Grubbs Kathleen M, Knopp Kayla C, Khalifian Chandra E, Wrape Elizabeth R, Mackintosh Margaret-Anne, Sohn Min Ji, Macdonald Alexandra, Morland Leslie A
Department of Veterans Affairs, VA San Diego Healthcare System, San Diego, California, USA.
Department of Psychiatry, University of California, San Diego, California, USA.
Fam Process. 2025 Mar;64(1):e13041. doi: 10.1111/famp.13041. Epub 2024 Oct 1.
Veteran and intimate partner perceptions of posttraumatic stress disorder (PTSD) may differ, and little is known about how agreement or disagreement on symptom severity is related to relationship satisfaction. Veterans and their partners (N = 199 couples) completed a baseline assessment for a clinical trial evaluating two couple-based PTSD interventions. Veterans completed the PTSD Checklist for DSM-5 (PCL-5). Partners completed the collateral PCL-5 (PCL-5-C), which asked them to rate the severity of the veteran's PTSD symptoms. Both partner and veteran completed the Couples Satisfaction Index (CSI-32). Intraclass correlations (ICC) assessed agreement between PCL-5 and PCL-5-C total and subscale scores, which was low for total PCL and for all subscales (ICC = 0.15-0.46). Actor-Partner Interdependence Models (APIMs; actor-only pattern) tested associations between relationship satisfaction and PTSD symptom severity (total PCL and subscales), and the magnitude and direction of difference between PCL-5 and PCL-5-C (total and subscales). For veterans, more severe total PTSD and negative cognition/mood scores were associated with lower relationship satisfaction, and the direction of discrepancy for negative cognition/mood (i.e., higher veteran-rated PTSD symptoms relative to partner's collateral report) was also associated with lower satisfaction. For partners, more severe collateral-reported symptoms for total PTSD and all four subscales were associated with lower relationship satisfaction; further, a larger discrepancy between veterans' and partners' reports of total PTSD, negative cognition/mood, and hyperarousal were associated with lower satisfaction. These results suggest that partners may have different perceptions of PTSD symptoms, and support the potential of fostering a shared understanding of PTSD symptom severity in couples.
退伍军人和亲密伴侣对创伤后应激障碍（PTSD）的认知可能存在差异，而对于症状严重程度的一致或不一致与关系满意度之间的关联却知之甚少。退伍军人及其伴侣（N = 199对夫妻）完成了一项临床试验的基线评估，该试验评估了两种基于夫妻的PTSD干预措施。退伍军人完成了《精神疾病诊断与统计手册》第5版创伤后应激障碍检查表（PCL-5）。伴侣们完成了附带的PCL-5（PCL-5-C），该表要求他们对退伍军人的PTSD症状严重程度进行评分。伴侣和退伍军人都完成了夫妻满意度指数（CSI-32）。组内相关性（ICC）评估了PCL-5和PCL-5-C总分及分量表得分之间的一致性，PCL总分和所有分量表的一致性都很低（ICC = 0.15 - 0.46）。行为者-伴侣相互依赖模型（APIMs；仅行为者模式）测试了关系满意度与PTSD症状严重程度（PCL总分和分量表）之间的关联，以及PCL-5和PCL-5-C（总分和分量表）之间差异的大小和方向。对于退伍军人来说，PTSD总症状和消极认知/情绪得分越严重，关系满意度越低，消极认知/情绪方面的差异方向（即退伍军人自评的PTSD症状相对于伴侣附带报告更高）也与较低的满意度相关。对于伴侣来说，PTSD总症状和所有四个分量表的附带报告症状越严重，关系满意度越低；此外，退伍军人和伴侣在PTSD总症状、消极认知/情绪和过度警觉方面的报告差异越大，满意度越低。这些结果表明，伴侣对PTSD症状可能有不同的认知，并支持在夫妻中培养对PTSD症状严重程度的共同理解的潜力。
