Posttraumatic stress disorder in an interpersonal context.

Abstract

Posttraumatic stress disorder (PTSD) is a relatively common mental health condition that can occur after exposure to a traumatic event. The lifetime prevalence of the disorder in the general population is about 8%, with a 2:1 prevalence of the disorder in women (10%) compared with men (5%; Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995). Although a range of traumatic stressors may cause PTSD, the genesis of most PTSD cases are man-made traumas (Norris, 1992), portending the inherently interpersonal phenomenology and consequences of the disorder. Nonetheless, there have been limited efforts to understand PTSD through an interpersonal lens, despite compelling evidence establishing an association between PTSD and relationship problems. In this chapter, we describe PTSD and its manifestation in adult close relationships, review the empirical literature documenting an association between PTSD and close relationship problems, discuss theoretical constructs and models explaining the association, present various interpersonally oriented PTSD treatment efforts, and consider future directions for research.

Traumatic Stress and Affect Management in Military Families

“…The emotional numbing or withdrawal mixed with unpredictable outbursts of hostility or aggression may result in family members feeling lonely and abandoned by the veteran (Renshaw et al, 2011). Partners reported decreased relationship satisfaction due to avoidance of previously enjoyed activities with the veteran family member and accommodations made for that person (Monson, Fredman, & Dekel, 2010). Social avoidance contributes to the maintenance of PTSD symptoms as post-deployment social support is a known factor in resiliency and recovery from PTSD (Kulka et al, 1990;Pietrzak et al, 2010).…”

“…Accommodating is also referred to as colluding or enabling and occurs when family members alter their behaviors to not upset the veteran, even if it is not in the best interest of the veteran or the family. Social workers intervening with a family system impacted by PTSD need to pay careful attention to the accommodations that family members make for trauma-related symptoms for the comfort of the veteran (Monson, Fredman, & Dekel, 2010). Many family members will avoid confrontations about PTSD-driven negative behaviors to prevent aggressive outbursts or emotional numbing reactions from the veteran.…”

A Preliminary Experimental Examination of the Effect of Emotion Dysregulation and Impulsivity on Risky Behaviors Among Women With Sexual Assault–Related Posttraumatic Stress Disorder

“…Indeed, a burgeoning literature highlights the robust relationship between PTSD and risky behaviors. For example, individuals with PTSD have been found to be at heightened risk for alcohol and drug use (Epstein, Saunders, Kilpatrick, & Resnick, 1998; Shipherd, Stafford, & Tanner, 2005), antisocial and/or aggressive behavior (Booth-Kewley, Larson, High-McRoy, Garland, & Gaskin, 2010; Monson, Fredman, & Dekel, 2010), binge eating and purging (Holzer, Uppala, Wonderlich, Crosby, & Simonich, 2008), deliberate self-harm (Gratz & Tull, 2012), and risky sexual behavior (Weiss, Tull, Borne, & Gratz, 2013), as well as negative outcomes associated with these behaviors, including revictimization (e.g., Messman-Moore, Ward, & Brown, 2009) and HIV (Hoff, Beam-Goulet, & Rosenheck, 1997). Notably, however, few studies have examined mechanisms that may underlie engagement in risky behaviors among individuals with PTSD.…”

Examining the Evidence for Complex Posttraumatic Stress Disorder as a Clinical Diagnosis

“…Evidence suggests that the samples that make up PTSD treatment trials might already include individuals who have been described as having C-PTSD (e.g., Chard, 2005;Resick et al, 2008;Resick et al, 2003). Finally, how PTSD is related to interpersonal functioning is an essential area of future research, as interpersonal difficulties are very common in individuals with PTSD and not solely in individuals with C-PTSD, and has been relatively underinvestigated to date in comparison with individual outcomes (Cloitre, Miranda, Stovall-McClough, & Han, 2005;Monson, Fredman, & Dekel, 2010).…”