National Center for PTSD at VA Boston Healthcare System, Boston, MA 02130, USA.
J Trauma Stress. 2013 Jun;26(3):329-37. doi: 10.1002/jts.21805. Epub 2013 May 1.
This study used structural equation modeling to evaluate a mediation model of the relationship between trauma exposure, posttraumatic stress disorder (PTSD) symptoms, and perpetration of intimate partner physical and psychological aggression in trauma-exposed veterans and their cohabitating spouses (n = 286 couples; 88% male veteran and female spouse, 80.8% White, non-Hispanic). Dyadic data analyses were used to simultaneously evaluate actor and partner effects using the actor-partner interdependence model (Kashy & Kenny, 2000). The primary hypothesis was that PTSD would mediate the association between trauma exposure and intimate partner physical and psychological aggression with these effects evident both within and across members of a couple (i.e., actor and partner effects). The best-fitting model included (a) equivalent actor and partner direct effects of trauma on veterans' acts of psychological aggression (β = .17 to .20, p = .001), and (b) equivalent actor and partner indirect effects via PTSD on veterans' acts of physical aggression (β = .08 to .10, p < .001). There were no direct or indirect effects predicting the spouses' aggression. Results suggest it is important to consider the trauma histories and possible presence of PTSD in both partners as this may be a point of intervention when treating distressed couples.
本研究采用结构方程模型评估创伤暴露、创伤后应激障碍（PTSD）症状与创伤暴露退伍军人及其同居配偶（共 286 对夫妇，88%为男性退伍军人和女性配偶，80.8%为白人，非西班牙裔）实施亲密伴侣身体和心理攻击之间关系的中介模型。使用演员-伙伴相互依存模型（Kashy & Kenny, 2000）对二元数据进行分析，同时评估演员和伙伴的影响。主要假设是 PTSD 将中介创伤暴露与亲密伴侣身体和心理攻击之间的关联，这些影响在夫妻双方成员内部和之间都明显存在（即演员和伙伴影响）。拟合最好的模型包括：（a）创伤对退伍军人心理攻击行为的演员和伙伴直接影响相当（β=.17 至.20，p =.001）；（b）通过 PTSD 对退伍军人身体攻击行为的演员和伙伴间接影响相当（β=.08 至.10，p <.001）。没有直接或间接影响预测配偶的攻击行为。研究结果表明，当治疗有困扰的夫妻时，考虑双方的创伤史和可能存在的 PTSD 非常重要，因为这可能是干预的一个切入点。
