Doctor of Philosophy / Department of Family Studies and Human Services / Briana S. Goff / The purpose of the current study is to understand the lived experiences of military couples regarding the effects of war-related trauma and deployment on couple functioning. An interpretive phenomenological perspective was utilized during data analysis. This type of phenomenological perspective suggests that human phenomena can only be understood in a situated context (Packer & Addison, 1989). This is to suggest that a person’s emotions, behaviors, and experiences cannot be separated from the context in which they occur. For the purpose of this study, the “context” under consideration was the Army culture and customs in which each of the participant couples was embedded. The Couple Adaptation to Traumatic Stress Model (CATS; Nelson Goff & Smith, 2005) offers a constructive step forward in systemically understanding and treating the impediments created by war-related trauma and deployment. The current study utilized the core terms included in the CATS Model (Nelson Goff & Smith, 2005) as sensitizing concepts to guide the qualitative analysis process. This includes the CATS Model couple functioning variables of attachment, satisfaction, stability, adaptability, support/nurturance, power, intimacy, communication, conflict, and roles. Using qualitative interviews from 90 participants (n = 45 couples), five themes were identified as salient, including communication, conflict management, roles, support/nurturance, and post-traumatic growth. Participants were divided into subgroups (n = 15 couples, 30 total participants) according to their scores on the Purdue Post-Traumatic Stress Disorder Scale – Revised (PPTSD-R; Lauterbach & Vrana, 1996) and the Dyadic Adjustment Scale (DAS; Spanier, 1976). This subsample was selected to examine differences in themes among couples with high and low levels of marital satisfaction, as well as those with high and low levels of post-traumatic stress symptoms. Many similarities were found among the couples with high marital satisfaction and those with low levels of post-traumatic symptoms. Likewise, similarities were also discovered among the couples with lowest levels of marital satisfaction and those with highest levels of post-traumatic stress symptoms. From the current study, there is clear evidence in support of the CATS Model elements of communication, conflict, roles, support/nurturance, and satisfaction. A new contribution to the CATS Model can be made from the current study, which is the inclusion of post-traumatic growth.

Objective: This study aims to explore the traumatic experiences and to estimate prevalence and predictor factors for PTSD, depression and general psychiatric morbidity amongst Palestinian adults living in the Gaza Strip. Method: A total of 500 Palestinian adults were recruited from four areas of the Gaza Strip using a snowball sampling. The same sample was used for both quantitative studies. Four scales were employed to identify predictors for trauma, PTSD, depression and general mental health. Participants were divided into three age groups: young adults (18 to 25 years), adults (26 to 49 years) and older adults (50 to 65 years). The third qualitative study was aimed at exploring the traumatic experiences of adults living in the Gaza Strip to expand upon the outcomes from the quantitative studies. Results: For Studies 1 and 2, the prevalence rate of PTSD symptoms was 90% and 36.7% met the criteria of DSM-IV for PTSD. Study 2 found depression was 38.4%, and general mental health comorbidity was 67.1%. Study 2 revealed significant differences in PTSD between age groups. Novel results were found amongst adults and older adults on the re-experiencing subscale for PTSD. Participants who lived in Gaza City scored significantly higher on the PTSD subscale for hyperarousal compared to those living in the middle Gaza region. Study 3 expanded on the psychometric data through interviewing members of the Gaza community. When analysed five main themes were identified: Siege related stressors; war related trauma; psychological negative effects; re-experiencing initial event and coping strategies. Conclusions: The findings indicated that blockade was the predominant cause of the increased prevalence rate of PTSD. These studies found that the Palestinian adult participants in Gaza had been exposed to a variety of traumatic events on an ongoing basis that was having a detrimental impact on their mental health.