Couple‐based interventions for PTSD among military veterans: An empirical review

2020

J Clin Psychol

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Objectives: Risk for suicide among female service members/veterans (SM/Vs) is increasing, suggesting a need for additional studies of risk factors in this population. This study examined relationship satisfaction as a correlate of suicidal ideation (SI) after accounting for established risk factors for SI. Method: Partnered female SM/Vs (N = 818) completed a demographic inventory and measures of SI, relationship satisfaction, sexual function, posttraumatic stress disorder (PTSD), and depression.Results: After accounting for covariates, lower relationship satisfaction, higher depression and PTSD severity, and minority race were associated with the presence of SI.PTSD and depression severity did not moderate this association, suggesting that regardless of mental health symptoms, relationship satisfaction is associated with increased SI risk.Conclusions: Screening for relationship satisfaction may identify SI risk in partnered female SM/Vs. Future studies should explore relationship satisfaction as a risk factor for suicidal attempts as not all SM/Vs who experience SI will attempt suicide.

Section: Introductionmentioning

confidence: 99%

Lower intimate relationship satisfaction among partnered female service members/veterans is associated with the presence of suicidal ideation

2020

J Clin Psychol

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“…That said, several couples’ therapy interventions for SM/Vs with histories of trauma and PTSD have been shown to be effective (see review, Kugler et al., 2019). Providers treating those with histories of sexual violence experienced during military service may consider focusing on helping these individuals see their sexual dysfunction as part of the traumatic reaction, and while avoiding sexual contact may decrease painful reminders of MST (Maltz, 2002), it may also prevent survivors from experiencing safe and rewarding sexual experiences that help them heal from MST.…”

Section: Discussionmentioning

confidence: 99%

“…That said, more recent research conducted in a sample of partnered female SM/Vs observed that interpersonal traumas, such as those that included sexual violence, were associated with poorer individual and interpersonal outcomes, such as higher PTSD symptoms, lower romantic relationship satisfaction, and poorer sexual health relative to nonsexual traumas (Blais, Zalta, & Livingston, 2020; DiMauro, Renshaw, & Blais, 2018). In addition to men representing the largest cohort of military SM/Vs, the majority of these men are married (Department of Defense, 2018), and are likely to be the identified patient in couples’ therapies for PTSD (see review, Kugler, Andresen, Bean & Blais, 2019), making it is critical to expand our understanding of how unique traumas relate to interpersonal function in men SM/Vs. This information may inform the development of treatment targets and goals in couples’ therapy.…”

mentioning

confidence: 99%

The Association of Exposure to Military Sexual Trauma and Romantic Relationship Satisfaction Among Partnered Men Service Members/Veterans: The Influence of Compulsive Sexual Behavior

2021

Family Process

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Civilian literature shows a strong, consistent association between exposure to sexual violence and poor romantic relationship satisfaction. The impact of sexual violence that occurred during military service, or military sexual trauma (MST), on romantic relationship satisfaction among partnered men service members/veterans (SM/Vs) is understudied. However, a recent study conducted in women observed that MST that involved an assault was associated with poorer relationship satisfaction through higher sexual dysfunction and lower sexual satisfaction. The current study extended the literature by examining sexual function as a mediator of the association of exposure to MST and romantic relationship satisfaction among partnered men SM/Vs (N = 499). Participants completed self‐report measures of MST exposure, romantic relationship satisfaction, erectile dysfunction, and compulsive sexual behavior, as well as a demographic inventory. The average score on relationship satisfaction was in the distressed range. Sixty‐four participants (12.83%) reported MST exposure. MST exposure was related to lower relationship satisfaction through higher compulsive sexual behavior. The model explained 16% of the variance in relationship satisfaction. The indirect effect of erectile dysfunction was nonsignificant. Current findings are consistent with research in women SM/Vs: the association of MST and romantic relationship satisfaction appears to be indirect, through the effects of sexual function. Couples’ therapy may be most effective if it addresses sexual health concerns among men MST survivors, particularly engagement in compulsive sexual behaviors. Due to low endorsement of MST that involved assault, the impact of MST severity could not be examined.

“…In addition to CBT, a recent review of the literature revealed that couples' therapy was effective in simultaneously reducing posttraumatic stress disorder (PTSD) symptoms and improving relationship satisfaction among partnered SM/Vs with a history of trauma (see Kugler, Andresen, Bean, & Blais, 2019). Moreover, couples' interventions specifically aimed at treating PTSD and relationship satisfaction also effectively reduced depression symptoms and other maladaptive coping strategies (e.g.…”

Section: Discussionmentioning

confidence: 99%

The association of assault military sexual trauma and sexual function among partnered female service members and veterans: the mediating roles of depression and sexual self-schemas

European Journal of Psychotraumatology

Livingston

2021

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Background : Military sexual trauma (MST) that involves assault is associated with poorer sexual function in U. S. women service members/veterans (SM/Vs). Theory of sexual function suggests that the presence of higher depression severity and more negative sexual self-schemas may contribute to sexual dysfunction. This has yet to be examined in partnered women SM/Vs who are survivors of MST. Objective : Using path analysis, the current study examined the associations of MST type, depression, sexual self-schemas, and sexual function in 818 partnered women SM/Vs. Method : Three separate mediation models were tested, all testing indirect effects of depression and sexual self-schemas on the association of MST type and sexual function. In Model 1, the mediation model assumed that exposure to MST predicted more severe depression, which then predicted more negative sexual self-schemas. More negative sexual self-schemas, in turn, predicted poorer sexual function. In Model 2, the mediation model assumed that exposure to MST predicted more negative sexual self-schemas, which then predicted more severe depression. More severe depression, in turn, predicted poorer sexual function. In Model 3, the mediation model assumed a parallel mediation in that exposure to MST predicted more severe depression and more negative sexual self-schemas, which in turn, predicted poorer sexual function. Results : The best fitting model suggested a parallel mediation of higher depression severity (estimate: −1.30, confidence interval: −1.91,-.69) and more negative sexual self-schemas (estimate: −2.09, confidence interval: −2.94,-1.24) on the association of assault MST and poorer sexual function (Model 3). Harassment-only MST was unrelated to sexual function through mediated pathways. Conclusions : Interventions to improve sexual function among MST survivors who experienced assault should address negative sexual self-schemas related to sexual performance and depressive symptoms. Cognitive behavioural interventions that include challenging maladaptive cognitions may be well suited to address this clinical need.