Longitudinal Associations in the Direction and Prediction of PTSD Symptoms and Romantic Relationship Impairment Over One Year in Post 9/11 Veterans: A Comparison of Theories and Exploration of Potential Gender Differences

Posttraumatic stress disorder (PTSD) is prevalent among combat veterans and is associated with intimate relationship difficulties. Few studies have examined the prospective longitudinal course of associations between PTSD and relationship difficulties and whether there are gender differences. In a sample comprised of 202 male and female post 9/11 veterans, this study examined gender differences in the association between PTSD symptoms measured 4 times over the course of 1 year and romantic relationship role impairment measured at the beginning and end of that year, accounting for the association of combat stress and noncombat stressful life events. Increases in PTSD symptoms over time were positively associated with increased relationship impairment; however, relationship impairment was not associated with changes in PTSD over time. Gender did not significantly moderate this relationship. However, allowing model parameters to vary between genders revealed that noncombat life stress was associated with changes in PTSD over time for women, but not men. Conversely, only men exhibited associations of baseline levels of combat stress and noncombat stress with baseline relationship functioning, and between baseline relationship functioning and baseline PTSD symptoms. Findings suggest women veterans in particular may benefit from clinical attention to the influence of general stress on PTSD symptoms, while clinical work to improve couple impairment in the context of PTSD symptoms may be beneficial for veterans of both genders.