Partner accommodation of PTSD symptoms involves modifying one’s behavior in response to the PTSD symptoms of a loved one. Examples include avoiding triggering situations, taking on extra responsibilities, or not expressing one’s own feelings.
While often well-intentioned, accommodation can inadvertently maintain PTSD symptoms and cause distress for both partners. Studying accommodation from both partners’ perspectives can provide insights for prevention, assessment, and couples-based PTSD interventions.
A wife supports a sad military husband who has health problems after returning home from the war.
Key Points
Rationale
However, little is known about how the trauma survivors themselves perceive the frequency and impact of their partners’ accommodative behaviors compared to partner reports.
Obtaining reports from both members of the couple can provide insight into how accommodation manifests and is experienced in military couples following deployment, even in a nonclinical sample.
Method
The study used across-sectionalsurvey design.
Male Army SMs and their female partners completed measures of perceived frequency of the female partner’s accommodation to the male SM’s PTSD symptoms and distress related to the accommodation.
They also completed measures of PTSD symptoms, depression, hostility, and relationship satisfaction.
Procedure
Army couples consisting of a recently deployed male SM and a civilian female partner were recruited online.
259 couples with complete data were included. Both partners completed an online survey containing the study measures.
Sample
Participants were 259 male Army SMs and their female civilian partners. SMs were an average age of 31 and partners 30. 98% were married. 80% were White, 10% Hispanic, 5% Black, 5% other. 98.5% of SMs had an OEF/OIF deployment.
Measures
Results
Insight
This study provides new insight into how both members of military couples perceive the manifestation and impact of partner accommodation of PTSD symptoms.
While SM and partner perceptions converged in many respects, the results suggest accommodation is more distressing for the partner engaging in it than for the SM being accommodated, on average.
Item-level differences point to potential mismatches in perceptions of certain accommodative behaviors that could be clinically relevant to explore.
Further research could explore other factors that influence levels of accommodation and associated distress, such as beliefs about accommodation, chronicity of symptoms, reasons/motivations for accommodating, and how perceptual differences between partners relate to outcomes.
Longitudinal research could examine patterns of accommodation and outcomes over time.
Strengths
Limitations
Clinical Implications
The present study supports collecting reports on partner accommodation of PTSD symptoms from both members of the couple in clinical and research settings.
While patient-only reports can inform case conceptualization when the partner is unavailable, obtaining both perspectives allows for a more comprehensive understanding of how accommodation manifests and impacts the couple.
Comparing partners’ reports can reveal meaningful similarities and differences. For example, this study found differences in perceived frequency of accommodation, possibly related to symptom/behavior overtness, and differences in distress, with partners engaging in accommodation being more distressed than those being accommodated.
In couples therapy, assessing partners’ perceptions of accommodation frequency and distress can guide psychoeducation, treatment monitoring, and exploration of discrepancies.
Partners can learn supportive strategies that don’t maintain PTSD symptoms. Cognitive-Behavioral Conjoint Therapy for PTSD targets accommodation and has been shown to decrease partner accommodation in both traditional and abbreviated formats.
References
Fredman, S. J., Vorstenbosch, V., Wagner, A. C., Macdonald, A., & Monson, C. M. (2014). Partner accommodation in posttraumatic stress disorder: Initial testing of the Significant Others’ Responses to Trauma Scale (SORTS).Journal of Anxiety Disorders, 28(4), 372–381.https://doi.org/10.1016/j.janxdis.2014.04.001
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Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
