https://aub.ie/MilitaryREACH-Fredman2022

Fredman, S. J., Le, Y., Renshaw, K. D., & Allen, E. S. (2022). Longitudinal associations among service members' PTSD symptoms, partner accommodation, and partner distress. Behavior Therapy, 53(6), 1161-1174. https://doi.org/10.1016/j.beth.2022.05.005

The cognitive-behavioral interpersonal theory of posttraumatic stress disorder (PTSD) posits that PTSD symptoms have an effect on dyadic processes. For example, partners may change their behaviors to avoid potential PTSD-related triggers (a term known as accommodation); in turn, accommodation has implications for individual and couple functioning. This study examined whether romantic partners’ accommodation of Soldiers’ PTSD symptoms explained the associations among Soldiers’ PTSD symptom severity and salient outcomes, partners’ depressive symptoms and relationship satisfaction, both within and between couples. Additionally, this study explored whether these associations were amplified based on partners’ levels of conflict avoidance and helplessness. Soldiers and their partners (N = 272 Army couples) completed questionnaires at 5 time points (i.e., baseline, 1 month after baseline, and every 6 months for the next 18 months). Overall, within couples, greater PTSD symptom severity among Soldiers was associated with more partner accommodation, and when partners engaged in more accommodating behaviors, they typically reported more depressive symptoms.

https://doi.org/10.1016/j.beth.2022.05.005

Couples
Trauma
Mental health

Army

Active Duty

Active duty service member
Spouse of service member or veteran

Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)

Longitudinal Study
Quantitative Study

Fredman, Steffany J., Le, Yunying, Renshaw, Keith D., Allen, Elizabeth S.

Romantic partners’ accommodation of trauma survivors’ posttraumatic stress disorder (PTSD) symptoms (e.g., participating in avoidance and safety behaviors, not expressing one’s thoughts and feelings) is a putative mechanism linking PTSD symptoms and partner distress, but this hypothesis has never been empirically tested. The current study investigated this proposed within-couple mediation process from service members’ PTSD symptoms to partners’ depressive symptoms and relationship satisfaction through partner accommodation, as well as between-couple associations among these constructs and the possible moderating role of partners’ conflict avoidance and helplessness (CAH) motivations for accommodating service members’ PTSD symptoms. We examined these questions in 272 male service member/female civilian couples assessed four times over an 18-month period using the multiple-group version of the random-intercept cross-lagged panel model. Within couples, service members’ higher levels of PTSD symptoms at one time point significantly predicted partners being more accommodating at the next time point (βs = .14 - .19), which, in turn, significantly predicted higher levels of partner depressive symptoms at the subsequent time point (βs = .09 - .19) but did not predict partners’ subsequent relationship satisfaction. At the between-couple level, partner accommodation was significantly positively associated with partners’ depressive symptoms only among those endorsing high CAH motivations for accommodation (r = .50). In addition, accommodation was significantly negatively associated with partners’ relationship satisfaction regardless of CAH motivation level (rs = -.43 to -.49). These findings are discussed in light of the potential for couple-based treatments for PTSD to enhance partner individual and relational well-being.

Elsevier

Article
REACH Publication

Department of Human Development and Family Studies, The Pennsylvania State University, SJF
Department of Human Development and Family Studies, The Pennsylvania State University, YL
Department of Psychology, George Mason University, KDR
Department of Psychology, University of Colorado Denver, ESA