Military posttraumatic stress disorder: a qualitative systematic review of the experience of families, parents and children

Objectives: Research into military-related posttraumatic stress disorder (PTSD) and the impact to families is growing. However, qualitative studies exploring the family life or parenting experiences of military/veteran families living with PTSD appears limited. The current paper aimed to systematically review research that explored different family members’ experiences of living in families where a parent had a military related PTSD. Methods: Adhering to the PRISMA guidelines for systematic reviews, six online databases were comprehensively searched, along with manual searches of relevant journals, reviews and reference lists. Interrater reliability for identifying papers was established through blind co-screening of 20% of search results, with minimal initial discrepancy. Eleven studies were identified. Each study was critically appraised for quality using the RATS (relevancy, appropriateness, transparency, soundness) qualitative research review guidelines. Results: Thematic analysis identified six primary themes including: the absent parent; walking on eggshells; still part of the family; children and partners as care givers; making sense and understanding; and long-term impacts upon the family. Quality of the identified research was mixed. Conclusions: The existing literature is extended by presenting a systematic review of published qualitative research on the subjective experiences of the parent with military-related PTSD, their partner and children. Themes across veteran, partner and child focused papers illustrated interconnected elements of the family experience of PTSD. Future studies might integrate the views of family members. Clinicians need to be mindful of the relational context in which PTSD exists.