The role of PTSD symptom severity and relationship functioning in male and female veterans’ mental health service use.

Abstract

Objective: Previous research has shown that difficulties in intimate relationships promote mental health treatment seeking for male veterans, but findings for female veterans have been mixed. The current study sought to further evaluate whether intimate relationship functioning is a motivator for mental health treatment seeking for male and female veterans and examine the impact of different types of trauma exposure on this association. Method: Using data from a longitudinal study, we examined whether intimate relationship functioning mediated the association between posttraumatic stress disorder (PTSD) symptom severity and mental health service use (0 = no mental health services, 1 = any mental health services) in male and female veterans (N = 1,200). We used multiple groups path analysis to examine whether intimate relationship functioning mediated the association between PTSD symptom severity and mental health service use for male and female veterans. Results: For male veterans, greater PTSD symptom severity was related to poorer intimate relationship functioning, which in turn explained increased likelihood of mental health service use (R2 = .18). This mediation effect was not significant for female veterans. Conclusions: Our findings suggest that targeting intimate relationship functioning in treatment for male veterans may be beneficial because difficulties in these relationships appear to be a motivating factor for treatment seeking.

Post-traumatic Stress Disorder in Veterans: A Concept Analysis

“…In addition, gender may influence treatment-seeking behavior among veterans. A longitudinal study conducted by Harper et al aimed to provide clarity on the associations between PTSD, intimate relationship functioning, and mental health service use for male and female veterans [ 14 ]. The findings revealed that poorer intimate relationship functioning related to PTSD severity had a positive effect on male veterans, but not women, in seeking treatment for PTSD.…”

“…The findings revealed that poorer intimate relationship functioning related to PTSD severity had a positive effect on male veterans, but not women, in seeking treatment for PTSD. However, women veterans in general were more likely to seek treatment than men [ 14 ]. Moreover, appropriate peer support significantly impacts PTSD symptoms, aiding veterans in better managing them [ 54 , 56 , 57 ].…”

“…The results indicated that negative post-traumatic cognitions, specifically negative thoughts about oneself, had a significant association with suicidal ideation after controlling for the severity of PTSD, depression, and pretreatment suicidal ideation. In addition, PTSD can negatively impact the status of intimate relationships leading to isolation and feelings of estrangement [ 14 ]. Notably, with the reduction in self-blame and negative cognitions, PTSD symptomology can be managed and changed [ 34 ].…”

“…It is common for them to suffer long-term interpersonal and social adversities that leave them feeling hopeless [ 33 ]. In the context of this effortful avoidance, individuals are unable to experience positive feelings and face challenges in trusting others [ 14 ]. In order to avoid other PTSD symptoms that often coincide with one another, those who experience PTSD often engage in avoidance behaviors [ 31 ].…”

“…The debilitating symptoms of PTSD lead to impaired daily functioning and interpersonal relationships [ 13 ]. Moreover, veterans have a lower rate of treatment initiation and engagement [ 14 ]. Although services are available, most veterans do not access them [ 15 ].…”