Publication year
2014
Citation Title
Partners' attributions for service members' symptoms of combat-related posttraumatic stress disorder.
Journal Name
Behavior Therapy
Journal Volume
45
Issue Number
2
Page Numbers
187-198
DOI
10.1016/j.beth.2013.10.005
Summary
Civilian wives married to U.S. Army Active Duty husbands completed questionnaires to explore the impact of attributions of their spouses' posttraumatic stress disorder (PTSD) symptoms and combat exposure on marital satisfaction. Symptom attributions were associated with marital satisfaction even when controlling for PTSD symptoms; external attributions were associated with more marital satisfaction and internal attributions with less marital satisfaction.
Key Findings
Spouses' attributions for their husbands' symptoms were associated with marital satisfaction, even when controlling for husbands' PTSD symptoms. Specifically, external attributions were associated with more marital satisfaction and internal attributions with less marital satisfaction.
Internal attributions of husbands' PTSD symptoms moderated the association between PTSD symptoms and marital satisfaction, such that the association became stronger as wives tended to make more internal attributions.
Wives' perceptions of more re-experiencing symptoms were associated with more external internal attributions. Wives' perceptions of more emotional numbing symptoms were associated with more internal attributions.
Wives' perceptions of higher levels of combat exposure were associated with a greater tendency to make external attributions for Service members' PTSD symptoms.
Implications for Program Leaders
Disseminate information regarding how external events might contribute to PTSD symptoms
Offer workshops to military couples who are managing combat related PTSD regarding how symptoms can influence relationship functioning
Provide couple support groups that allow Service members to share the totality of their PTSD symptoms to help attenuate the internal attributions their spouses may make
Implications for Policy Makers
Continued support for programs aimed at PTSD psychoeducation, particularly for significant others
Continue to develop and evaluate interventions aimed at decreasing internal attributions and increasing external attributions for Service members' PTSD symptoms
Encourage collaboration between DoD and community-based programs that work with military couples coping with mental health issues, such as PTSD
Methods
Wives of couples from a previous randomized clinical trial of a 14-hour marriage education intervention and two day workshop participated.
They completed baseline and two year follow-up measures of spousal perceptions of PTSD and combat exposure, marital satisfaction, internal and external attributions of their spouse's behavior, and demographics.
Only survey responses from the two year follow-up assessment were utilized for the current study.
Participants
Participants included 483 civilian wives of Active Duty U.S. Army husbands.
The majority of participants were White (71%) and had a mean age of 30.80 years (SD = 6.12).
For 52% of the sample, their highest degree was a high school diploma or GED.
Limitations
The portion of the sample that completed the follow-up questionnaire had high levels of marital satisfaction at baseline, and all were willing to participate in a marriage education seminar; results may be biased.
The variables measured accounted for only a small portion of the variance in the outcomes; additional unmeasured factors are likely implicated.
These results may not generalize beyond U.S. Army Active Duty husbands and civilian wives who participated in marriage enrichment programs.
Avenues for Future Research
Assess pre-combat couple functioning measures and use a longitudinal design to address these questions more thoroughly
Replicate the current study with different samples of military couples
Continue to examine the effectiveness of marriage interventions with military couples
Focus
Army
Target Population
Population Focus
Military Branch
Military Component
Abstract
The association of service members' combat-related PTSD with partners' distress is weaker when spouses/partners believe that service members experienced more traumatic events during deployment. Also, when simultaneously examining partners' perceptions of all PTSD symptoms, perceptions of reexperiencing symptoms (the symptoms most obviously connected to traumatic events) are significantly negatively related to distress in partners. These findings are consistent with the notion that partners may be less distressed if they make external, rather than internal, attributions for service members' symptoms. The present study explicitly tests this possibility. Civilian wives of active duty service members completed measures regarding their own marital satisfaction, their perceptions of service members' combat exposure during deployments, their perceptions of service members' symptoms of PTSD, and their attributions for those symptoms. External attributions were significantly positively associated with perceptions of combat exposure (rp = .31) and reexperiencing symptoms (β = = .33) and significantly Negatively associated with perceptions of numbing/withdrawal symptoms (rp = -.22). In contrast, internal attributions were significantly negatively associated with perceptions of reexperiencing symptoms (β = -.18) and significantly positively associated with perceptions of numbing/ withdrawal symptoms (β = .46). Internal attributions significantly moderated the negative association of PTSD symptoms with marital satisfaction, such that the association strengthened as internal attributions increased. These findings are the first explicit support for an attributional understanding of distress in partners of combat veterans. Interventions that alter partners' attributions may improve marital functioning.
Abstract Document
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