The significant others' responses to trauma scale (SORTS): applying factor analysis and item response theory to a measure of PTSD symptom accommodation.

Background: Symptom accommodation by family members (FMs) of individuals with posttraumatic stress disorder (PTSD) includes FMs' participation in patients' avoidance/safety behaviours and constraining self-expression to minimise conflict, potentially maintaining patients' symptoms. The Significant Others' Responses to Trauma Scale (SORTS) is the only existing measure of accommodation in PTSD but has not been rigorously psychometrically tested.Objective: We aimed to conduct further psychometric analyses to determine the factor structure and overall performance of the SORTS. Method: We conducted exploratory and confirmatory factor analyses using a sample of N = 715 FMs (85.7% female, 62.1% White, 86.7% romantic partners of individuals with elevated PTSD symptoms).Results: After dropping cross-loading items, results indicated good fit for a higher-order model of accommodation with two factors: an anger-related accommodation factor encompassed items related largely to minimising conflict, and an anxiety-related accommodation factor encompassed items related primarily to changes to the FM's activities. Accommodation was positively related to PTSD severity and negatively related to relationship satisfaction, although the factors showed somewhat distinct associations. Item Response Theory analyses indicated that the scale provided good information and robust coverage of different accommodation levels.Conclusions: SORTS data should be analysed as both a single score as well as two factors to explore the factors' potential differential performance across treatment and relationship outcomes.

We examined the Significant Others' Responses to Trauma Scale (SORTS), a measure of symptom accommodation in PTSD, among a large sample of family members.As measured by the SORTS, accommodation in PTSD could be broken down into two aspects: anger-related accommodation and anxiety-related accommodation.Accommodation was positively related to PTSD severity and negatively related to relationship satisfaction.

Association Between Firearm Purchasing in Response to the COVID-19 Pandemic and Symptoms of Anxiety, Depression, and Stress, August 2021.

Introduction: Firearm sales and firearm-related injuries and deaths increased during the pandemic. Little is known about motivations for firearm purchasing in response to the COVID-19 pandemic and the mental health status of first-time purchasers. The purpose of this study was to estimate the association between firearm purchasing in response to the COVID-19 pandemic and anxiety symptoms, depressive symptoms, and stress. Methods: The authors analyzed data from a survey that approximated a nationally representative sample of American adults (N=3,528) who either did not own firearms (n=2,327) or purchased firearms for the first time in response to the pandemic (n=240). Self-reported stress, depressive symptoms, and anxiety symptoms were determined using standardized self-assessment questionnaires (Perceived Stress Scale, Patient Health Questionnaire, and Depression Anxiety Stress Scale, respectively). Using multivariable logistic regression, the association between firearm purchasing and each mental health measure were assessed after controlling for demographics and other determinants. Results: In each model, first-time firearm owners were more likely to be younger, live in urban areas, believe the government does too much for its citizens, stay home, stock up on items, and keep their children at home. First-time owners had significantly higher odds of anxiety and depressive symptoms than non-owners (AOR=1.05; 95% CI=1.04, 1.07 and AOR=1.15; 95% CI=1.04, 1.26, respectively). Conclusions: First-time firearm purchasers report higher depressive and anxiety symptoms than non-owners, suggesting that there may be a risk of suicide and other related firearm violence.

An exploration of potential pressures to engage in parenting accommodation of PTSD symptoms for military couples.

In the context of service member posttraumatic stress disorder (PTSD) symptoms, intimate partners may experience pressure to take over parenting roles and run interference between the service member and the children; that is, to engage in partner accommodation focal to parenting. The current study quantitatively assessed potential pressures to engage in parenting accommodation (PPEPA) in a sample of 207 female partners married to male service members with at least one child in the home and the convergence of PPEPA with service member PTSD symptoms, general partner accommodation, couple functioning, parenting, and child functioning. Partners' reports of PPEPA were associated with higher levels of service member PTSD symptoms and partners' general accommodation of PTSD symptoms. When controlling for service member PTSD symptoms and general partner accommodation, partner reports of PPEPA still accounted for unique variance in lower parenting alliance (as reported by both service member and partner), lower levels of service members' reports of closeness with children in the home, higher levels of harsh parenting by both the service member and partner, and greater child behavioral difficulties. Findings support PPEPA as related to partners' accommodative responses to PTSD but demonstrating unique associations with parenting alliance, parenting, and child outcomes. Parenting interventions in the context of PTSD may benefit from conjoint or family approaches that attend to the intersection of PTSD and broader family functioning, including pressures to engage in accommodation focal to the parenting domain.

Exploring the influence of behavioral factors on depression and anxiety scores during the COVID-19 pandemic: insights from the Virginia statewide COVIDsmart longitudinal study.

BACKGROUND: Amidst the COVID-19 pandemic, there has been growing concern about the declining mental health and healthy behaviors compared to pre-pandemic levels. Despite this, there is a lack of longitudinal studies that have examined the relationship between health behaviors and mental health during the pandemic. In response, the statewide COVIDsmart longitudinal study was launched. The study's main objective is to better understand the effects of the pandemic on mental health. Findings may provide a foundation for the identification of public health strategies to mitigate future negative impacts of the pandemic. METHODS: Following online recruitment in spring of 2021, adults, ages 18 to 87, filled out social, mental, economic, occupational, and physical health questionnaires on the digital COVIDsmart platform at baseline and through six monthly follow-ups. Changes in the participant's four health behaviors (e.g., tobacco and alcohol consumption, physical activity, and social media use), along with sex, age, loneliness score, and reported social and economic (SE) hardships, were analyzed for within-between group associations with depression and anxiety scores using Mixed Models Repeated Measures. RESULTS: In this study, of the 669 individuals who reported, the within-between group analysis indicated that younger adults (F = 23.81, p < 0.0001), loneliness (F = 234.60, p < 0.0001), SE hardships (F = 31.25, p < 0.0001), increased tobacco use (F = 3.05, p = 0.036), decreased physical activity (F = 6.88, p = 0.0002), and both positive and negative changes in social media use (F = 7.22, p = 0.0001) were significantly associated with worse depression scores. Additionally, females (F = 6.01, p = 0.015), younger adults (F = 32.30, p < 0.0001), loneliness (F = 154.59, p < 0.0001), SE hardships (F = 22.13, p < 0.0001), increased tobacco use (F = 4.87, p = 0.004), and both positive and negative changes in social media use (F = 3.51, p = 0.016) were significantly associated with worse anxiety scores. However, no significant changes were observed in the within-between group measurements of depression and anxiety scores over time (p > 0.05). Physical activity was not associated with anxiety nor was alcohol consumption with both depression and anxiety (p > 0.05). CONCLUSIONS: This study demonstrates the longitudinal changes in behaviors within the context of the COVID-19 pandemic. These findings may facilitate the design of preventative population-based health approaches during the COVID-19 pandemic or future pandemics.

Emotion socialization profiles in military parents: Associations with post-traumatic stress disorder.

Military families face many difficulties, including a parent deploying to a warzone and the subsequent risk of returning with symptoms of posttraumatic stress disorder (PTSD). Symptoms of PTSD are associated with parenting difficulties; however, little is known about how PTSD symptoms may be associated with emotion socialization (ES), a set of processes crucial to children's emotional well-being. This project investigated observed ES behaviors in deployed and non-deployed parents in a sample of 224 predominantly White, non-Hispanic National Guard/Reserve (NG/R) families with deployed fathers, non-deployed mothers, and a child between the ages of 4 and 13. Parents completed self-report questionnaires and families engaged in videotaped parent-child discussions, which were coded for three types of ES behaviors. Latent profile analyses of the coded behaviors identified five profiles of parental ES: Balanced/Supportive, Balanced/Limited Expression, Unsupportive/Distressed, Unsupportive/Positive, and Involved/Emotive/Angry. Multinomial logistic regressions of each parent's profile membership on fathers' PTSD symptoms revealed no significant associations, while additional analyses including additional family factors revealed that greater father PTSD symptoms were associated with a greater likelihood of mothers being in the Balanced/Supportive profile compared to the Balanced/Limited Expression profile, particularly when children displayed average to low levels of emotion during discussion tasks. No other significant associations with PTSD symptoms were detected. Overall, in contrast to the hypotheses, the majority of these findings indicated that PTSD symptoms did not play a significant role in parental ES behaviors.

Feeling pressured to talk about trauma: How pressure to disclose alters the association between trauma disclosure and posttraumatic growth.

Talking with others about traumatic experiences (i.e., trauma disclosure) has been associated with increased posttraumatic growth (PTG). Although this association indicates the value of disclosing, there is evidence that external pressure to disclose can hinder the benefits of trauma disclosure. The aim of the current study was to examine the influence of pressure to disclose on the association between trauma disclosure and PTG. People who had experienced a traumatic event and disclosed their trauma to a close other were recruited using Amazon's Mechanical Turk (N = 208). Participants completed measures of trauma exposure, trauma disclosure, pressure to disclose, PTG, posttraumatic stress symptoms, and response to disclosure. The results indicated that the linear association between trauma disclosure and PTG was quadratically moderated by pressure to disclose, ηp 2 = .025. Pressure to disclose strengthened the positive association between trauma disclosure and PTG from low, B = 0.818 (SE = 0.267), to moderate levels of pressure, B = 2.109 (SE = 0.471). However, when pressure was high, the association between disclosure and PTG was not significant, B = -1.19 (SE = 1.327). These findings indicate that a moderate amount of pressure to disclose may facilitate the positive impact of disclosure on PTG, yet a high amount of pressure may impede the positive association between disclosure and PTG. This research furthers understanding of the nuances of trauma disclosure and how close others' involvement in disclosure can impact the process of PTG for trauma survivors.

A Digital Health Initiative (COVIDsmart) for Remote Data Collection and Study of COVID-19's Impact on the State of Virginia: Prospective Cohort Study.

BACKGROUND: The COVID-19 pandemic has affected people's lives beyond severe and long-term physical health symptoms. Social distancing and quarantine have led to adverse mental health outcomes. COVID-19-induced economic setbacks have also likely exacerbated the psychological distress affecting broader aspects of physical and mental well-being. Remote digital health studies can provide information about the pandemic's socioeconomic, mental, and physical impact. COVIDsmart was a collaborative effort to deploy a complex digital health research study to understand the impact of the pandemic on diverse populations. We describe how digital tools were used to capture the effects of the pandemic on the overall well-being of diverse communities across large geographical areas within the state of Virginia. OBJECTIVE: The aim is to describe the digital recruitment strategies and data collection tools applied in the COVIDsmart study and share the preliminary study results. METHODS: COVIDsmart conducted digital recruitment, e-Consent, and survey collection through a Health Insurance Portability and Accountability Act-compliant digital health platform. This is an alternative to the traditional in-person recruitment and onboarding method used for studies. Participants in Virginia were actively recruited over 3 months using widespread digital marketing strategies. Six months of data were collected remotely on participant demographics, COVID-19 clinical parameters, health perceptions, mental and physical health, resilience, vaccination status, education or work functioning, social or family functioning, and economic impact. Data were collected using validated questionnaires or surveys, completed in a cyclical fashion and reviewed by an expert panel. To retain a high level of engagement throughout the study, participants were incentivized to stay enrolled and complete more surveys to further their chances of receiving a monthly gift card and one of multiple grand prizes. RESULTS: Virtual recruitment demonstrated relatively high rates of interest in Virginia (N=3737), and 782 (21.1%) consented to participate in the study. The most successful recruitment technique was the effective use of newsletters or emails (n=326, 41.7%). The primary reason for contributing as a study participant was advancing research (n=625, 79.9%), followed by the need to give back to their community (n=507, 64.8%). Incentives were only reported as a reason among 21% (n=164) of the consented participants. Overall, the primary reason for contributing as a study participant was attributed to altruism at 88.6% (n=693). CONCLUSIONS: The COVID-19 pandemic has accelerated the need for digital transformation in research. COVIDsmart is a statewide prospective cohort to study the impact of COVID-19 on Virginians' social, physical, and mental health. The study design, project management, and collaborative efforts led to the development of effective digital recruitment, enrollment, and data collection strategies to evaluate the pandemic's effects on a large, diverse population. These findings may inform effective recruitment techniques across diverse communities and participants' interest in remote digital health studies.

Military-related relocation stress and psychological distress in military partners.

Spouses/partners play a crucial role in providing support to military service members (SMs), maintaining a sense of stability for the family, and supporting the overall mission of the armed forces. However, several aspects of the military lifestyle may impact their own psychological health. Much research has focused on the role of SMs' deployments and posttraumatic stress disorder (PTSD) symptoms in partners' distress, but no study has yet quantitatively investigated these factors in tandem with the common military life stressor of frequent relocations. The present study investigated the degree to which problems from service-related moves, couple deployment separation, and SMs' PTSD symptoms uniquely predict partner psychological distress. Data were collected from female partners of Army soldiers who completed online surveys across four timepoints (over 1.5 years) following a deployment. Surveys assessed psychological distress, perceptions of SMs' PTSD symptoms, problems from service-related moves, and deployment separation. Multilevel modeling was used, with longitudinal data treated as repeated measures (i.e., not modeling change over time). Results indicated that problems from service-related moves were associated with greater psychological stress, even when accounting for SMs' PTSD symptoms and deployment separation. Deployment separation itself was not a significant predictor of psychological distress. Findings indicate that problems associated with frequent moves may be a significant contributor to increased psychological distress for partners above and beyond challenges associated with SMs' PTSD symptoms. Recommendations for future research and limitations are also provided. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Longitudinal Associations Among Service Members' PTSD Symptoms, Partner Accommodation, and Partner Distress.

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 (ßs = .14-.19), which, in turn, significantly predicted higher levels of partner depressive symptoms at the subsequent time point (ßs = .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.

Longitudinal Associations of Global and Daily Support with Marital Status.

The provision and receipt of emotional support demonstrates benefits for relationships; however, little research has investigated how either global or day-to-day spousal support influences marital stability. This project assessed how global perception of support from a partner and daily provision and receipt of emotional support over 1 week contributed to divorce 10 years later, accounting for demographic covariates. There were no significant associations of support variables with future divorce. Greater education attainment was the only factor significantly associated with decreased risk for divorce. Results suggest that despite potential short-term benefits, global and daily support may not predict long-term marital stability.

Trauma-Related Disclosure in Sexual Assault Survivors' Intimate Relationships: Associations With PTSD, Shame, and Partners' Responses.

Relative to survivors of other traumatic events, survivors of sexual assault have an increased likelihood of meeting criteria for posttraumatic stress disorder (PTSD). They are also comparatively more likely to exhibit higher levels of PTSD symptom severity. Recent research has highlighted the importance of trauma-related disclosure within the context of intimate relationships for posttrauma functioning and recovery, but this phenomenon has yet to be examined specifically in sexual assault survivor samples. Accordingly, this study examines the association of PTSD symptom severity with disclosure about one's experience of sexual assault to one's intimate partner, as well as the association of such disclosure with trauma-related shame and perception of partners' negative and positive responses to trauma-related disclosure. A sample of 104 female participants who had disclosed their experience of sexual assault to their current romantic partner provided survey data. On average, these participants reported a moderate amount of trauma-related disclosure. Counter to hypotheses, level of engagement in trauma-related disclosure was not significantly correlated with PTSD symptom severity, shame, or perceived negative responses to disclosure. Only perceived positive responses to disclosure demonstrated a significant, bivariate association with overall level of engagement in trauma-related disclosure. Similarly, when trauma-related shame, negative responses, and positive responses were accounted for simultaneously, only positive responses were related to level of disclosure. Overall, results suggest that intimate relationships may serve as a unique context for disclosure about one's history of sexual assault, with perceived positive responses demonstrating particularly strong associations with level of engagement in trauma-related disclosure.

PTSD in veterans, couple behavior, and cardiovascular response during marital conflict.

Posttraumatic stress disorder (PTSD) is associated with strain in marriage and similar intimate relationships, and such difficulties could contribute to associations of PTSD with risk of cardiovascular disease (CVD). Heightened cardiovascular reactivity (CVR) during stressful marital interactions may be an important mechanism in this regard. This study examined dysfunctional behavior during marital conflict as a mediator of the association of PTSD with heightened CVR during these interactions. In 64 couples comprising male military veterans and female partners, participants underwent a 17-min video-recorded conflict discussion, with assessment of blood pressure and cardiac sympathetic activation (i.e. preejection period). In half of the couples, veterans met interview and questionnaire criteria for PTSD. Behavior was coded for aspects of affiliation (e.g., warmth vs. hostility) and control (e.g., dominance vs. deference), as well as blends of these broader dimensions. Extending previous reports from this study, actor-partner mediational analyses indicated that PTSD contributed to larger increases in veterans' and spouses' systolic blood pressure during the interaction through effects of the individual's own expressions of low warmth. PTSD contributed to veterans' and spouses' greater cardiac sympathetic activation through effects of the individual's own expressions of hostile control (e.g., blame, criticism). Hence, expressions of low warmth and high hostile control contribute to effects of PTSD on veterans' and spouses' heightened CVR during marital conflict discussions, suggesting a mechanism linking PTSD with CVD risk and potential targets for risk-reducing behavioral interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Relative accuracy of social and medical determinants of suicide in electronic health records.

OBJECTIVE: This paper compares the accuracy of predicting suicide from Social Determinants of Health (SDoH) or history of illness. POPULATION STUDIED: 5 313 965 Veterans who at least had two primary care visits between 2008 and 2016. STUDY DESIGN: The dependent variable was suicide or intentional self-injury. The independent variables were 10 495 International Classification of Disease (ICD) Version 9 codes, age, and gender. The ICD codes included 40 V-codes used for measuring SDoH, such as family disruption, family history of substance abuse, lack of education, legal impediments, social isolation, unemployment, and homelessness. The sample was randomly divided into training (90 percent) and validation (10 percent) sets. Area under the receiver operating characteristic (AROC) was used to measure accuracy of predictions in the validation set. PRINCIPAL FINDINGS: Separate analyses were done for inpatient and outpatient codes; the results were similar. In the hospitalized group, the mean age was 67.2 years, and 92.1 percent were male. The mean number of medical diagnostic codes during the study period was 37; and 12.9 percent had at least one SDoH V-code. At least one episode of suicide or intentional self-injury occurred in 1.89 percent of cases. SDoH V-codes, on average, elevated the risk of suicide or intentional self-injury by 24-fold (ranging from 4- to 86-fold). An index of 40 SDoH codes predicted suicide or intentional self-injury with an AROC of 0.64. An index of 10 445 medical diagnoses, without SDoH V-codes, had AROC of 0.77. The combined SDoH and medical diagnoses codes also had AROC of 0.77. CONCLUSION: In predicting suicide or intentional self-harm, SDoH V-codes add negligible information beyond what is already available in medical diagnosis codes. IMPLICATIONS FOR PRACTICE: Policies that affect SDoH (eg, housing policies, resilience training) may not have an impact on suicide rates, if they do not change the underlying medical causes of SDoH.

Resting high frequency heart rate variability and PTSD symptomatology in Veterans: Effects of respiration, role in elevated heart rate, and extension to spouses.

Heart rate variability (HRV) associated with parasympathetic activity (i.e., cardiac vagal tone) is reduced in posttraumatic stress disorder (PTSD), but possible confounding effects of respiration have not been studied sufficiently. Further, reduced parasympathetic inhibition might contribute to elevated heart rate (HR) in PTSD. Finally, reduced HRV in PTSD might extend to intimate partners, given their chronic stress exposure. In 65 couples (male Veterans, female partners), elevated PTSD symptomatology (n = 32; 28 met full DSM IV criteria, 4 fell slightly short) was documented by structured interview and self-reports. Baseline HR, high-frequency HRV (HF-HRV), cardiac pre-ejection period (PEP), and respiration rate and depth were measured via impedance cardiography. Veterans with PTSD symptoms displayed reduced lnHF-HRV, even when adjusting for respiration, but their partners did not. In mediational analyses, elevated resting HR in PTSD was accounted for by lnHF-HRV but not PEP. Results strengthen evidence regarding HF-HRV and elevated HR in PTSD.

Partners' motivations for accommodating posttraumatic stress disorder symptoms in service members: The reasons for accommodation of PTSD scale.

Emerging research reinforces the importance of partner accommodation in the interpersonal context of posttraumatic stress disorder (PTSD). A better understanding of partners' motivations for accommodation is needed to help refine or design interventions that target accommodation. To explore partners' motivations, we created the Reasons for Accommodation of PTSD Scale (RAPS) and evaluated it in 263 female partners of male Army soldiers who had returned from a deployment within the past 2 years. Soldiers completed a measure of military-related PTSD, and partners completed a measure of accommodation and the newly created RAPS. Factor analysis of the RAPS yielded a clear, 3-factor solution suggesting the following reasons for accommodating: (1) Relationship & Obligation, or a desire for positive relationship outcomes and a sense of duty or responsibility; (2) Helping Recovery, or a belief that avoidance was helpful for the service member; and (3) Conflict Avoidance/Helplessness, or a desire to avoid conflict or simply not knowing what else to do. Analyses of these factors in relation to soldiers' PTSD clusters indicated that hyperarousal symptoms were uniquely associated with relationship and obligation motivations, re-experiencing symptoms were uniquely associated with helping recovery motivations, and emotional numbing symptoms were uniquely associated with conflict avoidance and helplessness motivations. Furthermore, conflict avoidance and helplessness accounted for the greatest variance in partners' accommodation frequency and distress. Assessment of partners' accommodative behaviors, as well as their motivations for engaging in accommodation, may aid in treatment planning and enhance outcomes for couples in which one individual has PTSD.

Everything Here is Fine: Protective Buffering by Military Spouses During a Deployment.

To minimize potential distractions for deployed military service members (SMs), some nondeployed romantic partners have reported engaging in protective buffering, or intentionally withholding information or concerns to protect their deployed partner. This study assessed the associations of protective buffering and psychological distress and marital satisfaction for military couples during and after deployment. Additionally, the study explored whether protective buffering was related to SM reports of being distracted during deployment by family matters. A total of 54 couples provided data before, during, and after an Army deployment. In multilevel models, higher protective buffering by partners was associated with higher psychological distress and lower marital satisfaction for both SMs and partners during, but not after, deployment. Additionally, partners reported frequent use of protective buffering during deployment; however, protective buffering was not significantly correlated with family related distraction for SMs during deployment. Limitations and implications of these findings are discussed.

Para minimizar posibles distracciones para miembros del servicio militar (SM) desplegados, algunas parejas románticas no desplegadas han informado que practican la amortiguación protectora, es decir, ocultan información o preocupaciones intencionalmente para proteger a su pareja desplegada. Este estudio evaluó las asociaciones de amortiguación protectora y angustia psicológica y satisfacción conyugal para parejas militares durante y después del despliegue. Además, el estudio exploró si la amortiguación protectora tenía relación con informes de los SM de estar distraídos durante el despliegue por cuestiones familiares. Un total de 54 parejas proporcionó datos antes, durante y después de un despliegue del ejército. En modelos multinivel, una amortiguación protectora mayor por parte de las parejas se asoció a mayor angustia psicológica y menor satisfacción conyugal tanto para los SM como para las parejas durante, pero no después del despliegue. Además, los socios informaron el uso frecuente de amortiguación protectora durante un despliegue; sin embargo, la amortiguación protectora no tuvo una correlación significativa con la distracción por motivos familiares para los SM durante el despliegue. Se discuten las limitaciones e implicaciones de estos hallazgos.

Protective Buffering by Service Members During Military Deployments: Associations with Psychological Distress and Relationship Functioning.

To shield a romantic partner from potential distress due to stressors occurring during deployment, service members (SMs) may engage in protective buffering, or withholding information or concerns from a romantic partner. This study utilized data from 54 couples collected before, during, and after a military deployment to assess whether SMs engaged in protective buffering while deployed and the possible associations between buffering and psychological, relationship, and contextual factors. Only 2% of SMs indicated never engaging in protective buffering during a deployment. In bivariate analyses, only partners' psychological distress prior to deployment was significantly associated (negatively) with protective buffering. In multilevel models with time nested within individuals, and individuals nested within couples, higher buffering was associated with less partner distress during deployment, but was also associated with higher SM distress both during and after deployment. In these multilevel models, protective buffering was not significantly associated with SM or partner marital satisfaction.

Para proteger a una pareja romántica del posible distrés debido a factores desencadenantes de estrés que se producen durante la movilización militar, los miembros de las fuerzas armadas pueden adoptar una conducta de atenuación protectora u ocultar información o preocupaciones a una pareja romántica. El presente estudio utilizó datos de 54 parejas recopilados antes, durante y después de una movilización militar para evaluar si los miembros de las fuerzas armadas adoptaron una conducta de atenuación protectora mientras estaban movilizados y las posibles asociaciones entre la atenuación y los factores psicológicos, relacionales y contextuales. Solo el 2% de los miembros de las fuerzas armadas indicaron no haber adoptado nunca una conducta de atenuación protectora durante una movilización militar. En los análisis bivariables, solo el distrés psicológico de las parejas antes de la movilización militar estuvo asociado considerablemente (negativamente) con la atenuación protectora. En los modelos multinivel, con el tiempo localizado dentro de las personas y las personas localizadas dentro de las parejas, una mayor atenuación estuvo asociada con menos distrés de la pareja durante la movilización militar, pero también estuvo asociada con un mayor distrés de los miembros de las fuerzas armadas tanto durante como después de la movilización militar. En estos modelos multinivel, la atenuación protectora no estuvo asociada de forma significativa con la satisfacción conyugal de la pareja o del miembro de las fuerzas armadas.

Deployment-related coping strategies in military couples: Associations with relationship satisfaction.

Military deployments are known to be stressful for both military service members (SMs) and their romantic partners. Little is known about how coping strategies used during deployment may relate to one's own and one's partner's relationship satisfaction following deployment. This project investigated the retrospective report of how 154 SMs and their romantic partners coped with deployment-related stress, using previously established coping constructs of problem-focused, emotion-focused, and avoidance coping. Examination of relative associations of coping strategies and mental health symptoms with SMs' and partners' relationship satisfaction showed that partners' emotion-focused coping was positively related to both SMs' and partners' relationship satisfaction, whereas partners' avoidance was negatively related to both their own and SMs' relationship satisfaction. Results highlight the importance of partner coping within military couples and point to potential strategies for coping with deployment that are associated with enhanced relationship functioning after deployment.

Supporting a Spouse With Military Posttraumatic Stress: Daily Associations With Partners' Affect.

Service members and veterans (SM/Vs) with posttraumatic stress disorder (PTSD) can receive significant benefits from social support by a spouse or romantic partner. However, little is known about how providing support impacts partners. This study sought to identify (a) how provision of support is associated with partners' daily negative and positive affect and (b) how SM/Vs' PTSD symptom severity might moderate such associations. In a 14-day daily-diary study that assessed 64 couples in which one member was an SM/V with PTSD symptoms, partners reported nightly on whether or not they provided instrumental support and/or emotional support that day as well as their current negative and positive affect. Multilevel modeling showed that the provision of emotional and instrumental support were both significantly related to partners' lower levels of negative affect, f 2 = 0.09, and higher levels of positive affect, f 2 = 0.03, on that same day but not the next day. The positive same-day effects were seen if any support was given, with no additive effects when both types of support were provided. Severity of SM/V PTSD moderated the association between provision of emotional support and lower same-day negative affect such that the association was significant only when PTSD symptoms were more severe. Overall, these findings indicate that support provision to a partner with PTSD is associated with improved affect for the romantic partner providing support. However, given that only same-day affect was associated with support, the findings may also suggest that positive affect increases the provision of support.

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Apoyo a un Cónyuge con Estrés Postraumático Militar: Asociaciones de la vida diaria con el Afecto de las Parejas EL APOYO A UNA ESPOSA CON SÍNTOMAS DE TEPT Los miembros del servicio y los veteranos (SM/Vs en sus siglas en inglés) con Trastorno de Estrés Postraumático (TEPT) pueden recibir significativos beneficios del apoyo social por parte de un cónyuge o pareja romántica. Sin embargo, poco se sabe acerca de cómo el hecho de proporcionar apoyo impacta a las parejas. Este estudio buscó identificar (a) cómo la provisión de apoyo está asociado con el afecto negativo y positivo diario de las parejas y (b) cómo la severidad de los síntomas TEPT de SM/Vs podría moderar tales asociaciones. En un estudio diario de 14 días que evaluó 64 parejas en las que un miembro era un SM/V con síntomas de TEPT, las parejas informaron cada noche sobre si proporcionaron o no apoyo instrumental y/o apoyo emocional ese día, como también informaron sobre su afecto negativo y positivo actual. El modelo multinivel mostró que la provisión del apoyo emocional e instrumental se relacionaron significativamente tanto con los niveles más bajos de afecto negativo, f2 = 0.09, y niveles más altos de afecto positivo, f2 = 0.03, en ese mismo día, pero no el día siguiente. Los efectos positivos del mismo día se observaron si se brindó cualquier tipo de apoyo, sin efectos adicionales cuando se proporcionaron ambos tipos de apoyo. La severidad del TEPT en SM/V moderó la asociación de la provisión de apoyo emocional con un afecto negativo más bajos en el mismo día, de modo que la asociación fue significativa solo cuando los síntomas del TEPT fueron más severos. En general, estos hallazgos indican que proveer apoyo a una pareja con TEPT se asocia con una mejora en los afectos en la pareja romántica que brinda apoyo. Aunque dado que solo el afecto del mismo día fue asociado con apoyo, los hallazgos también pueden sugerir que un afecto positivo incrementa la provisión de apoyo.

Standardized Assessment of Relationship Functioning in Iraq and Afghanistan Veterans with PTSD.

Posttraumatic Stress Disorder (PTSD) is associated with difficulties in intimate relationships, with most prior research examining associations with continuous, single-dimension, and often-unstandardized measures of general relationship quality or aggression. Standardized, well-normed assessments that include multiple couple problem areas could provide more precise information about the presence and specific nature of clinically significant concerns in patient care settings. This investigation aimed to replicate findings regarding increased difficulties in relationship functioning among Operations Enduring and Iraqi Freedom Veterans with PTSD and their romantic partners, specifically using a standardized assessment that permits identification of cases of clinically significant general couple distress and difficulties across multiple problem areas. We compared 32 male Veterans with PTSD and 33 without PTSD, and their romantic partners on reports of several problem areas using the revised Marital Satisfaction Inventory (MSI-R). All participants underwent structured diagnostic interviewing. PTSD couples reported clinically significant levels of relationship distress several times more frequently than comparison couples, both for general distress and across all specific problem areas (e.g., aggressive behavior, quality of leisure time together, sexual functioning, conflicts about finances and child rearing). The most notable problem areas for PTSD couples were affective and problem-solving communication. These results replicate associations of PTSD with general couple discord and multiple specific areas of couple difficulties and extend them by documenting the clinical severity of these problems. Mental health providers may consider incorporating standardized couple assessments into their evaluations of Veterans' functioning. Couples therapies may consider using such measures to prioritize targets for treatment.