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Posttraumatic stress disorder symptom clusters in service members predict new-onset depression among military spouses

APA Citation:

Walter, K. H., Leardmann, C. A., Carballo, C. E., McMaster, H. S., Donoho, C. J., & Stander, V. A. (2021). Posttraumatic stress disorder symptom clusters in service members predict new on-set depression among military spouses. Journal of Traumatic Stress, 34(1), 229-240. https://doi.org/10.1002/jts.22575

Abstract Created by REACH:

This study examined how different posttraumatic stress disorder (PTSD) symptoms in Service members were associated with their spouses’ risk of developing a diagnosis of major depressive disorder. PTSD symptoms, also termed symptom clusters, include reexperiencing, effortful avoidance, emotional numbing, and hyperarousal. Service members reported on their own PTSD symptoms, and spouses provided information regarding major depressive disorder diagnosis approximately three years later. A total of 563 military couples participated in this study. One PTSD symptom cluster, specifically, Service members’ effortful avoidance, was associated with an increased risk of spouses’ new-onset depression over time.


Mental health

Military Affiliation:

Active Duty

Subject Affiliation:

Active duty service member
Spouse of service member or veteran


Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)


Longitudinal Study
Quantitative Study
Secondary Analysis


Walter, Kristen H., LeardMann, Cynthia A., Carballo, Carlos E., McMaster, Hope Seib, Donoho, Carrie J., Stander, Valerie A.


Military operations in Iraq and Afghanistan have brought increased attention to posttraumatic stress disorder (PTSD) among service members and, more recently, its impact on spouses. Existing research has demonstrated that PTSD among service members is associated with depression among military spouses. In the current study, we extended these findings by using data from service member–spouse dyads enrolled in the Millennium Cohort Family Study for which the service member had evidence of PTSD (n = 563). Prospective analyses identified the association between PTSD symptom clusters reported by the service member and new-onset depression among military spouses. Over the 3-year study period, 14.4% of these military spouses met the criteria for new-onset depression. In adjusted models, service member ratings of symptoms in the effortful avoidance cluster, odds ratio (OR) = 1.61, 95% CI [1.03, 2.50], predicted an increased risk of new-onset depression among military spouses, whereas reexperiencing symptoms, adjusted OR = 0.57; 95% CI [0.32, 1.01], were marginally protective. These findings suggest that PTSD symptom clusters in service members differentially predict new-onset depression in military spouses, which has implications for treatment provision.

Publisher/Sponsoring Organization:

John Wiley & Sons

Publication Type:

REACH Publication

Author Affiliation:

Health and Behavioral Sciences Department, Naval Health Research Center, KHW
Leidos, Reston, CAL
Deployment Health Department, Naval Health Research Center, CAL
Leidos, Reston, CEC
Deployment Health Department, Naval Health Research Center, CEC
Leidos, Reston, HSM
Deployment Health Department, Naval Health Research Center, HSM
Department of Psychiatry, Uniformed Services University of the Health Sciences, CJD
Deployment Health Department, Naval Health Research Center, VAS


PTSD, spouses, depression in military spouses, ptsd in service members, Millennium Cohort Study

View Research Summary:

REACH Publication Type:

Research Summary


Military Operational Medicine Research Program. Grant Number: N1240

REACH Newsletter:

  June 2021

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