Between Mourning and Hope: A Mixed-Methods Study of Ambiguous Loss and Posttraumatic Stress Symptoms Among Partners of Israel Defence Force Veterans

Objective: Spouses of military combatants often experience adverse outcomes, including posttraumatic stress symptoms (PTSS) in the event of ambiguous loss (AL). AL refers to an uncertain situation regarding a person’s status as alive or as cognitively present. The former ambiguity is categorized by the term physical AL (PAL), which refers to the continued psychological presence of a person, despite their physical absence. The latter ambiguity, categorized by the term psychological AL or ambiguous presence, refers to when a person is emotionally absent, despite their physical presence. Though AL has been widely researched, there are still gaps around the AL–posttraumatic stress disorder (PTSD) relationship, especially regarding dyadic variables that can moderate this relationship. Also, most of the AL military-related studies are qualitative, with only a few that combine qualitative and quantitative research methods. We address these gaps in an innovative mixed-methods study examining the emotional experience of Israeli veterans’ spouses with a focus on the relationship between AL, PTSS, and dyadic adjustment (DA). Method: The study included 63 participants, all spouses of Israeli veterans. We used self-report questionnaires (AL, Dyadic Adjustment Scale, and PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, fifth edition) and a semistructured narrative interview. Results: Our results revealed positive correlations between AL–PTSS and PAL–PTSS. Also, an interaction effect was found in which the lower the DA level, the stronger the PAL–PTSS correlation. Conversely, the higher the DA level, the stronger the ambiguous presence–PTSS correlation. Qualitative findings identified themes in the experience of these situations, including uncertainty and ambivalence. Conclusions: Our qualitative and quantitative results combined suggest that the way military couples deal with AL may be an important emotional experience requiring specific attention from mental health professionals.