Tag Support

Supporting Veterans and Their Mental Health: A National Responsibility

Veterans have served their country with dedication and, upon returning to civilian life, often face numerous challenges that require our support and understanding. Many veterans experience significant mental health issues, including post-traumatic stress disorder (PTSD), depression, anxiety, and substance use disorders. These challenges can hinder their ability to reintegrate into civilian life and maintain relationships, employment, and a healthy lifestyle. Recognizing the mental health needs of veterans and implementing effective support strategies is crucial for honoring their service and supporting their well-being.

The Mental Health Landscape for Veterans

Veterans are at a higher risk of mental health issues compared to the general population. A report from the U.S. Department of Veterans Affairs (VA) indicated that approximately 11-20% of veterans who served in Iraq and Afghanistan suffer from PTSD in any given year, and the prevalence is even higher among those who served in the Vietnam War (U.S. Department of Veterans Affairs, 2022). Additionally, veterans are at an increased risk for depression, anxiety, and substance abuse issues, with research suggesting that over 25% of veterans experience symptoms related to depression and other mood disorders (Hoge et al., 2004).

A primary cause of these mental health challenges is the exposure to trauma and high-stress situations during service. Repeated exposure to combat, violence, and injury can leave lasting psychological scars that are difficult to heal. This stress may also exacerbate pre-existing mental health issues, making it even more difficult for veterans to transition back to civilian life.

Barriers to Mental Health Care for Veterans

While the VA and other organizations offer resources for veterans, barriers to accessing mental health care persist. According to the RAND Corporation, veterans may face significant obstacles, such as long wait times for appointments, stigma surrounding mental health, and a lack of providers who understand military culture (Tanielian et al., 2018). This stigma can prevent veterans from seeking help, as they may feel that mental health challenges are a sign of weakness or that others will not understand their experiences.

Rural veterans often face additional obstacles due to the lack of nearby mental health resources. Research has shown that nearly a quarter of all veterans live in rural areas, where specialized mental health services may be limited (Weeks et al., 2008). Telemedicine and virtual counseling have helped bridge some of these gaps, but there remains a need for more accessible, culturally informed care tailored to the unique needs of veterans.

Strategies for Supporting Veterans’ Mental Health

  1. Increasing Access to Mental Health Services:
    Expanding mental health resources specifically tailored for veterans is essential. The VA and other organizations are implementing initiatives to reduce wait times, increase the availability of telehealth services, and provide alternative therapies, such as art therapy, music therapy, and mindfulness practices (U.S. Department of Veterans Affairs, 2022). Community-based programs can also provide veterans with accessible care, particularly in rural areas.
  2. Building a Community of Support:
    Peer support programs can be highly effective for veterans, as they allow veterans to connect with others who have had similar experiences. Programs like the Veterans Crisis Line and the VA’s Peer Support program connect veterans with trained peers, who provide support, understanding, and guidance. Research suggests that peer support reduces PTSD symptoms and increases veterans’ willingness to seek help (Resnick et al., 2012).
  3. Reducing Stigma through Public Awareness:
    Public awareness campaigns can play a crucial role in reducing stigma around veterans’ mental health issues. Campaigns should focus on educating both veterans and the general public about the commonality of mental health challenges, emphasizing that seeking help is a sign of strength. The VA’s “Make the Connection” campaign is an example of an initiative aimed at reducing stigma and encouraging veterans to pursue mental health treatment (U.S. Department of Veterans Affairs, 2022).
  4. Encouraging Family Involvement and Support:
    Family members can be a crucial source of support for veterans dealing with mental health issues. Programs that educate family members about PTSD, depression, and other mental health conditions can equip them to support their loved ones effectively. Involving families in therapy sessions can also create a support network that extends beyond formal mental health services, which may improve outcomes for veterans (Monson et al., 2006).
  5. Employment and Reintegration Support:
    Meaningful employment can significantly impact veterans’ mental health and quality of life. Programs like the VA’s Vocational Rehabilitation and Employment services provide veterans with job training, career counseling, and job placement assistance, helping veterans reintegrate into civilian life (U.S. Department of Veterans Affairs, 2022). Research shows that veterans who find stable employment report higher levels of satisfaction and mental well-being (Resnik et al., 2012).

A Call to Action

Supporting veterans’ mental health is not only a moral duty but also a way to ensure the well-being of individuals who have made profound sacrifices. By addressing the barriers veterans face in accessing mental health care, expanding peer support networks, reducing stigma, and providing employment and family support, society can help veterans lead healthier and more fulfilling lives. Moreover, these actions honor their service by providing the respect, care, and compassion they deserve.

We must continue to advocate for policies that support veterans’ mental health, fund research into effective treatments, and raise public awareness about the unique challenges veterans face. Providing veterans with the resources and support they need to thrive is one of the most meaningful ways we can repay them for their service and dedication to our country.

This article has been written by John S. Collier, MSW, LCSW. Mr. Collier has over 25 years of experience in the social work field and is based in London Kentucky through Southeast Kentucky Behavioral Health, LLC. Mr. Collier may be reached by phone at (606) 657–0532 extension 101 or by email at [email protected].

References

Hoge, C. W., Castro, C. A., Messer, S. C., McGurk, D., Cotting, D. I., & Koffman, R. L. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. New England Journal of Medicine, 351(1), 13-22.

Monson, C. M., Schnurr, P. P., Stevens, S. P., & Guthrie, K. A. (2006). Cognitive-behavioral conjoint therapy for PTSD: Pilot results from a community sample. Journal of Traumatic Stress, 19(3), 289-299.

Resnick, S. G., & Rosenheck, R. A. (2012). Integrating peer-provided services: A quasi-experimental study of recovery orientation, confidence, and empowerment. Psychiatric Services, 63(6), 541-547.

Tanielian, T., Jaycox, L. H., & RAND Corporation. (2008). Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery. RAND Corporation.

U.S. Department of Veterans Affairs. (2022). PTSD: National Center for PTSD. https://www.ptsd.va.gov

Post-Traumatic Stress Disorder in Soldiers: Understanding, Effects, and Treatment

Post-Traumatic Stress Disorder (PTSD) is a mental health condition that has long affected soldiers and military personnel, often impacting their lives in profound ways. According to the U.S. Department of Veterans Affairs, up to 20% of veterans who served in Iraq and Afghanistan experience PTSD, underscoring the prevalence of this condition among soldiers who endure the harsh realities of combat and warfare. This article explores the causes, symptoms, and effects of PTSD in soldiers, examines various treatment options, and discusses emerging approaches to care.

Causes of PTSD in Soldiers

PTSD is generally triggered by exposure to traumatic events. For soldiers, combat is a primary source of trauma, involving life-threatening situations, witnessing injury or death, and enduring extreme physical and emotional stress. Studies have found that prolonged and repeated exposure to combat conditions increases the risk of PTSD, particularly if soldiers are subjected to high levels of intensity and frequency of traumatic events (American Psychological Association, 2020). Further risk factors include military rank, training, and support systems, with enlisted personnel and those lacking robust support networks being more vulnerable (Gradus, 2023).

The severity of PTSD symptoms often varies based on the intensity and nature of the traumatic events experienced. For instance, individuals who encounter close combat situations or who witness the death of comrades are more likely to develop severe PTSD symptoms (Hoge et al., 2004).

Symptoms of PTSD in Soldiers

PTSD symptoms are generally grouped into four categories:

  1. Intrusive Thoughts: Soldiers with PTSD often experience unwanted, distressing memories or flashbacks of traumatic events, causing them to relive the traumatic moment repeatedly.
  2. Avoidance: Avoiding situations, people, or places that remind the individual of the trauma is a common coping mechanism. Soldiers might withdraw from social settings or avoid seeking help.
  3. Negative Changes in Thought and Mood: Symptoms may include persistent negative emotions, distorted beliefs about oneself or others, and a feeling of detachment from family and friends.
  4. Hyperarousal and Reactivity: PTSD often causes soldiers to experience heightened anxiety, irritability, or hypervigilance. They may have difficulty sleeping and feel constantly on edge (National Institute of Mental Health, 2021).

In military contexts, PTSD can lead to significant challenges in social and family relationships, making reintegration into civilian life difficult. Soldiers may experience guilt over actions taken or not taken in combat, known as moral injury, which exacerbates the symptoms of PTSD (Litz et al., 2009).

Effects of PTSD on Soldiers’ Lives

PTSD can have a severe impact on veterans’ physical, mental, and emotional well-being, with potential long-term consequences that affect not only the individual but also their families and communities. Some of the major effects include:

  • Depression and Anxiety: Soldiers with PTSD often experience comorbid depression and anxiety, which can further complicate their recovery. The stress and trauma they face in combat environments have lasting effects that increase susceptibility to these conditions.
  • Substance Abuse: To cope with symptoms, many veterans turn to alcohol or drugs, which often results in dependency issues. Research has shown that PTSD and substance use disorders are closely linked in military populations, with soldiers attempting to self-medicate to alleviate PTSD symptoms (Seal et al., 2011).
  • Suicidal Ideation and Attempts: PTSD is a significant risk factor for suicide among veterans, with some studies indicating that the risk of suicide is higher among those with PTSD than the general population (Kang et al., 2015).
  • Difficulties in Employment and Social Reintegration: Veterans with PTSD may struggle to find and maintain stable employment due to symptoms such as hyperarousal, anxiety, and avoidance, impacting their social and economic well-being. Reintegration challenges, compounded by stigmatization of mental health issues, further isolate veterans from support systems that could aid in their recovery.

Treatment Options for PTSD in Soldiers

A wide range of treatment options is available for soldiers with PTSD. The goal of these treatments is not only to alleviate symptoms but to enable veterans to lead fulfilling lives after service. Treatments can be broadly categorized into:

  1. Psychotherapy: Psychotherapy, particularly Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR), are among the most effective treatments for PTSD. CBT helps patients process and alter their trauma-related thoughts and behaviors, while EMDR helps in processing traumatic memories by stimulating the brain’s natural healing process (Watkins et al., 2018).
  2. Pharmacotherapy: Antidepressants like selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for PTSD, as they help manage symptoms of anxiety and depression. Medication, however, is often used alongside psychotherapy rather than as a standalone treatment (VA/DoD Clinical Practice Guideline, 2017).
  3. Group Therapy and Support Groups: These provide veterans with a community that understands their experiences, fostering a support system that can help them cope with the effects of trauma. Research indicates that group therapy is particularly beneficial for soldiers, as it promotes shared understanding and mutual support (Browne et al., 2016).
  4. Emerging Treatments: New therapies, such as virtual reality exposure therapy (VRET) and MDMA-assisted psychotherapy, have shown promising results. VRET immerses patients in a controlled, simulated environment to help them confront and process traumatic experiences. MDMA-assisted therapy, under clinical investigation, has demonstrated significant reductions in PTSD symptoms in early trials (Mithoefer et al., 2018).

Challenges in Addressing PTSD in Military Contexts

Despite available treatments, several challenges remain in addressing PTSD among soldiers. A significant barrier is stigma—many military personnel fear seeking help for PTSD due to concerns about appearing weak or unfit for duty. Additionally, the military structure can sometimes be resistant to mental health care initiatives, emphasizing resilience and self-reliance over seeking assistance. Efforts are ongoing to destigmatize PTSD and encourage open discussions about mental health in military settings (Hoge et al., 2004).

Accessibility of mental health services is another issue. Many veterans live in rural areas with limited access to specialized PTSD treatments. Telemedicine has been identified as a potential solution, offering remote therapy sessions that improve access for veterans in underserved areas (Rosen et al., 2017).

Conclusion

PTSD remains a significant mental health concern for soldiers, with far-reaching impacts on individuals, families, and communities. The military context poses unique challenges for both the onset and treatment of PTSD, underscoring the need for continued research, awareness, and innovation in treatment options. By addressing stigma and improving access to mental health care, society can better support veterans in managing PTSD and lead them toward healthier, more fulfilling lives post-service.

This article was written by John S. Collier, MSW, LCSW. Mr. Collier has over 25 years of experience in the Social Work field. He currently serves as the Executive Director and Outpatient provider for Southeast Kentucky Behavioral Health based out of London Kentucky. He may be reached at (606) 657-0532 extension 101 or by email at [email protected]

References

  • American Psychological Association. (2020). PTSD and the Military. Retrieved from APA.org.
  • Gradus, J. (2023). PTSD in Military Veterans. VA National Center for PTSD. Retrieved from PTSD.va.gov.
  • Hoge, C. W., et al. (2004). Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care. The New England Journal of Medicine, 351(1), 13-22.
  • Kang, H. K., et al. (2015). Association of PTSD with increased suicide risk among veterans. Journal of Military Medicine, 180(9), 982-989.
  • Litz, B. T., et al. (2009). Moral injury and moral repair in war veterans: A preliminary model and intervention strategy. Clinical Psychology Review, 29(8), 695-706.
  • Mithoefer, M. C., et al. (2018). MDMA-assisted psychotherapy for PTSD: A breakthrough therapy. Journal of Psychopharmacology, 32(1), 4-12.
  • National Institute of Mental Health. (2021). Post-Traumatic Stress Disorder. Retrieved from NIMH.nih.gov.
  • Rosen, C. S., et al. (2017). Telemedicine for PTSD: A review of clinical evidence and practice. Telemedicine and e-Health, 23(3), 192-202.
  • Seal, K. H., et al. (2011). Substance use disorders in Iraq and Afghanistan veterans. Journal of Addiction Medicine, 5(1), 5-10.
  • VA/DoD Clinical Practice Guideline. (2017). Management of Post-Traumatic Stress Disorder and Acute Stress Reaction. Department of Veterans Affairs.
Can Someone Change Their Love Language?

The concept of love languages was introduced by Dr. Gary Chapman in his 1992 book “The Five Love Languages: How to Express Heartfelt Commitment to Your Mate.” Chapman’s theory posits that people express and experience love in one of five primary ways: Words of Affirmation, Acts of Service, Receiving Gifts, Quality Time, and Physical Touch. These love languages help individuals and couples better understand each other’s emotional needs. A common question that arises is whether love languages are static or if they can change over time. In fact, research and anecdotal evidence suggest that a person’s love language can shift due to a variety of factors.

Understanding Love Languages

Chapman’s theory emphasizes that every individual has a primary love language—one that resonates the most in making them feel loved and appreciated. However, it’s important to recognize that love languages are not rigid personality traits but dynamic preferences that can evolve. According to Dr. Chapman, love languages are shaped by upbringing, cultural influences, and past experiences, but they are also adaptable as we navigate through life changes.

Can Love Languages Change?

Several factors can lead to shifts in a person’s love language over time:

  1. Life Transitions and Circumstances
    Major life events such as marriage, parenthood, career changes, or even personal crises can lead to a shift in how individuals prioritize love languages. For instance, someone whose primary love language used to be Words of Affirmation may find themselves valuing Acts of Service after becoming a parent. The practical help offered by a partner during stressful periods may feel like the most profound expression of love. Research suggests that significant life events and environmental contexts can shift what people value most in relationships (Neff & Karney, 2009).
  2. Changes in Relationship Dynamics
    As relationships evolve, partners may learn to express love in new ways or find new ways of feeling loved. A study by Horan & Booth-Butterfield (2013) found that partners in long-term relationships tend to adapt their communication styles and emotional expressions over time. In such cases, love languages can shift in response to changing relationship dynamics. For example, a person who previously valued Receiving Gifts may, over time, begin to prioritize Quality Time if the relationship has grown emotionally distant.
  3. Personal Growth and Emotional Maturity
    Emotional and psychological development can also influence a person’s love language. People evolve, and their emotional needs do too. An individual who has gone through therapy, for instance, may become more comfortable with Physical Touch after working through issues related to intimacy. Similarly, someone who has gained confidence or self-assurance might find that they now crave Words of Affirmation less than before. Research on emotional intelligence highlights that as people become more emotionally mature, their ways of connecting with others evolve (Schutte et al., 2001).

Adaptability and Communication in Relationships

It’s essential to note that just because a person’s love language may change doesn’t mean that love languages are irrelevant or overly fluid. The primary purpose of love languages is to enhance communication in relationships, and as such, being attuned to these shifts is crucial. When individuals notice their love language or their partner’s has changed, open communication is key to ensuring that both partners feel supported and loved.

According to Chapman (2010), couples should regularly check in with one another about their emotional needs, as this allows them to adapt and accommodate shifts in love languages. It’s not uncommon for couples to experience a shift in the ways they express love, especially as they mature and face new challenges together.

Conclusion

While a person’s love language may feel like an integral part of their identity, it’s clear that love languages can change over time. Whether influenced by life circumstances, relationship dynamics, or personal growth, individuals may find their emotional needs evolving. This is a natural part of human development. The key to sustaining healthy relationships lies in the ability to recognize and adapt to these changes through ongoing communication and mutual understanding.

This article has been written by John S. Collier, MSW, LCSW. John has over 25 years experience in the Social Work Field. He currently serves as the Executive Director and Provider within Southeast Kentucky Behavioral Health based out of London Kentucky. He may be reached at (606) 657-0532 extension 101 or by email at [email protected].

References

Chapman, G. (1992). The Five Love Languages: How to Express Heartfelt Commitment to Your Mate. Northfield Publishing.
Chapman, G. (2010). The Five Love Languages: The Secret to Love That Lasts. Northfield Publishing.
Horan, S. M., & Booth-Butterfield, M. (2013). Understanding the Communicative Aspects of Love: Interpersonal Communication in Romantic Relationships. Communication Quarterly, 61(5), 552-567.
Neff, L. A., & Karney, B. R. (2009). Stress and Reappraisal of Marital Interactions. Journal of Personality and Social Psychology, 97(3), 561–576.
Schutte, N. S., Malouff, J. M., Simunek, M., McKenley, J., & Hollander, S. (2001). Characteristic Emotional Intelligence and Emotional Well-Being. Cognition & Emotion, 16(6), 769-785.

Did you Lose Yourself in your Marriage?

Marriage is often seen as a union of two individuals who merge their lives, goals, and values. While this partnership requires compromise, trust, and mutual support, there is a risk of losing one’s personal identity in the process. Losing oneself in a marriage refers to the tendency to prioritize the relationship at the expense of individual identity, interests, and personal development. While the idea of “becoming one” is often romanticized, losing oneself in a marriage can have significant negative consequences for both personal well-being and the relationship itself.

The Concept of Losing Yourself in Marriage

To lose oneself in a marriage means that an individual’s personal identity becomes submerged in the identity of the couple. This can manifest in giving up personal hobbies, values, friendships, or ambitions for the sake of maintaining the relationship. While compromise is an essential part of any marriage, consistently abandoning one’s personal interests and values can lead to feelings of disconnection, resentment, and dissatisfaction over time (Aron & Aron, 2001).

Researchers have explored the psychological phenomenon of “relationship enmeshment,” which occurs when boundaries between partners become blurred, and one partner’s identity is overtaken by the couple’s shared identity (Cramer, 2003). While it’s normal for couples to grow together and make sacrifices for one another, maintaining individual autonomy is equally important for long-term happiness and mental health.

Negative Consequences of Losing Yourself in Marriage

Losing oneself in a marriage can result in several adverse effects, both on an individual level and within the relationship itself.

  1. Loss of Personal Fulfillment: When a person consistently prioritizes their spouse’s needs and interests over their own, they may begin to lose touch with the things that once brought them personal joy and satisfaction (Miller, 2019). Over time, this can lead to feelings of emptiness, as the individual may feel they have lost their sense of purpose outside the marriage.
  2. Emotional Burnout and Resentment: Constantly putting the relationship above one’s own needs can lead to emotional exhaustion. This can result in feelings of resentment towards the spouse, as the individual may feel that they have sacrificed too much for the relationship (Waller & McLanahan, 2005). This, in turn, can create tension within the marriage, as unresolved feelings of resentment and burnout may lead to conflict.
  3. Imbalanced Power Dynamics: In cases where one partner continually prioritizes the other, an imbalanced power dynamic can emerge. The partner who has lost themselves may feel powerless or dependent on their spouse, while the other partner may unknowingly become the dominant figure in the relationship (Anderson & Chen, 2002). This imbalance can create long-term strain on the relationship, as both partners may struggle to navigate the power dynamic.
  4. Increased Risk of Codependency: Losing oneself in a marriage can also contribute to codependency, a situation where one partner becomes overly reliant on the other for emotional support and self-worth. Codependency can limit personal growth, independence, and self-sufficiency, making the individual feel trapped within the relationship (Hendrick & Hendrick, 2006). This can further erode the quality of the marriage, as both partners may struggle with the limitations that codependency imposes.

Why It’s Important to Maintain Individuality in Marriage

Maintaining individuality within a marriage is not only beneficial for personal well-being but also for the health of the relationship. When both partners have their own identities, interests, and friendships, they are more likely to experience personal fulfillment, which can positively impact the marriage. Here are a few reasons why individuality is crucial:

  1. Promotes Personal Growth: Maintaining one’s own hobbies, ambitions, and social connections outside of the marriage allows for continued personal growth. When individuals have space to grow independently, they bring new perspectives and experiences back to the relationship, enriching the partnership as a whole (Aron & Aron, 2001).
  2. Encourages Healthy Boundaries: Healthy marriages thrive on mutual respect and understanding. Setting and maintaining personal boundaries can help ensure that both partners feel valued and respected in the relationship. This allows for a balance of independence and togetherness, preventing the suffocation that often comes with losing oneself in the marriage (Cramer, 2003).
  3. Fosters Emotional Stability: When individuals maintain a sense of self outside of the relationship, they are less likely to become emotionally dependent on their spouse. This fosters emotional stability, as each partner feels confident and secure in their own identity (Sprecher & Felmlee, 1992). Emotional stability contributes to a healthier and more balanced relationship dynamic, where both partners support each other’s individual growth.

How to Prevent Losing Yourself in Marriage

To avoid losing oneself in marriage, it is essential to establish and maintain boundaries, communicate openly with your partner, and prioritize self-care. Here are some practical steps to ensure a healthy balance between individuality and partnership:

  1. Prioritize Personal Hobbies and Interests: It is important to continue pursuing personal hobbies and interests, even after getting married. Engaging in activities that bring personal fulfillment allows individuals to maintain a sense of self (Waller & McLanahan, 2005). Additionally, this can help prevent feelings of boredom or stagnation within the marriage.
  2. Foster Open Communication: Having honest conversations with your partner about personal needs, boundaries, and concerns is essential. Open communication helps prevent misunderstandings and ensures that both partners feel heard and respected (Hendrick & Hendrick, 2006).
  3. Maintain Relationships Outside of the Marriage: Cultivating friendships and maintaining relationships with family members outside the marriage is vital. These connections provide emotional support and offer different perspectives, helping to prevent isolation within the marriage (Miller, 2019).
  4. Reflect on Personal Goals: Take time to regularly reflect on personal goals, values, and aspirations. This helps ensure that personal ambitions are not lost in the pursuit of relationship harmony (Aron & Aron, 2001).

Conclusion

While marriage is a deeply rewarding partnership, it is important to avoid losing oneself in the relationship. Maintaining individuality, setting healthy boundaries, and fostering open communication can help ensure that both partners thrive both individually and as a couple. By balancing personal growth with marital commitment, individuals can experience greater fulfillment, emotional stability, and long-term relationship satisfaction.

This article has been written by John S. Collier, MSW, LCSW. Mr. Collier has over 25 years in the social work field. He currently serves as the executive director and provider within Southeast Kentucky Behavioral Health based out of London Kentucky. He may be reached at 6066570532 or by email at [email protected].

References

Anderson, S. M., & Chen, S. (2002). The relational self: An interpersonal social-cognitive theory. Psychological Review, 109(4), 619–645. https://doi.org/10.1037/0033-295X.109.4.619

Aron, A., & Aron, E. N. (2001). Self-expansion model of motivation and cognition in close relationships and beyond. Handbook of Motivation and Cognition Within Close Relationships, 63–84.

Cramer, D. (2003). Perceived respect for privacy, need for independence, and personal well-being in close relationships. Journal of Social and Personal Relationships, 20(2), 253–271. https://doi.org/10.1177/0265407503020002005

Hendrick, S. S., & Hendrick, C. (2006). Close relationships: A sourcebook. Sage Publications.

Miller, K. (2019). Boundaries in relationships: The key to maintaining intimacy and trust. Healthy Connections Press.

Sprecher, S., & Felmlee, D. (1992). The influence of self-disclosure on liking: Separate meta-analyses for men and women. Psychological Bulletin, 112(3), 487-492.

Waller, M. R., & McLanahan, S. (2005). “His” and “Her” marriage expectations: Determinants and consequences. Journal of Marriage and Family, 67(1), 53-67.