I am like 99,9% sure that the spouse will survive and you can have them as a follower. It just makes sense, if i am wrong i'll eat my shoe.
I think that as well. I'm fairly confident the spouse and child survive, but have been kidnapped by the Institute of some such thing. Seems to be a better motivation to make one's way through a game than waking up after a 200 year cryo-sleep; everyone's dead; and I have no real purpose here but to make the world pay. Build settlements? Help people? Good karma? I don't think so.
Of course, on the other hand, the Institute could be the boogie man, and your motivation is to tear it apart because they are responsible for destroying your family.
Suppose we'll see, but the family man side of me hopes in the former.