Dataset Information

Between- and within-subject associations of PTSD symptom clusters and marital functioning in military couples.

ABSTRACT: Using data from 570 male service members and their wives, the current study investigated over-time associations between male service members' self-report of posttraumatic stress disorder (PTSD) symptoms and marital functioning (marital satisfaction, positive bonding, conflict behavior) as perceived by both spouses. Analyses spanned 5 time points over a 2-year period and fully disentangled between- and within-subject effects. Higher levels of all four PTSD symptom clusters (numbing, hyperarousal, effortful avoidance, and reexperiencing) showed significant between-subject associations with lower levels of marital satisfaction and positive bonding, and higher levels of conflict for both men and women, whereas there were markedly fewer significant within-subject associations. When running models with all four PTSD symptom clusters entered at once, the primary between-subject finding was that men with higher numbing symptoms overall reported poorer marital functioning in all domains; there were no significant between-subject links between numbing and marital functioning for women. In contrast, within-subject effects for numbing were found for both men and women, linking increased numbing with decreased positive bonding and increased conflict behavior over time; women also had lower marital satisfaction when their husbands reported relatively higher numbing. Between-subject analyses also revealed that for men with higher average levels of effortful avoidance, wives reported lower levels of satisfaction and positive bonding, whereas men themselves reported less frequent conflict behavior. Finally, within-subject effects showed that at times when men reported increased hyperarousal, they also perceived increased marital conflict, whereas women surprisingly reported increased marital satisfaction. Implications of divergent between- and within-subject results are discussed. (PsycINFO Database Record

SUBMITTER: Allen E

PROVIDER: S-EPMC5858587 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Between- and within-subject associations of PTSD symptom clusters and marital functioning in military couples.

Allen Elizabeth E Knopp Kayla K Rhoades Galena G Stanley Scott S Markman Howard H

Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43) 20180201 1

Using data from 570 male service members and their wives, the current study investigated over-time associations between male service members' self-report of posttraumatic stress disorder (PTSD) symptoms and marital functioning (marital satisfaction, positive bonding, conflict behavior) as perceived by both spouses. Analyses spanned 5 time points over a 2-year period and fully disentangled between- and within-subject effects. Higher levels of all four PTSD symptom clusters (numbing, hyperarousal, ...[more]

PMID: 29543488

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Project description:BACKGROUND:Symptom management in glioma patients remains challenging, as patients suffer from various concurrently occurring symptoms. This study aimed to identify symptom clusters and examine the association between these symptom clusters and patients' functioning. METHODS:Data of the CODAGLIO project was used, including individual patient data from previously published international randomized controlled trials (RCTs) in glioma patients. Symptom prevalence and level of functioning were assessed with European Organisation for Research and Treatment of Cancer (EORTC) quality of life QLQ-C30 and QLQ-BN20 self-report questionnaires. Associations between symptoms were examined with Spearman correlation coefficients and partial correlation networks. Hierarchical cluster analyses were performed to identify symptom clusters. Multivariable regression analyses were performed to determine independent associations between the symptom clusters and functioning, adjusted for possible confounders. RESULTS:Included in the analysis were 4307 newly diagnosed glioma patients from 11 RCTs who completed the EORTC questionnaires before randomization. Many patients (44%) suffered from 5-10 symptoms simultaneously. Four symptom clusters were identified: a motor cluster, a fatigue cluster, a pain cluster, and a gastrointestinal/seizures/bladder control cluster. Having symptoms in the motor cluster was associated with decreased (≥10 points difference) physical, role, and social functioning (betas ranged from -11.3 to -15.9, all P < 0.001), independent of other factors. Similarly, having symptoms in the fatigue cluster was found to negatively influence role functioning (beta of -12.3, P < 0.001), independent of other factors. CONCLUSIONS:Two symptom clusters, the fatigue and motor cluster, were frequently affected in glioma patients and were found to independently have a negative association with certain aspects of patients' functioning as measured with a self-report questionnaire.

Project description:Structural neuroimaging studies of posttraumatic stress disorder (PTSD) have typically reported reduced cortical thickness (CT) and gray matter volume (GMV) in subcortical structures and networks involved in memory retrieval, emotional processing and regulation, and fear acquisition and extinction. Although PTSD is more common in women, and interpersonal violence (IPV) exposure is a more potent risk factor for developing PTSD relative to other forms of trauma, most of the existing literature examined combat-exposed men with PTSD. Vertex-wise CT and subcortical GMV analyses were conducted to examine potential differences in a large, well-characterized sample of women with PTSD stemming from IPV-exposure (n = 99) compared to healthy trauma-free women without a diagnosis of PTSD (n = 22). Subgroup analyses were also conducted to determine whether symptom severity within specific PTSD symptom clusters (e.g., re-experiencing, active avoidance, hyperarousal) predict CT and GMV after controlling for comorbid depression and anxiety. Results indicated that a diagnosis of PTSD in women with IPV-exposure did not significantly predict differences in CT across the cortex or GMV in the amygdala or hippocampus compared to healthy controls. However, within the PTSD group, greater re-experiencing symptom severity was associated with decreased CT in the left inferior and middle temporal gyrus, and decreased CT in the right parahippocampal and medial temporal gyrus. In contrast, greater active avoidance symptom severity was associated with greater CT in the left lateral fissure, postcentral gyrus, and middle/lateral occipital cortex, and greater CT in the right paracentral, posterior cingulate, and superior occipital gyrus. In terms of GMV, greater hyperarousal symptom severity was associated with reduced left amygdala GMV, while greater active avoidance symptom severity was associated with greater right amygdala GMV. These findings suggest that structural brain alterations among women with IPV-related PTSD may be driven by symptom severity within specific symptom clusters and that PTSD symptom clusters may have a differential (increased or decreased) association with brain structures.

Dataset Information

Between- and within-subject associations of PTSD symptom clusters and marital functioning in military couples.

Publications

Between- and within-subject associations of PTSD symptom clusters and marital functioning in military couples.

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