The association of self-reported romantic relationship satisfaction and anhedonia symptoms secondary to posttraumatic stress among trauma-exposed male service members/veterans.

Abstract

Objective: Higher posttraumatic stress disorder (PTSD) symptoms are associated with poorer romantic relationship satisfaction in military samples. Studies have examined PTSD symptom clusters and their association with relationship satisfaction, but these studies are limited to the pre-Diagnostic and Statistical Manual (DSM)-5 PTSD models or samples of women. The current study explored the best fitting model of PTSD using contemporary symptoms and examined the association of symptom clusters and relationship satisfaction in a sample of partnered male service members/veterans who reported exposure to a probable Criterion A event. Method: Factor analyses of 6 competing PTSD models were compared using confirmatory factor analysis in a sample of 499 men. Path analysis was then used to examine which symptom clusters were uniquely associated with relationship satisfaction after accounting for covariates in a subsample of 217 men who reported probable Criterion A exposure. Results: The Anhedonia and Hybrid Models had the best fit to the data in both the larger sample and subsample of men reporting probable trauma exposure. Models had comparable model fit, thus symptom clusters from both models were examined as predictors of relationship satisfaction in 2 separate analyses adjusted for covariates. In both analyses, only higher anhedonia symptoms were associated with lower romantic relationship satisfaction. Conclusions: Data was cross-sectional so causality cannot be inferred, but it appears that poorer relationship satisfaction is more common when symptoms of anhedonia are high. Interventions to improve relationship satisfaction among those reporting posttraumatic stress symptoms may be most effective if they focus on reducing anhedonia. Clinical Impact StatementThe Hybrid and Anhedonia Models of PTSD showed the most optimal fit to the data relative to other models of PTSD. Of the symptom clusters identified in these models, only higher anhedonia symptoms were associated with lower relationship satisfaction. Clinicians providing psychological care to male service members/veterans reporting low relationship satisfaction may consider the utility of these non-DSM-5 models of PTSD when conceptualizing their patient's distress. Therapies to improve satisfaction should focus on reducing anhedonia, which reflects the depressive components of PTSD. Behavioral activation and increasing the frequency of rewarding couples' behaviors (e.g., date night) may be particularly useful.

Posttraumatic Cognitions Differ Between Men and Women after Military Sexual Assault Revictimization in Their Contribution to PTSD Symptoms

“…Keywords revictimization, sexual assault, military, gender, posttraumatic stress symptoms, posttraumatic cognitions Posttraumatic stress disorder (PTSD) is one of the most prevalent mental health disorders among Veterans Affairs (VA)-enrolled veterans (Veterans Health Administration, 2013) and active duty service members (Meadows et al, 2018), accounting for over 55% of those with a probable mental health diagnosis (VA, 2017). PTSD and posttraumatic stress symptoms (PTSS) are associated with lower quality of life (Vogt et al, 2017), sexual dysfunction , poorer interpersonal functioning (Blais, 2020(Blais, , 2022Blais & Zalta, 2023), substance misuse (Schumm & Chard, 2012), and suicidal ideation and attempts (Wisco et al, 2014), highlighting the importance of continuing to study risk factors of PTSS to fine-tune assessments and treatments. Traumas that involve sexual violation are associated with the highest risk for PTSS (Blais et al, 2020;Wisco et al, 2014), with repeated exposure conferring even greater risk (see review, Classen et al, 2005;Tirone, Bagley et al, 2020a).…”