Longitudinal Associations Between PTSD Symptoms and Dyadic Conflict Communication Following a Severe Motor Vehicle Accident

Abstract

There are well-documented associations between posttraumatic stress disorder (PTSD) symptoms and intimate relationship impairments, including dysfunctional communication at times of relationship conflict. To date, the extant research on the associations between PTSD symptom severity and conflict communication has been cross-sectional and focused on military and veteran couples. No published work has evaluated the extent to which PTSD symptom severity and communication at times of relationship conflict influence each other over time or in civilian samples. The current study examined the prospective bidirectional associations between PTSD symptom severity and dyadic conflict communication in a sample of 114 severe motor vehicle accident (MVA) survivors in a committed intimate relationship at the time of the accident. PTSD symptom severity and dyadic conflict communication were assessed at 4 and 16 weeks post-MVA, and prospective associations were examined using path analysis. Total PTSD symptom severity at 4 weeks prospectively predicted greater dysfunctional communication at 16 weeks post-MVA but not vice versa. Examination at the level of PTSD symptom clusters revealed that effortful avoidance at 4 weeks prospectively predicted greater dysfunctional communication at 16 weeks, whereas dysfunctional communication 4 weeks after the MVA predicted more severe emotional numbing at 16 weeks. Findings highlight the role of PTSD symptoms in contributing to dysfunctional communication and the importance of considering PTSD symptom clusters separately when investigating the dynamic interplay between PTSD symptoms and relationship functioning over time, particularly during the early posttrauma period. Clinical implications for the prevention of chronic PTSD and associated relationship problems are discussed.

Battling on the Home Front: Posttraumatic Stress Disorder and Conflict Behavior Among Military Couples

“…Although preliminary evidence suggests that PTSD influences couple dysfunction, rather than the opposite (Fredman et al, in press), longitudinal investigations of the links between interpersonal behavior, relationship distress, and PTSD remain important. Because PTSD may generate, exacerbate, or itself be sustained by interpersonal processes, future work must be designed to tease apart causal and temporal effects.…”

Heterogeneity in the Strength of the Relation Between Social Support and Post-Trauma Psychopathology

“…The relation among these variables is proposed as bidirectional in that social support protects against psychopathology as well as psychopathology reducing social support (Fredman et al 2017). Considered as a protective factor, the results suggest that social support may protect against psychopathology by addressing symptoms of low mood.…”

“…The range of post-trauma outcomes, from resilience to psychopathology, suggest that there are several factors that affect recovery. Social support is proposed as one of the strongest factors that protects against negative outcomes after a PTE, although there is evidence that this relation is bidirectional (Fredman et al 2017). Social support is defined as the perceived empathy and emotional care that an individual receives from friends, family, or a significant other (Ullman and Filipas 2001).…”

Posttraumatic stress disorder and relationship functioning: A comprehensive review and organizational framework

“…To answer such questions requires prospective data, ideally from time periods that predate the experience of trauma and onset of PTSD, but at least starting at the onset of trauma. The limited data of this nature suggest that, shortly after a trauma, interpersonal problems contribute to the development of PTSD, whereas over time, PTSD symptoms appear to drive interpersonal difficulties (Hall, Bonanno, Bolton, & Bass, 2014; Kaniasty & Norris, 2008; Robinaugh et al, 2011; Shallcross, Arbisi, Polusny, Kramer, & Erbes, 2016; but see Fredman et al, 2017). As the preponderance of existing research focuses on couples in which one partner already has PTSD, we have little information on how relationship problems might contribute to the development of PTSD.…”