Veterans Affairs San Diego Healthcare System, San Diego, California, USA.
Department of Psychiatry, University of California, San Diego, La Jolla, California, USA.
Fam Process. 2023 Dec;62(4):1725-1739. doi: 10.1111/famp.12835. Epub 2022 Nov 8.
Insomnia contributes to individual mental and physical health and relationship well-being. Veterans' PTSD symptoms are associated with their own insomnia. However, research has not explored whether and how veterans' PTSD symptoms are associated with their partners' insomnia. The present study examined the association between veterans' PTSD symptom severity and veterans' and partners' insomnia. Veterans (n = 192) and their partners (n = 192; total N = 384) completed baseline assessments in a PTSD treatment study for veterans with PTSD and their partners. Path analysis was used to examine the relation between veterans' PTSD symptom severity, as measured by the PTSD symptom checklist-5 (PCL-5) and veterans' and partners' insomnia, as measured by the Insomnia Severity Index (ISI). Veterans' full-scale PCL-5 was positively related to veterans' and partners' insomnia. For veterans, intrusion and arousal symptoms were positively related to their own insomnia severity, while veterans' negative alterations in cognition and mood were associated with partners' insomnia severity. In exploratory analyses, partners' depressive symptoms fully mediated the relation between veterans' negative cognitions and mood and partners' insomnia. PTSD symptoms impact both veterans' and partners' insomnia. However, different PTSD symptom clusters were related to insomnia for each partner, and the link for partners was explained by their own depression symptoms. PTSD, insomnia, and integrated treatments should consider strategies for including partners in treatment to address these interconnected problems.
失眠会影响个人的身心健康和人际关系的幸福。退伍军人的 PTSD 症状与其自身的失眠有关。然而，目前的研究尚未探讨退伍军人的 PTSD 症状是否以及如何与其伴侣的失眠有关。本研究考察了退伍军人 PTSD 症状严重程度与退伍军人及其伴侣失眠之间的关系。192 名退伍军人及其 192 名伴侣（总计 384 人）在一项 PTSD 治疗研究中完成了 PTSD 治疗研究的基线评估。路径分析用于检验 PTSD 症状检查表-5（PCL-5）衡量的退伍军人 PTSD 症状严重程度与失眠严重程度指数（ISI）衡量的退伍军人和伴侣失眠之间的关系。退伍军人的 PCL-5 总分与退伍军人和伴侣的失眠呈正相关。对于退伍军人来说，侵入和觉醒症状与他们自己的失眠严重程度呈正相关，而退伍军人的认知和情绪负性改变与伴侣的失眠严重程度有关。在探索性分析中，伴侣的抑郁症状完全介导了退伍军人的负性认知和情绪与伴侣失眠之间的关系。PTSD 症状会影响退伍军人及其伴侣的失眠。然而，对于每个伴侣来说，不同的 PTSD 症状群与失眠有关，而伴侣的联系则可以用他们自己的抑郁症状来解释。PTSD、失眠和综合治疗应考虑将伴侣纳入治疗的策略，以解决这些相互关联的问题。
