RESUMEN
OBJECTIVE: Posttraumatic stress symptoms (PTSS) can have detrimental influences on both individual and couple functioning, including how individuals respond to stressors and regulate emotions. Respiratory sinus arrhythmia (RSA) can serve as a key indicator of emotion regulation; however, few studies have examined psychophysiological stress reactions within a couple's context. METHOD: Forty-three couples (N = 86 individuals) with a trauma history were assessed for PTSS and RSA at baseline. One partner then completed a stressor task using a film-clip depicting sexual assault. Afterward, the couple was reunited and completed a dyadic discussion task where both partners' RSA was continuously measured while they discussed the stressed partner's thoughts and feelings about the stressful film-clip. RESULTS: Moderated repeated measures actor-partner interdependence models were conducted, examining the self and coregulation of RSA and moderation of such regulation by PTSS. There was significant self-regulation from both partners, and a coregulation process whereby the nonstressed partner's RSA influenced the rate of change in RSA of their stressed partner. Additionally, greater PTSS in the nonstressed partner was associated with a weakening of both self and coregulation. CONCLUSION: Patterns of both self- and coregulation, within and between romantic partners emerged and illustrate the impact of PTSS within these dyadic physiologic processes. Findings have theoretical and clinical implications in physiological dyadic interactions and potential stress recovery, particularly emphasizing the relevance of examining biomarkers such as RSA among partners with a trauma history during recovery from stress. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
RESUMEN
OBJECTIVE: Evidence for the use of integrated treatments targeting co-occurring posttraumatic stress disorder (PTSD) and alcohol use disorders is steadily growing. However, limited work has evaluated the temporal association between posttraumatic stress symptoms (PTSS) and alcohol misuse over the course of integrated treatment, with no studies examining such interventions in primary care (PC). The current study examined temporal changes in PTSS and heavy drinking among individuals who received a brief treatment for co-occurring PTSD and alcohol misuse in PC (Primary Care Treatment Integrating Motivation and Exposure; PC-TIME) compared with those who received PC treatment as usual (PC-TAU). METHOD: A total of 63 veterans (33 randomized to PC-TIME and 30 randomized to PC-TAU) presenting to PC with co-occurring PTSD and alcohol misuse were included in this study. PTSS and heavy drinking were examined at each treatment session for those in PC-TIME. Veterans in both conditions provided reports of PTSS and heavy drinking at baseline, 8-weeks (post-treatment), 14-weeks, and 20-week follow-ups. RESULTS: Session-by-session findings for PC-TIME demonstrated that PTSS at Session 1 predicted a greater decrease in heavy drinking from Session 1 to Session 2. Moreover, heavy drinking at baseline predicted greater decreases in PTSS at 8-weeks for those in PC-TIME, whereas the reverse association was found for those randomized to PC-TAU. Additionally, heavy drinking at 8-weeks predicted decreased PTSS at 14-weeks for those randomized to PC-TAU. CONCLUSIONS: The current study evidenced mixed support for the temporal precedence of PTSS and alcohol misuse. Relations between PTSS and heavy drinking appeared to be linked to treatment targets within PC-TIME and varied between treatment condition (PC-TIME versus PC-TAU). Notably, those with greater than average heavy drinking at the initiation of integrated treatment appeared to have greater reductions in PTSS at post-treatment. Results suggest a mutual maintenance model may best characterize the association between co-occurring PTSS and heavy drinking among treatment-seeking individuals.