Couple Functioning and Posttraumatic Stress in OIF/OEF Veterans and Spouses.

摘要

Purpose: To (a) understand and explain how posttraumatic stress symptoms (PTSS) affect couple functioning in Army soldiers returning from combat, and their spouses/partners, (b) test the moderating effects of age, gender, rank, resilience, coercion in the relationship and previous history of trauma on the relationship between PTSS and couple functioning, (c) examine the prevalence of secondary traumatic stress (STS) in civilian spouses, (d) analyze whether the relationships between PTSS and couple functioning differ for male versus female soldiers and their spouses/partners, and (e) explore experiences of couples with high levels of couple functioning in spite of clinically significant levels of PTSS in one or both partners. Design: A cross-sectional descriptive sequential mixed-methods design was employed for this dyadic study. The Couple Adaptation to Traumatic Stress (CATS) model (Nelson-Goff & Smith, 2005) was used to guide this study. The CATS model is a framework designed to explain the interactive processes of a couple adapting to traumatic experiences. Methods: Mailed surveys on PTSS and couple functioning were sent separately to interested couples, along with optional written consent forms for further contact for the purpose of in-depth interviews. Sample: Data were collected among male (n = 43), and dual (both spouses served in the armed forces) (n = 30) Army couples. From this total sample (N = 73 couples), using a maximum variation purposive sampling design, 14 consenting couples were then selected for in-depth semi-structured interviews. The interview couples were further stratified based on their couple functioning scores, and the five highest functioning couples with clinically significant levels of PTSS were selected for a multiple case study analysis. Analysis: Quantitative data were analyzed using a generalized linear model controlling for interdependence of couple dyads. Qualitative data were analyzed using a multiple case study approach.