Posttraumatic stress disorder symptoms impact the emotional experience of intimacy during couple discussions

PTSD Symptom Cluster Severity Predicts Momentary Emotion Dynamics During Couple Conversations

This study investigated the associations between momentary emotion dynamics and posttraumatic stress disorder (PTSD) symptoms. Using a sample of 61 couples (N = 122 individuals) in which all individuals were trauma exposed and at least one partner screened positive for PTSD, we examined the intra- and interpersonal regulation of vocally encoded emotional arousal (fundamental frequency [f0]) and how these momentary emotion regulatory patterns relate to specific PTSD symptoms during two couple conversations: one designed to elicit conflict and one to elicit intimacy. PTSD symptoms were assessed using a gold standard clinical interview. In both conversations, higher reexperiencing symptoms were associated with greater emotional inertia (i.e., more resistance to change in emotional state following deviation from one's emotional equilibrium), and higher avoidance symptoms were associated with less emotional inertia (i.e., quicker return to emotional equilibrium). In the intimacy conversations, individuals also responded to their partners' arousal. Furthermore, individuals whose partners exhibited higher emotional numbing symptoms exhibited more emotional inertia, suggesting that emotion regulation may be a function of both one's own and one's partner's PTSD symptoms. Attending to the interpersonal context of emotion dynamics during PTSD treatment may enhance outcomes.

Posttraumatic stress symptoms and interpersonal processes in burn survivors and their partners

Background: A burn event can elicit symptoms of posttraumatic stress disorder (PTSD) in survivors and their partners and may impact the way these couple members interact with each other. They may try to protect each other from further emotional distress by avoiding talking about the burn event, but they may also show concern towards each other.Objective: The aim of this study was to investigate bidirectional relationships between survivor's and partner's PTSD symptoms and two interpersonal processes: partner-oriented 'self-regulation', which is avoidance-oriented, and 'expressed concern', which is approach-oriented.Method: In this longitudinal multi-centre study, 119 burn survivors and their partners participated. Measures of PTSD symptoms, self-regulation, and expressed concern were administered in the acute phase following the burns, and follow-ups took place up to 18 months postburn. Intra- and interpersonal effects were examined in a random intercept cross-lagged panel model. Exploratory effects of burn severity were also investigated.Results: Within individuals, survivor's expressed concern predicted later higher levels of survivor's PTSD symptoms. In their partners, self-regulation and PTSD symptoms reinforced each other in the early phase postburn. Between the two couple members, partner's expressed concern predicted later lower levels of survivor's PTSD symptoms. Exploratory regression analyses showed that burn severity moderated the effect of survivor's self-regulation on survivor's PTSD symptoms, indicating that self-regulation was continuously related to higher levels of PTSD symptoms over time within more severely burned survivors, but not in less severely burned survivors.Conclusion: PTSD symptoms and self-regulation reinforced each other in partners and possibly also in more severely burned survivors. Partner's expressed concern was related to lower levels of survivor's PTSD symptoms, whereas survivor's expressed concern was related to higher levels of survivor's PTSD symptoms. These findings emphasize the importance of screening for and monitoring PTSD symptoms in burn survivors and their partner and of encouraging couple's self-disclosure.

Daily Posttraumatic Stress Disorder Symptom Accommodation and Relationship Functioning in Military Couples

Romantic partners' accommodation of trauma survivors' posttraumatic stress disorder (PTSD) symptoms (e.g., taking on tasks, survivors avoid participating in social withdrawal) is associated with lower relationship satisfaction for both partners and survivors. Little is known about associations of partner accommodation with other aspects of relationship functioning, like intimacy. Sixty-four male military veterans with at least subclinical PTSD and their partners participated in a 2-week daily diary study. Veterans completed nightly measures of PTSD symptoms, while female partners completed nightly measures of accommodating behaviors performed that day. Both partners reported feelings of intimacy each night. Multilevel models revealed that accommodation was significantly, negatively associated with feelings of intimacy, with stronger effects for partners (t = -8.70) than for veterans (t = -5.40), and stronger effects when veterans had lower (t = -7.43) rather than higher (t = -5.20) levels of daily PTSD symptoms. Therapists should consider accommodating behaviors as a potential impediment to relationship intimacy, particularly when veterans have less severe symptoms of PTSD. Accommodating behaviors are an ideal treatment target in behavioral couple therapies.

The impact of negative attributions on the link between observed partner social support and posttraumatic stress disorder symptom severity

Lack of perceived social support is one of the strongest correlates of the development and maintenance of posttraumatic stress disorder (PTSD). However, little is known about observed social support and PTSD. The stress buffering effect of social support may be partly determined by the subjective experience of support, which is created by attributions regarding support behaviors. We examined negative attributions about partner-provided support as a moderator of the expected relation between observed support during couple discussions and PTSD symptom severity. Participants included 128 individuals from 64 heterosexual married or cohabitating couples. Per clinician-administered interview, 72 (56%) participants met subthreshold or diagnostic criteria for PTSD. Receipt of relatively more partner support was modestly associated with lower PTSD symptom severity. Negative causal attributions about partner support were not associated with the amount of support received, but were associated with higher PTSD severity. Additionally, the frequency and quality of received partner support was associated with lower PTSD symptom severity only among those who did not make strong negative causal attributions about partner support. Thus, negative causal attributions may dampen the positive effects of social support on PTSD symptoms. PTSD treatments may more effectively facilitate recovery from trauma by decreasing negative support attributions.

Posttraumatic stress disorder and relationship functioning: A comprehensive review and organizational framework

Posttraumatic stress disorder (PTSD) is associated with impairments in relationship functioning. Beyond the abundance of research that has demonstrated this basic link, more recent research has begun to explore possible mediators and moderators of this association. The present paper reviews and synthesizes existing literature in the context of an overarching organizational framework of potential ways in which PTSD impacts relationship functioning. The framework organizes findings in terms of specific elements of PTSD and comorbid conditions, mediators (factors that are posited to explain or account for the association), and moderators (factors that are posited to alter the strength of the association). Specific symptoms of PTSD, comorbid symptoms, and many of the potential mediators explored have extensive overlap, raising questions of possible tautology and redundancy in findings. Some findings suggest that non-specific symptoms, such as depression or anger, account for more variance in relationship impairments than trauma-specific symptoms, such as re-experiencing. Moderators, which are characterized as individual, relational, or environmental in nature, have been the subject of far less research in comparison to other factors. Recommendations for future research and clinical implications of the findings reviewed are also presented.

Observed Emotional Expressivity, Posttraumatic Stress Disorder Symptoms, and Intimate Partner Violence Perpetration Among Community Couples

Impaired emotional processes are related to posttraumatic stress disorder (PTSD) and are implicated in intimate partner violence (IPV) perpetration. To address the interpersonal context of PTSD, emotion, and IPV, we examined interactions among one's own and one's partner's emotional expressivity and PTSD symptom severity in association with IPV perpetration. Heterosexual couples (N = 56) in which at least one partner met screening criteria for PTSD engaged in two video-recorded discussions about negative and positive aspects of their relationships. Videos were coded for observed emotional expressiveness during moments participants reported experiencing significant emotions. Actor-partner interdependence models revealed few main effects of emotional expressivity, except that women's expressivity of positive emotions was positively associated with men's IPV perpetration, r²_adj = .14. Emotional expressivity played a larger role among couples managing PTSD symptoms; that is, the association between one's own PTSD symptom severity and more IPV perpetration was stronger among men who expressed more negative emotions, r²_adj = .19, and women who expressed fewer negative emotions, r²_adj = .21. Several partner effects suggested the importance of understanding the dyadic nature of these constructs. For example, men's PTSD symptom severity was differentially associated with each partners' IPV perpetration based on women's expressivity of positive emotion, r²_adj = .22-.27. Understanding of emotional expressivity in the link between PTSD and IPV must include consideration of gender differences in how these constructs operate interpersonally. Strategies to promote moderate and safe communication of positive and negative emotions may prevent IPV escalation, particularly among couples managing PTSD symptoms.