Self-determination theory can be viewed as a theory of optimal relationship development and functioning. We examine the concept of self that is employed in self-determination theory and explain how its unique definition allows an important and novel characterization of investing one's "self" in romantic relationships. A self-determined perspective on romantic relationships integrates several theories on romantic relationship development, but also goes beyond them by explicitly articulating the personality, developmental, and situational factors that facilitate optimal self-investment and relational functioning. Self-determination promotes openness rather than defensiveness and facilitates perspective-taking, authenticity, and support of close others. The dyadic context of romantic relationships affords great opportunity for theoretical development and integration of self-determination theory with current theories of interdependence and relational well-being.

BackgroundPosttraumatic stress disorder (PTSD) often co-occurs with other psychiatric disorders, particularly major depressive disorder (MDD). The current study examined longitudinal trajectories of PTSD and MDD symptoms among service members and veterans with comorbid PTSD/MDD.MethodsEligible participants (n = 1704) for the Millennium Cohort Study included those who screened positive at baseline for both PTSD (PTSD Checklist–Civilian Version) and MDD (Patient Health Questionnaire). Between 2001 and 2016, participants completed a baseline assessment and up to 4 follow-up assessments approximately every 3 years. Mixture modeling simultaneously determined trajectories of comorbid PTSD and MDD symptoms. Multinomial regression determined factors associated with latent class membership.ResultsFour distinct classes (chronic, relapse, gradual recovery, and rapid recovery) described symptom trajectories of PTSD/MDD. Membership in the chronic class was associated with older age, service branch, deployment with combat, anxiety, physical assault, disabling injury/illness, bodily pain, high levels of somatic symptoms, and less social support.ConclusionsComorbid PTSD/MDD symptoms tend to move in tandem, and, although the largest class remitted symptoms, almost 25% of participants reported chronic comorbid symptoms across all time points. Results highlight the need to assess comorbid conditions in the context of PTSD. Future research should further evaluate the chronicity of comorbid symptoms over time.

Posttraumatic stress disorder (PTSD) is a common psychiatric disorder among service members and veterans. The clinical course of PTSD varies between individuals, and patterns of symptom development have yet to be clearly delineated. Previous studies have been limited by convenience sampling, short follow-up periods, and the inability to account for combat-related trauma. To determine the trajectories of PTSD symptoms among deployed military personnel with and without combat exposure, we used data from a population-based representative sample of 8,178 US service members who participated in the Millennium Cohort Study from 2001 to 2011. Using latent growth mixture modeling, trajectories of PTSD symptoms were determined in the total sample, as well as in individuals with and without combat exposure, respectively. Overall, 4 trajectories of PTSD were characterized: resilient, pre-existing, new-onset, and moderate stable. Across all trajectories, combat-deployed service members diverged from non-combat-deployed service members, even after a single deployment. The former also generally had higher PTSD symptoms. Based on the models, nearly 90% of those without combat exposure remained resilient over the 10-year period, compared with 80% of those with combat exposure. Findings demonstrate that although the clinical course of PTSD symptoms shows heterogeneous patterns of development, combat exposure is uniformly associated with poor mental health.

BackgroundPosttraumatic growth is the positive change resulting from traumatic experiences and is typically assessed with retrospective measures like the Posttraumatic Growth Inventory (PTGI). The PTGI was designed to include reference to a specific traumatic event, making it difficult to implement, without change, in prospective survey studies. Thus, a modified Posttraumatic Growth Inventory–Short Form (PTGI-SF) was included in a large prospective study of current and former U.S. military personnel. The current study provides preliminary psychometric data for this modified measure and its ability to assess psychological well-being at a single time point.MethodsThe study population (N = 135,843) was randomly and equally split into exploratory and confirmatory samples that were proportionately balanced on trauma criterion. Exploratory factor analysis and confirmatory factor analysis (CFA) were performed to assess the psychometric validity of the modified measure. The final model was also assessed in a subset of the confirmatory sample with a history of trauma using CFA.ResultsResults supported a single-factor model with two additional correlations between items assessing spirituality and items assessing compassion/appreciation for others. This model also fits among the subset with a history of trauma. The resulting measure was strongly associated with social support and personal mastery.ConclusionsThe modified PTGI-SF in this study captures psychological well-being in cross-sectional assessments, in addition to being able to measure posttraumatic growth with multiple assessments. Results indicate that the modified measure is represented by a single factor, but that items assessing spirituality and compassion/appreciation for others may be used alone to better capture these constructs.

Objectives-We investigated (1) age of onset of hoarding disorder (HD) symptoms and diagnosis, (2) late-onset HD, (3) progression of HD symptoms, and (4) association between demographics and hoarding progression.Method-Eighty-two older adults with HD provided retrospective ratings of their hoarding symptoms for each decade of life. Age of onset of symptoms (saving, difficulty discarding, and clutter) was operationalized as the first decade in which the participant reported at least minor symptom severity, and age of onset for possible HD diagnosis was operationalized as the first decade in which the participant reported all three symptoms. We used mixed effects modeling to examine the progression of HD symptoms.Results-The median age of onset for symptoms was between 10 and 20 years, and the median age of onset for possible HD diagnosis was between 20 and 30 years. Twenty-three percent of participants reported onset of possible HD diagnosis after the age of 40. All HD symptoms increased in severity over time. Men reported higher initial clutter and a slower increase in hoarding severity for all symptoms. Increased education was associated with slower increase in saving. Having at least one parent with hoarding tendencies was associated with higher initial hoarding symptoms.Conclusion-Generally, symptoms of HD begin relatively early and worsen across the lifespan. However, approximately one fourth of older adults with HD reported a possible onset after the age of 40.