Laura E. Watkins

Posttraumatic stress disorder and intimate relationship problems: a meta-analysis.

OBJECTIVE The authors conducted a meta-analysis of empirical studies investigating associations between indices of posttraumatic stress disorder (PTSD) and intimate relationship problems to empirically synthesize this literature. METHOD A literature search using PsycINFO, Medline, Published International Literature on Traumatic Stress (PILOTS), and Dissertation Abstracts was performed. The authors identified 31 studies meeting inclusion criteria. RESULTS True score correlations (ρ) revealed medium-sized associations between PTSD and intimate relationship discord (ρ = .38, N = 7,973, K = 21), intimate relationship physical aggression perpetration (ρ = .42, N = 4,630, K = 19), and intimate relationship psychological aggression perpetration (ρ = .36, N = 1,501, K = 10). The strength of the association between PTSD and relationship discord was higher in military (vs. civilian) samples, and when the study was conducted in the United States (vs. other country), and the study represented a doctoral dissertation (vs. published article). The strength of the association between PTSD and physical aggression was higher in military (vs. civilian) samples, males (vs. females), community (vs. clinical) samples, studies examining PTSD symptom severity (vs. diagnosis), when the physical aggression measure focused exclusively on severe violence (vs. a more inclusive measure), and the study was published (vs. dissertation). For the PTSD-psychological aggression association, 98% of the variance was accounted for by methodological artifacts such as sampling and measurement error; consequently, no moderators were examined in this relationship. CONCLUSIONS Findings highlight a need for the examination of models explaining the relationship difficulties associated with PTSD symptomatology and interventions designed to treat problems in both areas.

Intimate Partner and General Aggression Perpetration Among Combat Veterans Presenting to a Posttraumatic Stress Disorder Clinic

This study examined rates and correlates of intimate partner and general aggression perpetration among 236 male combat veterans seeking services in a Veterans Affairs posttraumatic stress disorder (PTSD) clinic. Approximately 33% of those in an intimate relationship reported perpetrating partner physical aggression in the previous year, and 91% reported partner psychological aggression. Comparable rates were found for general aggression perpetration among partnered and nonpartnered veterans. PTSD symptoms as well as symptoms of depression were associated with aggression across subgroups and forms of aggression, and PTSD symptoms reflecting arousal and lack of control were generally the strongest predictor of aggression. Findings indicate a need for additional aggression screening and intervention development for this population, and highlight the targeting of heightened arousal and lack of behavioral control in aggression interventions.

An Investigation of Posttraumatic Stress Disorder and Depressive Symptomatology among Female Victimsof Interpersonal Trauma

This study examined factors associated with PTSD-depression comorbidity among a sample of 162 adult female rape or assault victims with PTSD, as well as potential differential predictors of PTSD and depression severity. PTSD-only participants reported higher levels of childhood sexual abuse than those with comorbid PTSD and depression, and the PTSD/MDD group reported relatively more distorted trauma-related beliefs, dissociation, PTSD severity, and depression severity. Distorted trauma-related beliefs and dissociation were the strongest unique predictors of higher PTSD and depressive symptoms. Rates of PTSD and depression comorbidity did not appear to be a function of symptom overlap. Study findings suggest possible explanations for the high PTSD and depression comorbidity rates commonly found among victims of interpersonal violence.

Associations Between PTSD Symptoms and Parenting Satisfaction in a Female Veteran Sample

ABSTRACT The goal of this brief article is to examine the relationships between the posttraumatic stress disorder (PTSD) symptom clusters and parenting satisfaction in a sample of 60 female veterans of the Vietnam war who had biological children. Significant negative relationships were found between the avoidance/numbing and hyperarousal clusters of PTSD symptoms and parenting satisfaction. The association between hyperarousal and parenting satisfaction remained significant when each of the PTSD symptom clusters were examined together as predictors, and controlling for partner violence. Results suggest that higher levels of certain PTSD symptoms may adversely affect womens satisfaction in the parenting role.

Posttraumatic Stress Disorder Symptoms, Relationship Adjustment, and Relationship Aggression in a Sample of Female Flood Victims

This study tested a model examining the interrelationships among posttraumatic stress disorder (PTSD) symptoms, intimate relationship adjustment, and intimate relationship aggression in a sample of 205 adult female flood victims. At the bivariate level, higher PTSD symptoms were associated with higher physical and psychological aggression victimization, poorer relationship adjustment, and higher physical and psychological aggression perpetration. Results from structural equation modeling (SEM) analyses indicated that relationship aggression victimization influenced aggression perpetration directly, and in the case of physical aggression, indirectly through its relationship with PTSD symptoms and relationship adjustment. The influence of PTSD symptoms on physical aggression perpetration was fully explained by poorer relationship adjustment. These findings extend prior work from other traumatized populations documenting associations between variables reflecting PTSD symptomatology and indices of relationship functioning, and indicate a need for further investigation in this area of inquiry.

Hazardous Alcohol Use and Intimate Partner Aggression Among Dating Couples: The Role of Impulse Control Difficulties

To date, research identifying moderators of the alcohol-intimate partner aggression (IPA) relationship has focused almost exclusively on male-perpetrated aggression, without accounting for the dyadic processes of IPA. The current study examined hazardous alcohol use and impulse control difficulties as predictors of IPA among a sample of 73 heterosexual dating couples. Both actor and partner effects of these risk factors on physical and psychological aggression were examined. Results indicated that impulse control difficulties were an important actor and partner predictor of both physical and psychological aggression. Findings supported the multiple threshold model such that the interaction between impulse control difficulties and hazardous alcohol use significantly predicted physical aggression severity. These results suggest the importance of targeting impulse control difficulties and hazardous alcohol use in IPA treatment, as well as the advantages of examining risk factors of IPA within a dyadic rather than individual framework.

The Interplay of Trait Anger, Childhood Physical Abuse, and Alcohol Consumption in Predicting Intimate Partner Aggression

The current study examined three well-established risk factors for intimate partner aggression (IPA) within Finkel and Eckhardt’s I3 model, including two impellance factors—trait anger and childhood physical abuse history—and the disinhibiting factor of alcohol consumption. Participants were 236 male and female college students in a committed heterosexual dating relationship who completed a battery of self-report measures assessing childhood physical abuse, trait anger, alcohol consumption, and IPA perpetration. Results revealed a significant three-way interaction showing that as the disinhibition factor alcohol consumption increased, the interaction of the two impelling factors, trait anger and childhood physical abuse, became increasingly more positive. Individuals who had high levels of childhood physical abuse and alcohol consumption were at greater risk of IPA perpetration when trait anger was high. Consistent with the I3 model, these findings suggest that trait anger and a history of childhood physical abuse may increase tendencies to aggress against one’s partner, whereas alcohol consumption may reduce individuals’ abilities to manage these aggressive tendencies. The importance of interplay among these risk factors in elevating IPA risk is discussed, as are the implications for clinicians working with male and female IPA perpetrators.

The Longitudinal Impact of Intimate Partner Aggression and Relationship Status on Women’s Physical Health and Depression Symptoms

Intimate partner aggression (IPA) has many detrimental effects, particularly among young women. The present study examined the longitudinal effects of IPA victimization and relationship status on physical health and depression symptoms in a sample of 375 community women between the ages of 18 and 25 years. All variables were assessed at 4 occasions over a 12-month period (i.e., 1 assessment every 4 months). Multilevel modeling revealed that IPA victimization had both between- and within-person effects on womens health outcomes, and relationship status had within-person effects when women did not report current IPA. Although IPA was generally related to greater physical health problems and depression symptoms, these findings varied depending on both the type of aggression experienced (i.e., psychological vs. physical) and relationship status (i.e., whether participants were in the same relationship or a new relationship). Findings suggest that IPA can be harmful to both physical and mental health, particularly among young women who stay in abusive relationships. Results highlight the importance of developing effective IPA intervention programs and providing help and resources to women who are experiencing physical or psychological IPA in their relationships.

Negative urgency and emotion regulation strategy use: associations with displaced aggression

The numerous public health consequences of interpersonal aggression highlight the necessity of a comprehensive understanding of factors influencing its perpetration. This study examined direct and interactive associations between negative urgency and emotion regulation strategy use in predicting displaced aggression under conditions of negative mood. Participants were 197 male and female undergraduate students who were randomly assigned to employ either cognitive reappraisal or expressive suppression in response to a negative mood induction. Immediately afterwards, participants engaged in an analog displaced aggression task. Results revealed direct, positive associations between negative urgency and aggression. In addition, the use of suppression was associated with greater aggression than was the use of reappraisal alone. Counter to the hypothesis, there were no interactive effects between negative urgency and emotion regulation strategy use in predicting aggression. Findings suggest reducing negative urgency and use of suppression as potential intervention targets for individuals who engage in aggressive behavior.

Predictors of Child Behavior Problems among Children of Female Vietnam Veterans

This study examined the impacts of intimate partner aggression by female Vietnam veterans and their male partners on their children’s behavior problems (N = 100 children). Veteran and partner psychological distress were also examined as potential mediators of these relationships. Results indicated that physical and psychological aggression perpetration by both the female veteran and the male partner was associated with child behavior problems. Contrary to expectations, psychological distress in the veteran and partner was not associated with child behavior problems and did not mediate the effects of physical and psychological aggression on this outcome.