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Grubbs KM, Knopp KC, Khalifian CE, Wrape ER, Mackintosh MA, Sohn MJ, Macdonald A, Morland LA. Discrepancies in perceptions of PTSD symptoms among veteran couples: Links to poorer relationship and individual functioning. FAMILY PROCESS 2024. [PMID: 39354674 DOI: 10.1111/famp.13041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/24/2024] [Accepted: 07/01/2024] [Indexed: 10/03/2024]
Abstract
Veteran and intimate partner perceptions of posttraumatic stress disorder (PTSD) may differ, and little is known about how agreement or disagreement on symptom severity is related to relationship satisfaction. Veterans and their partners (N = 199 couples) completed a baseline assessment for a clinical trial evaluating two couple-based PTSD interventions. Veterans completed the PTSD Checklist for DSM-5 (PCL-5). Partners completed the collateral PCL-5 (PCL-5-C), which asked them to rate the severity of the veteran's PTSD symptoms. Both partner and veteran completed the Couples Satisfaction Index (CSI-32). Intraclass correlations (ICC) assessed agreement between PCL-5 and PCL-5-C total and subscale scores, which was low for total PCL and for all subscales (ICC = 0.15-0.46). Actor-Partner Interdependence Models (APIMs; actor-only pattern) tested associations between relationship satisfaction and PTSD symptom severity (total PCL and subscales), and the magnitude and direction of difference between PCL-5 and PCL-5-C (total and subscales). For veterans, more severe total PTSD and negative cognition/mood scores were associated with lower relationship satisfaction, and the direction of discrepancy for negative cognition/mood (i.e., higher veteran-rated PTSD symptoms relative to partner's collateral report) was also associated with lower satisfaction. For partners, more severe collateral-reported symptoms for total PTSD and all four subscales were associated with lower relationship satisfaction; further, a larger discrepancy between veterans' and partners' reports of total PTSD, negative cognition/mood, and hyperarousal were associated with lower satisfaction. These results suggest that partners may have different perceptions of PTSD symptoms, and support the potential of fostering a shared understanding of PTSD symptom severity in couples.
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Affiliation(s)
- Kathleen M Grubbs
- Department of Veterans Affairs, VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California, San Diego, California, USA
- Center for Mental Health Outcomes Research, Central Arkansas VA Healthcare System, Little Rock, Arkansas, USA
| | - Kayla C Knopp
- Department of Veterans Affairs, VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California, San Diego, California, USA
| | - Chandra E Khalifian
- Department of Veterans Affairs, VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California, San Diego, California, USA
| | - Elizabeth R Wrape
- Department of Veterans Affairs, VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California, San Diego, California, USA
| | - Margaret-Anne Mackintosh
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Healthcare System, Palo Alto, California, USA
| | - Min Ji Sohn
- Department of Veterans Affairs, VA San Diego Healthcare System, San Diego, California, USA
| | - Alexandra Macdonald
- The Citadel, Military College of South Carolina, Charleston, South Carolina, USA
| | - Leslie A Morland
- Department of Psychiatry, University of California, San Diego, California, USA
- National Center for PTSD - Women's Health Science Division, VA Boston Healthcare System, San Diego, California, USA
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Sullivan K, Park Y, Kale CN, Adler A, Sipos ML, Riviere LA. Positive and negative family communication and mental distress: Married service members during a non-combat deployment. FAMILY PROCESS 2023. [PMID: 37051805 DOI: 10.1111/famp.12874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 02/18/2023] [Accepted: 02/19/2023] [Indexed: 06/19/2023]
Abstract
This study examines whether married service member perceptions of positive or negative communication moderate the relationship between how frequently they communicate home during a deployment and their mental distress. Participants included 382 married service members who completed surveys regarding their marital relationships, communication, and mental health while on a non-combat deployment. Though marital satisfaction was not significantly associated with service member reports of their mental distress, perceptions of negative (β = 4.32, SE = 0.59, p < 0.001) and positive communication (β = -1.32, SE = 0.57, p < 0.05) were. Further, significant interactions between frequency of communication and the perception of negative (β = 0.54, SE = 0.13, p < 0.001) and positive (β = 0.17, SE = 0.07, p < 0.01) communication suggest positive communication may be protective for service members while frequent, negative communication can exacerbate distress. Findings highlight the importance of engaging families in planning and skill building to support healthy communication across the deployment cycle.
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Affiliation(s)
- Kathrine Sullivan
- Silver School of Social Work, New York University, New York, New York, USA
| | - Yangjin Park
- School of Social Work, The University of Texas at Arlington, Arlington, Texas, USA
| | - Caroline N Kale
- Silver School of Social Work, New York University, New York, New York, USA
| | - Amy Adler
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Maurice L Sipos
- Department of Command, Leadership, and Management, US Army War College, Carlisle, Pennsylvania, USA
| | - Lyndon A Riviere
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
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Knobloch LK, Monk JK, MacDermid Wadsworth SM. Relationship Maintenance among Military Couples. JOURNAL OF SOCIAL AND PERSONAL RELATIONSHIPS 2023; 40:734-772. [PMID: 37200941 PMCID: PMC10191153 DOI: 10.1177/02654075221105025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
A burgeoning body of research on the relationship maintenance of military couples over the past two decades suggests the time is right to organize, assimilate, and critique the literature. We conducted a systematic review informed by the integrative model of relationship maintenance (Ogolsky et al., 2017) that considered issues of intersectionality (Crenshaw, 1991). Our literature search identified 81 relevant journal articles representing 62 unique samples. With respect to theory, 59.3% of the journal articles employed one or more formal theoretical frameworks. In terms of research design, 88.7% of the studies focused on the U.S. military, 83.9% of the studies recruited convenience samples, 54.8% of the studies utilized quantitative methods, and 30.6% of the studies collected longitudinal data. Among the studies reporting sample demographics, 96.8% of participants were married, 77.2% of participants identified as non-Hispanic White, and only one same-sex relationship was represented. Our narrative synthesis integrated findings about relationship maintenance from studies examining (a) relationship maintenance overtly, (b) communicating to stay connected across the deployment cycle, (c) disclosure and protective buffering, (d) support from a partner, (e) dyadic coping, and (f) caregiving and accommodating a partner's symptoms. We interpret our results with an eye toward advancing theory, research, and practice.
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Affiliation(s)
| | - J. Kale Monk
- Department of Human Development and Family Science, University of Missouri
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