Understanding the interpersonal impact of trauma: Contributions of PTSD and depression

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Abstract

To build on the growing literature on interpersonal relationships among individuals with PTSD, this study examined the separate influences of PTSD symptoms and depression on functioning with friends, romantic partners, and family. To examine the influence of measurement, both interviewer-rated assessment of interpersonal functioning and self-reported assessment of perceived social support were included. The sample included 109 community members who sought help for mental health problems in the aftermath of a serious motor vehicle accident. Building on previous research, hierarchical regression models were used to examine the impact of re-experiencing, avoidance, emotional numbing, and hyperarousal on relationship functioning, followed by depression. Results suggest that assessment modality makes a difference in understanding factors contributing to interpersonal strain. When assessed by an interviewer, depression seems to play a larger role in interpersonal strain, relative to PTSD symptoms. When assessed via self-reported perceived social support, weaker associations were observed, which highlighted the role of emotional numbing. Results are discussed in light of the possible role that PTSD comorbidity with depression plays in interpersonal functioning following a traumatic event, with implications for future research.

Section snippets

Understanding the interpersonal impact of trauma: contributions of PTSD and depression

For several decades, it has been recognized that patients with posttraumatic stress disorder (PTSD) have a reduced quality of life (QOL; Mendlowicz & Stein, 2000). A recent meta-analysis suggests that PTSD exerts a particularly large negative impact on physical health, social functioning, and relationships with close others, relative to other anxiety disorders (Olatunji, Cisler, & Tolin, 2007). Although the association between PTSD and impaired functioning has been clearly established, little

Participants

The sample included 109 individuals who sought assessment and possible treatment for mental health problems following their MVA. Participants were recruited from the community, using flyers distributed at pain clinics, a local trauma center, physical therapists, specialists in rehabilitation and internal medicine, gyms, and libraries, as well as public service announcements. Individuals qualified for assessment if they had experienced a MVA involving actual or threatened death or serious injury

Results

The data were evaluated for the presence of univariate and multivariate outliers and none were detected. Additionally, skew and kurtosis values were examined. All were in the normal range (i.e., skew values less than 2, kurtosis values less than 4, Tabachnick & Fidell, 2001), suggesting that the data exhibited normality.

Table 1 presents the zero-order correlations and the means and standard deviations of the variables. As can be seen, depression showed significant negative correlations with CSI

Discussion

This study examined the separate influences of PTSD symptoms and depression on interpersonal functioning with friends, romantic partners, and family. Building on previous research, hierarchical models were tested in which the four PTSD symptoms clusters were entered in the first step, followed by depression in the second step. To examine the influence of assessment modality, interpersonal functioning was evaluated with both an interviewer-administered scale, which quantified relationship

Acknowledgement

We appreciate Joanne Davila’s comments on an earlier version of this manuscript.

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    This project was supported in part by National Research Service Award MH 075130 and by Research Grant MH 64777 from the National Institute of Mental Health.

    1

    Now at the University of Memphis, USA.

    2

    Now at Oklahoma State University, USA.

    3

    Now at Stanford University Medical School, USA.

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