couple resources in longitudinal studies is recommended.