Elsevier

Behavior Therapy

Volume 43, Issue 2, June 2012, Pages 416-426
Behavior Therapy

Relationship Distress in Partners of Combat Veterans: The Role of Partners’ Perceptions of Posttraumatic Stress Symptoms

https://doi.org/10.1016/j.beth.2011.09.002Get rights and content

Abstract

Partners of combat veterans with posttraumatic stress disorder report elevated relationship and psychological distress, but little is known about the mechanisms by which such distress develops. In two separate samples, we examined partners’ perceptions of veterans’ PTSD symptoms, with a specific focus on the simultaneous associations of partners’ distress with their perceptions of veterans’ reexperiencing, withdrawal/numbing, and hyperarousal symptom clusters. The first sample consisted of 258 partners of Operation Enduring- and Iraqi Freedom-era veterans who completed questionnaires. The second sample consisted of 465 partners of Vietnam-era veterans who completed interviews as part of the National Vietnam Veterans Readjustment Study. In both samples, path analyses revealed that, when examined simultaneously, partners’ perceptions of withdrawal/numbing symptoms were associated with greater distress, but perceptions of reexperiencing symptoms were unrelated to psychological distress and significantly associated with lower levels of relationship distress. Given the cross-sectional nature of the data in both samples, there are multiple plausible interpretations of the results. However, the pattern is consistent with an attributional model of partner distress, whereby partners are less distressed when symptoms are more overtly related to an uncontrollable mental illness. Potential clinical implications are discussed.

Highlights

► We examined spouses’ perceptions of PTSD symptoms in combat veterans in two samples. ► Spouses’ distress was simultaneously predicted by perceptions of each PTSD cluster. ► Perceptions of withdrawal/numbing predicted higher spousal distress. ► Perceptions of reexperiencing symptoms predicted lower marital distress.

Section snippets

Participants

The sample consisted of 258 spouses or cohabiting partners of Utah NG/R service members. Almost all couples (98.4%) were married, with an average length of marriage of 9.72 years (SD = 8.03). Partners’ mean age was 32.64 (SD = 8.25), and the majority were female (98.4%) and White (91.7%). A total of 5.4% had a high school degree or less, 49.6% had some college education or an associate's degree, and 27.6% had a bachelor's or advanced degree. Of the service members, 218 had deployed overseas at least

Participants

The sample consisted of 465 spouses or cohabiting partners of Vietnam-era veterans. All were participants in the Family Interview Component of the NVVRS. The NVVRS was a nationally representative survey that examined the prevalence of PTSD and readjustment problems among Vietnam-era veterans in the late 1980s (Kulka et al., 1990). Partners’ ages ranged from 21 to 73 (M = 40.0, SD = 7.44). Most partners (80.6%) were female; 19% were African American, 18.6% were Hispanic American, and 62.4% were

Discussion

The current paper explored how psychological and relationship distress in partners of combat veterans were associated with their perceptions of veterans’ reexperiencing symptoms, emotional numbing/withdrawal, and hyperarousal symptoms. We examined these associations in two separate samples, one with partners of veterans from the recent era of conflicts centered around Afghanistan and Iraq and a second with partners of veterans from the Vietnam era. As expected, perceptions of all types of

References (46)

  • C.M. Monson et al.

    Military-related PTSD and intimate relationships: From description to theory-driven research and intervention development

    Clinical Psychology Review

    (2009)
  • K.D. Renshaw et al.

    Psychological and marital distress in spouses of Vietnam veterans: Importance of spouses’ perceptions

    Journal of Anxiety Disorders

    (2010)
  • American Psychiatric Association

    Diagnostic and statistical manual of mental disorders

    (1980)
  • American Psychiatric Association

    Diagnostic and statistical manual of mental disorders

    (1994)
  • Diagnostic and statistical manual of mental disorders

    (2000)
  • M.M. Antony et al.

    Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample

    Psychological Assessment

    (1998)
  • C.R. Brewin et al.

    Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults

    Journal of Consulting and Clinical Psychology

    (2000)
  • L.L. Carstensen

    Social and emotional patterns in adulthood: Support for socioemotional selectivity theory

    Psychology and Aging

    (1992)
  • J.M. Cook et al.

    Posttraumatic stress disorder and current relationship functioning among World War II ex-prisoners of war

    Journal of Family Psychology

    (2004)
  • C.R. Erbes et al.

    Couple therapy with combat veterans and their partners

    Journal of Clinical Psychology

    (2008)
  • L. Evans et al.

    Chronic posttraumatic stress disorder and family functioning of Vietnam veterans and their partners

    Australian and New Zealand Journal of Psychiatry

    (2003)
  • J.C. Gallagher et al.

    Female partners’ estimations of male veterans’ combat-related PTSD severity

    Journal of Traumatic Stress

    (1998)
  • J.R. Greenley

    Social control and expressed emotion

    Journal of Nervous and Mental Disease

    (1986)
  • S.S. Hendrick

    A generic measure of relationship satisfaction

    Journal of Marriage and the Family

    (1988)
  • C.W. Hoge et al.

    Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care

    New England Journal of Medicine

    (2004)
  • J.M. Hooley

    The nature and origins of expressed emotion

  • J.M. Hooley et al.

    Psychopathology and marital distress: The positive side of positive symptoms

    Journal of Abnormal Psychology

    (1987)
  • B.K. Jordan et al.

    Problems in families of male Vietnam veterans with posttraumatic stress disorder

    Journal of Consulting and Clinical Psychology

    (1992)
  • T.M. Keane et al.

    Mississippi Scale for Combat-Related Posttraumatic Stress Disorder: Three studies in reliability and validity

    Journal of Consulting and Clinical Psychology

    (1988)
  • L.A. King et al.

    Latent structure of the Mississippi Scale for Combat-Related Post-Traumatic Stress Disorder: Exploratory and higher-order confirmatory factor analyses

    Assessment

    (1994)
  • B.M. Kuehn

    Soldier suicide rates continue to rise: Military, scientists work to stem the tide

    Journal of the American Medical Association

    (2009)
  • R.A. Kulka et al.

    Trauma and the Vietnam war generation: Report of the findings from the National Vietnam Veterans Readjustment Study

    (1990)
  • S.H. Lovibond et al.

    Manual for the Depression Anxiety Stress Scales

    (1995)
  • Cited by (39)

    • The role of perceived sleep quality in the relationship between PTSD symptoms and general mental health

      2017, Mental Health and Prevention
      Citation Excerpt :

      Impairments in these domains are indicative of poor general mental health functioning (Lambert & Bergin, 1994). Symptoms of PTSD have been found to contribute to poor general mental health functioning in a number of studies (Boudoukha, Altintas, Rusinek, Fantini-Hauwel, & Hautekeete, 2013; Campbell & Renshaw, 2013; Renshaw & Caska, 2012). Despite numerous empirical studies examining the effect of PTSS on life quality (Giacco, Matanov, & Priebe, 2013; Laffaye, Kennedy, & Stein, 2003), little research has explored the pathways through which PTSS impacts general mental health functioning (for exceptions, see Baranyi, Krauseneck, & Rothenhäusler, 2013; Matthiesen & Einarsen, 2004), and no research in civilian samples has examined mediators of this relationship.

    View all citing articles on Scopus

    This study was funded by the first author's start-up funds, provided by the University of Utah. The authors wish to thank Camila S. Rodrigues for her assistance with the data collection and management involved in this study, as well as the Utah National Guard Chaplains and the Utah National Guard/Reserve service members and families for their support of this project.

    View full text