PTSD and Couple Relationships Among Veterans: Annotated Bibliography

Annotated Bibliography

Allen, E., Knopp, K., Rhoades, G., Stanley, S., & Markman, H. (2018). Between- and within- subject associations of ptsd symptom clusters and marital functioning in military couples. Journal of Family Psychology, 32(1), 134-144. http://dx.doi.org/10.1037/fam0000363

[bookmark: _Hlk34389355]This article focuses on the effects of posttraumatic stress disorder (PTSD) in marriage among military service members. The researchers conduct an analysis to examine the associations between PTSD symptom clusters and the effects on marital functioning among married military couples. The study included 570 married couples. The assessment included factors such as their ages, ethnicity, history of deployment, and combat exposure. They also used information regarding husbands’ PTSD symptoms, such as being satisfied in marriage, bonding with their spouse, and how they deal with conflict. Although some patterns of positive and negative factors were not included in the study, they discussed varying associations when studying these symptom clusters. All data presented in this article concerning (internal and external) validity and reliability, such as collecting data on marital satisfaction using the Kansas Satisfaction Scale are strong. The material in this study an abundance of information on PTSD symptom clusters and the effects it causes on marital functioning that can be used to further my project.

Blow, A. J., Curtis, A. F., Wittenborn, A. K., & Gorman, L. (2015). Relationship problems and military related ptsd: The case for using emotionally focused therapy for couples. Contemporary Family Therapy: An International Journal, 37(3), 261-270. https://doi.org/10.1007/s1059-015-9345-7

[bookmark: _Hlk34389302]The authors of this article recommend that Emotionally Focused Therapy (EFT) should be an important part of treatment for counseling military couples who are struggling with posttraumatic stress disorder (PTSD) that resulted from being deployed in combat for a long period of time. The authors also believe that this type of therapy can reduce stress and can have a significant impact on mental health when it comes to service members and their families that live with PTSD. EFT intervention can also help reduce the potential risk for domestic violence. The authors also find that veterans who discuss their experiences with their partners can have reduced PTSD symptoms. Although EFT has not been used as a primary source for couple therapy, it is an ideal approach for helping those that have been exposed to traumatic and stressful events. The authors use different scenarios to give valid and reliable information concerning military couples that are coping with PTSD. The descriptions given in this article are clear in giving important aspects on EFT that can be useful for my project.

Dekel, R., & Monson, C. M. (2010). Military related post-traumatic stress disorder and family relations: Current knowledge and future directions. Aggression and Violent Behavior, 15(4), 303-309. https://doi.org/10.1016/j.avb.2010.03.001

Dekel and Monson describe in detail the three main clusters of symptoms associated with PTSD. This includes re-experiencing, wherein a veteran reexperiences traumatic episodes in the form of nightmares, flashbacks, and painful memories. They also discuss the ways that veterans will oftentimes avoid any activity that reminds them of their traumatic combat experiences. This is known as avoidance. The third main cluster of symptoms they describe are hyperarousal symptoms. While hyperarousal can cause the veteran to lose sleep, and experience difficulty concentrating, hyperarousal is usually marked by an overreaction to being startled. Their main purpose of this article was to understand the connection between PTSD symptoms and family problems. Not only does PTSD affect the individual, but oftentimes the environment of their loved ones. PTSD is a growing concern in mental health that needs to be properly addressed through future evaluation. Because this article gives detailed information on the effects of PTSD and how it affects the relationships of the veterans’ family, this source would be helpful in describing what families experience when a loved one has PTSD.

Finley, E., Baker M., Pugh, M., & Peterson, A. (2010). Patterns and perceptions of intimate partner violence committed by returning veterans with post-traumatic stress disorder. Journal of Family Violence, 25(8), 737-743. https://doi.org/10.1007/s10896-010-9331-7

The researchers in this article collected data from three case studies on how often Intimate Partner Violence (IPV) occurred in relationships between veterans with PTSD and their partners. The data they studied found three distinct patterns of violence that appeared in PTSD symptoms and describe how each of these patterns influenced both partners’ response to partner violence. A study was conducted on 50 male Veterans with PTSD and 16 family members. From this study, they reviewed the transcripts of 19 randomly selected veterans and their spouses. They found that 16 of the 19 Veterans had been diagnosed with PTSD by at least one doctor. Although there is a lack of research done on IPV among veterans with PTSD and their partners, there is enough evidence to support the need for more investigations on this topic. Although the sample size is small, the reliability of this article has helpful information in describing how often patterns of violence occur in the home between the veteran diagnosed with PTSD and their spouse.

Lambert, J. E., Engh, R., Hasbun, A., & Holzer, J. (2012). Impact of posttraumatic stress disorder on the relationship quality and psychological distress of intimate partners: A meta-analytic review. Journal of Family Psychology, 26(5), 729-737. https://doi.org/10.1037/a0029341

The researchers evaluated the association between those who suffer from PTSD symptoms and the distinctions of the symptoms that affect their partner’s mental well-being in the relationship. In their findings the researchers found that couples therapy, such as cognitive-behavioral conjoint therapy (CBCT) and emotionally focused therapy (EFT), is essentially the best means of treatment for couples that are dealing with PTSD. They suggest that more research should be evaluated in future studies. The analysis of this research did have limitations. There are limited amounts of studies on those suffering from PTSD and how their condition effects the well-being of their spouses. This article may not be as useful for my further project because of the lack of information that has been provided.

McGinn, M. M., Hoerster, K. D., Stryczek, K. C., Malter, C. A., & Jakupcak, M. (2017). Relationship satisfaction, ptsd symptom severity, and mental healthcare utilization among oef/oif veterans. Journal of Family Psychology, 31 (1), 111-116. https://doi.org/10.1037/fam0000224

The authors, researchers at the VA Puget Sound Healthcare System and the University of Washington, used data from previous research to help identify barriers encountered by veterans when attempting to utilize mental healthcare. They also used this research to determine what data helped the veterans obtain the mental healthcare they needed. The researchers used data from self-reports on the severity of PTSD that concluded good reliability and validity that were tested on a Likert scale rating, and based on criteria from the DSM-IV-TR. Other methods of measurement that were used also indicated good consistency and validity. Through this study, the researchers were limited to variables on self-report data and a small sample size. While this study would be more useful if they used a larger population sample, this does seem to be have reliable information for further use in my project.

Mobbs, M. C.,& Bonanno, G. A. (2018). Beyond war and ptsd: The crucial roles of transition stress in the lives of military veterans. Clinical Psychology Review, 59, 137-144. https://doi.org/10.1016/j.cpr.2017.11.007

Mobbs and Bonanno’s main focus in this article addresses veterans’ high levels of stress during their transition into civilian life and the factors that affect these transitions. Because there is limited resources available on transitioning veterans, their goal was to outline solutions and support systems during this period. The authors offer specific scenarios that should be applied to future research in hopes of a better understanding and ideas to support our servicemen in this crucial time in their lives. There were limitations on sample size and self-report data, as well as, information regarding outpatient mental care. This article also fails to include how often patients were treated for PTSD. Despite its shortcomings, the information given in this article would be useful to my research in giving scenarios of what these men and women experience and what they face before and after deployment.

Monson, C. M., Fredman, S. J., Macdonald, A., Pukay-Martin, N. D., Resick, P. A., & Schnurr, P. P. (2012). Effect of cognitive-behavioral couple therapy for ptsd: A randomized controlled trial. Jama, 308(7), 700-709. https://doi.org/10.1001/jama.2012.9307

[bookmark: _Hlk34397457]There has been numerous studies conducted on individual therapy for those suffering with PTSD that have shown significant improvement in their social life, but little evidence has shown improvement in their intimate relationships. The researchers’ goal in this study was to conduct a randomized study using cognitive-behavioral conjoint therapy (CBCT) to help those within a relationship suffering from PTSD symptoms. In this study, they found conclusive evidence that CBCT improves PTSD symptoms and improved relationships for the couples undergoing therapy. With these findings, the researchers decided to follow a wait-list control. The study consisted of 40 intimate partners aged 18 to 70, from Boston, Massachusetts and Toronto, Ontario, Canada. The research lacks external validity because of the small population sample. Unlike some other studies regarding couples in which one partner suffers from PTSD, the researchers also performed an analysis using criteria from the DSM-IV-TR that measured reliability to be excellent. The researchers were able to detect evidence in the positive difference between couples using and couples waiting for therapy. Due to the level of reliability of this article, it should be useful for future study.

Sautter, F. J., Armelie, A. P., Glynn, S. M., & Wiett, D. B. (2011). The development of a couple-based treatment for ptsd in returning veterans. Professional Psychology: Research and Practice, 42(1), 63-69. https://doi.org/10.1037/a0022323

[bookmark: _Hlk34470608]A great deal of evidence has indicated that servicemembers who were deployed in Iraq and Afghanistan suffer from the impact of PTSD and high levels of emotional distress and issues in intimate relationships. The authors of this article discuss a couple-based therapy treatment, called Structured Approach Therapy (SAT). This treatment was used to provide veterans and their partners with communication and coping skills to help restore intimacy into their relationship. Interventions, such as SAT, show that with increased social support from spouses and others can help increase positive outcomes in mental health and reduce negative outcomes within social interactions. These interventions are organized through stress inoculation training (SIT) consisting of three phases, including an educational phase, a skills training phase, and an application phase. Each of these phases use different processes to help encourage positive reinforcement within intimate relationships. Although there is a limited amount of data concerning the success of SAT and combat-related PTSD, more studies are being evaluated for future research. This article is informative and has a great deal of information that will help with my project. It gives specific details in treatment for SAT and phases of SIT that will help explain treatment options.

Weissman, N., Batten, S. V., Rheem, K. D., Wiebe, S. A., Pasillas, R. M., Potts, W., Barone, M., Brown, C. H., & Dixon, L. B. (2018). The effectiveness of emotionally focused couple therapy with veteran with ptsd: A pilot study. Journal of Couple & Relationship Therapy, 17(1), 25-41. https://doi.org/10.1080/15332691.2017.1285261

The researchers in this study examined emotionally focused therapy (EFT) among veterans diagnosed with PTSD and their spouses. They also discussed the psychological symptoms and distress that PTSD can cause in an intimate relationship. Using t-tests, the researchers investigated changes in depression, PTSD symptoms, relationship satisfaction, and quality of life (Weissman et al., 2018). The study consisted of 15 couples at the average age of 43. Out of 15 couples, only 7 completed the study. Basic demographic information was included in the questionnaire. The researchers also used several self-report questionnaires, rating scales, and structured interviews to measure the severity of PTSD symptoms. The results concluded that the data from the self-report showed adequate validity and reliability. Although more participants are needed for this study, the validity and reliability of these different measurements may be important information needed for my project.