Objective Preliminary research suggests that perceptions of institutional betrayal are associated with more severe symptoms of posttraumatic stress disorder (PTSD) and depression, as well as suicide attempts in military sexual trauma (MST) survivors. However, results have not been replicated. Additionally, associations of institutional betrayal with specific PTSD symptom clusters or sexual function are understudied. Method Female service members/veterans who reported experiencing MST (N = 679) completed self‐report measures of PTSD and depression symptom severity, suicidal ideation, and sexual function. Institutional betrayal was assessed from free‐text descriptions of self‐reported index traumas. Results Institutional betrayal was significantly associated with more severe depression and PTSD symptoms, including avoidance, negative alterations in cognitions and mood, re‐experiencing, and dysphoric arousal. Conclusions Targeting specific PTSD and depressive symptoms through evidence‐based treatment may be important for managing institutional betrayal sequelae. Future research should identify specific strategies to help support survivors in their recovery following institutional betrayal.

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Objective Treatment for posttraumatic stress disorder (PTSD) is a commonly sought mental health service among military service members and veterans (SM/Vs). Such treatment is typically individually‐based, despite many SM/Vs reporting a desire for greater partner involvement in treatment. This review examined couple‐based treatments for PTSD among SM/Vs and their romantic partners. Method A database search conducted in July, 2018 yielded 167 studies, of which 16 (10%) met inclusion criteria. Brief intervention summaries, effect sizes, and distress change scores (where applicable) are reported. Results The 16 studies tested 7 interventions, which showed a reduction in self‐rated and clinician‐rated PTSD symptoms with large effect sizes observed in most studies. Relationship outcomes also improved for SM/Vs and their partners, with effect sizes ranging from small‐to‐medium for SM/Vs and small‐to‐large for partners. Conclusions Couple‐based interventions show success in reducing PTSD symptoms and improving relationship outcomes, offering several alternatives to individual‐based interventions among partnered SM/Vs.

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