“…Instead, these combat service veterans might be preoccupied with self-destructive behavior, preoccupation with the war, frustration, outrage, guilt/survival guilt, and for some, mortal fear. Research (e.g., Mills & Turnbull, 2001;Riggs, Byrne, Weathers, & Litz, 1998) has suggested that there is an association between PTSD and intimacy in two of the symptom clusters: numbing and avoidance (avoidance of trauma triggers by shutting down the affective system), hyperarousal (sleep disturbances, profound hypervigilance and exaggerated startle response, poor concentration, and irritability), intrusive reexperiencing (dreams or intrusive thoughts and powerful emotions; Criteria C and D in the Diagnostic and Statistical Manual of Mental Disorders, Text Revision, Fourth Edition [DSM-TR-IV]; American Psychiatric Association, 2000). Several studies focused on the avoidance cluster (deficit in experiencing and expressing positive emotions such as loss of interest in activities, detachment, and alienation from others, restricted affects, emotional numbing) and impact on combat veterans (heroes and less valiant veterans) being in well-functioning relationships, dyadic adjustment, communication, satisfaction, and intimate exchanges (Cook, Riggs, Thompson, & Coyne, 2004;Evans, McHugh, Hopwood, & Watt, 2003).…”