Sarah B. Campbell

The Role of Personality Traits and Profiles in Posttrauma Comorbidity

Many service members experience symptoms of posttraumatic stress disorder (PTSD) after deployment. PTSD can vary widely in its presentation and associated features, such as comorbid conditions. Research has shown that veterans with PTSD and an internalizing personality profile are more likely to experience internalizing comorbidity (e.g., anxiety, depression), whereas veterans with PTSD and an externalizing personality profile are more likely to experience externalizing comorbidity (e.g., substance abuse, aggression). To date, however, this research has been limited by a focus on diagnosable disorders and personality categories. In a nonclinical sample of 224 National Guard/Reserve service members who had served since 2001, we explored whether personality traits (measured continuously) moderated associations of PTSD symptom severity with the severity of internalizing (depression, anxiety) and externalizing (alcohol abuse, aggression) symptoms. Results showed that the association of PTSD with anxiety was stronger when extraversion was lower (corresponding to an internalizing personality profile). Moreover, the association of PTSD with alcohol abuse was stronger when extraversion was high and conscientiousness was low (corresponding to an externalizing personality profile). Surprisingly, this association was also stronger when extraversion was low and conscientiousness was high. Results offer additional insights into prior research on personality and comorbidity.

Military Couples and Posttraumatic Stress: Interpersonally Based Behaviors and Cognitions as Mechanisms of Individual and Couple Distress

Substantial research indicates that spouses and romantic partners of veterans who have been diagnosed with combat-related posttraumatic stress disorder (PTSD) experience significant amounts of both psychological and relationship distress. Although research has made great strides in understanding the mechanisms of trauma-related distress in veterans, knowledge about the mechanisms of distress experienced by veterans’ spouses and romantic partners is more limited. Given the high numbers of troops returning from combat in Iraq and Afghanistan in the past decade with symptoms of PTSD and the important role spouses/partners play in supporting traumatized troops, more information about the mechanisms of distress in spouses/partners is needed to enhance treatments intended to aid both members of the couple. This chapter provides an updated overview of research studies concerning mechanisms of distress in spouses and partners of veterans traumatized by combat, specifically as they relate to a cognitive-behavioral interpersonal framework. In addition, we provide recommendations for future areas of research based on current findings and gaps in the literature.

Posttraumatic stress disorder and relationship functioning: A comprehensive review and organizational framework

Posttraumatic stress disorder (PTSD) is associated with impairments in relationship functioning. Beyond the abundance of research that has demonstrated this basic link, more recent research has begun to explore possible mediators and moderators of this association. The present paper reviews and synthesizes existing literature in the context of an overarching organizational framework of potential ways in which PTSD impacts relationship functioning. The framework organizes findings in terms of specific elements of PTSD and comorbid conditions, mediators (factors that are posited to explain or account for the association), and moderators (factors that are posited to alter the strength of the association). Specific symptoms of PTSD, comorbid symptoms, and many of the potential mediators explored have extensive overlap, raising questions of possible tautology and redundancy in findings. Some findings suggest that non-specific symptoms, such as depression or anger, account for more variance in relationship impairments than trauma-specific symptoms, such as re-experiencing. Moderators, which are characterized as individual, relational, or environmental in nature, have been the subject of far less research in comparison to other factors. Recommendations for future research and clinical implications of the findings reviewed are also presented.

Sex Differences in Associations of Hostile and Non-hostile Criticism with Relationship Quality

ABSTRACT Three studies examine whether the type of criticism (hostile vs. non-hostile) or the sex of the person perceiving criticism affect the association of criticism with relationship satisfaction. Analyses of the samples of undergraduates (Studies 1 and 2) and community couples (Study 3) indicated that hostile criticism was negatively associated with relationship functioning, whereas non-hostile criticism was positively associated with relationship functioning. The former association was stronger for women than for men (Studies 2 and 3), while the latter association was stronger for men than for women (Study 1). The results also suggest that hostile criticism may be more strongly associated with negative relationship processes in women than men, whereas non-hostile criticism may be more strongly associated with positive relationship processes for men than women.

The Role of Patient Characteristics in the Concordance of Daily and Retrospective Reports of PTSD

Research has documented discrepancies between daily and retrospective reports of psychological symptoms in a variety of conditions. A limited number of studies have assessed these discrepancies in samples of individuals with posttraumatic stress disorder (PTSD), with even less research addressing potential covariates that may influence such discrepancies. In the current study, 65 individuals with co-occurring PTSD and alcohol use disorder (AUD) completed daily assessments of their PTSD symptoms for 1 month, followed by a standard retrospective report of PTSD over the same month. Initial analyses explored the mean levels of daily and retrospective PTSD symptoms, while multilevel models assessed the level of agreement between daily and retrospective reports and the role of demographic variables and comorbid psychopathology (e.g., depression) or substance use (e.g., alcohol use) in moderating the association of daily and retrospective reports. Results showed that retrospective reports of arousal and avoidance symptoms were weakly related to daily reports of these symptoms, while reports of reexperiencing and numbing symptoms showed better agreement. Intra-individual alcohol consumption also moderated associations of reexperiencing and avoidance symptoms, such that on days individuals drank more, their daily reports resembled their retrospective reports less well. Future research should explore the degree to which these results generalize to nondually diagnosed samples, as well as the role such reporting discrepancies may play in PTSD treatment.