Factors Influencing Family Environment Reporting Concordance Among U.S. War Zone Veterans and Their Partners.

A key challenge in the assessment of family variables is the discrepancies that arise between reports. Although prior research has observed levels of interpartner agreement on the family environment, no studies have investigated factors that may influence agreement. In this study, war zone veterans (WZVs) and their partners (N = 207 couples) completed assessments of the family environment. We examined interpartner agreement in relation to WZV and partner posttraumatic stress disorder (PTSD) symptoms, WZV time away from home, and family size. More severe WZV PTSD symptoms were associated with greater interpartner agreement on family environment, whereas more severe partner PTSD symptoms were associated with reporting more negative perceptions of the family environment relative to WZV reports. Family size was associated with greater interpartner agreement. Factors associated with concordance in this study should be considered by clinicians and researchers seeking to understand and address reporting discrepancies on the family.

Trauma Exposure and PTSD Among Women Receiving Treatment for Intimate Partner Violence Perpetration.

Trauma exposure and posttraumatic stress disorder (PTSD) symptoms have been associated with men's perpetration of intimate partner violence (IPV), but relatively little research has examined these associations among women who perpetrate IPV. This exploratory investigation evaluated the associations among trauma, PTSD symptoms, and IPV perpetration for women and a comparison sample of men. During intake at a community-based Abuse Intervention Program (AIP), women (n = 32) and a demographically similar comparison sample of men (n = 64) completed measures of trauma exposure, PTSD symptoms, physical aggression and emotional abuse perpetration, and use of alcohol and other drugs. The vast majority of women (93.5%) reported traumatic event exposure, and close to half (43.8%) screened positive for a probable PTSD diagnosis. Women's level of PTSD symptoms correlated positively with emotional abuse perpetration, with medium-to-large effect sizes. After controlling for substance use, women's PTSD symptoms were significantly and positively correlated with physical assault and emotional abuse perpetration. Women reported significantly higher rates of exposure to IPV victimization and had significantly higher rates of probable PTSD and PTSD symptoms than did men from the same AIP. Gender did not significantly moderate the associations between PTSD symptoms and IPV perpetration. Overall, findings indicate that trauma exposure and PTSD symptoms are important correlates of women's IPV perpetration. Women in treatment for IPV perpetration may benefit from additional assessment and treatment of trauma and trauma-related symptoms.

Individual Versus Group Cognitive-Behavioral Therapy for Partner-Violent Men: A Preliminary Randomized Trial.

A randomized clinical trial tested the hypothesis that a flexible, case formulation-based, individual treatment approach integrating motivational interviewing strategies with cognitive-behavioral therapy (ICBT) is more efficacious than a standardized group cognitive-behavioral approach (GCBT) for perpetrators of intimate partner violence (IPV). Forty-two men presenting for services at a community domestic violence agency were randomized to receive 20 sessions of ICBT or a 20-week group cognitive-behavioral therapy (CBT) program. Participants and their relationship partners completed assessments of relationship abuse and relationship functioning at baseline and quarterly follow-ups for 1 year. Treatment uptake and session attendance were significantly higher in ICBT than GCBT. However, contrary to the study hypothesis, GCBT produced consistently equivalent or greater benefits than ICBT. Participant self-reports revealed significant reductions in abusive behavior and injuries across conditions with no differential benefits between conditions. Victim partner reports revealed more favorable outcomes for group treatment, including a statistically significant difference in psychological aggression, and differences exceeding a medium effect size for physical assault, emotional abuse, and partner relationship adjustment. In response to hypothetical relationship scenarios, GCBT was associated with greater reductions than ICBT (exceeding a medium effect) in articulated cognitive distortions and aggressive intentions. Treatment competence ratings suggest that flexible, individualized administration of CBT creates challenges in session agenda setting, homework implementation, and formal aspects of relationship skills training. Although caution is needed in generalizing findings from this small-scale trial, the results suggest that the mutual support and positive social influence available in group intervention may be particularly helpful for IPV perpetrators.

Examining Positive and Negative Reactions and Conciliatory Behaviors After Partner Violence Perpetration.

This study investigated positive and negative reactions and conciliatory behaviors after perpetration of intimate partner violence (IPV). The goals were to examine the rates of these reactions and their associations with key attitudinal and personality factors. During program intake at a community agency, 172 partner violent men completed assessments of positive reactions (e.g., feeling justified) and negative reactions (e.g., feeling ashamed) after IPV, conciliatory behaviors after IPV (e.g., buying flowers for the partner), frequency of physical assault and abuse perpetration, and motivational readiness to change. In addition, a subset of participants ( n = 64-71) completed assessments of outcome expectancies of IPV and borderline, antisocial, and psychopathic personality characteristics. The vast majority of participants (89.8%) reported negative reaction(s) after IPV; 32.7% reported positive reaction(s), and 67.5% reported conciliatory behavior(s). Positive reactions after IPV were associated with positive outcome expectancies of IPV, more frequent abuse perpetration, and antisocial features. Negative reactions after IPV were associated with greater motivation to change, more frequent abuse perpetration, and borderline features, and were inversely linked to psychopathic traits. Conciliatory behaviors were associated with motivation to change, borderline characteristics, and lower levels of psychopathic traits. Cognitive, emotional, and behavioral reactions to IPV may be important for stimulating clinical discussion of motivations and barriers to change, and can inform the functional analysis of IPV.

Newlyweds' perceptions of partner conflict behaviors and change in intimate safety over time.

The aim of this study was to examine hypotheses from Cordova and Scott's (2001) behavioral conceptualization of intimacy. This theory defines intimacy as a process that involves exhibiting interpersonally vulnerable behavior (i.e., behavior that is at risk of censure or punishment by another person) that is reinforced rather than punished by the other person's response. Over time, as more vulnerable behaviors are reinforced than are punished by a relationship partner, one develops feelings of intimate safety (i.e., a sense of comfort and safety in being vulnerable with one's partner). The current study investigated whether individuals' perceptions of how frequently their partner engages in reinforcing and punishing behaviors during conflict are associated with change in intimate safety. Ninety one newlywed couples completed assessments of intimate safety at Time 1 and Time 2 (1 year later), and completed assessments of their perceptions of partners' positive conflict behaviors (e.g., understanding one another's viewpoint) and negative conflict behaviors (e.g., criticizing, blaming) at Time 2 (reporting on the previous 6 months). Results indicated that individuals who reported that their partners engaged in high levels of negative conflict behaviors experienced decreased intimate safety from Time 1 to Time 2. Further, wives who reported that their husbands engaged in high levels of positive conflict behaviors experienced increased intimate safety from Time 1 to Time 2. This study is the first to test a key hypothesis of the behavioral conceptualization of intimacy, and findings are generally consistent with the theory. This line of research has important implications for couple interventions, which often target intimacy. (PsycINFO Database Record

Trauma, posttraumatic stress disorder symptoms, and dissociative experiences during men's intimate partner violence perpetration.

OBJECTIVE: Research with partner-violent men has found that a subset of this population reports dissociative experiences during their violence (e.g., inability to remember violence [despite admission that it had occurred]; flashbacks during violence). However, the literature examining this phenomenon has been primarily limited to clinical observations and case studies, and there is a need for more thorough empirical investigation regarding the prevalence and correlates of dissociative violence among individuals in intimate partner violence (IPV) intervention programs. The primary goals of this study were to provide descriptive information about the rates of endorsement of dissociative experiences during IPV perpetration and to examine their associations with trauma exposure and posttraumatic stress disorder (PTSD) symptoms. METHOD: Participants were 302 men presenting for services at a community-based IPV intervention program. All variables were assessed via self-report and clinician interview at program intake. RESULTS: Results indicated that 22.2% of participants reported 1 or more dissociative experiences during partner violence perpetration. Additionally, frequency of dissociative IPV perpetration showed significant positive correlations with the total number of potentially traumatic events (PTEs) reported and PTSD symptoms, with effect sizes in the small and medium ranges of magnitude, respectively. Finally, PTSD symptoms significantly mediated the relationship between total number of PTEs and dissociative IPV perpetration. CONCLUSIONS: Findings indicate a potentially meaningful relationship between trauma, PTSD symptoms, and dissociative experiences during IPV perpetration. Further qualitative and quantitative investigation is needed to better understand this phenomenon and how it can be addressed in IPV treatment. (PsycINFO Database Record

Sleep problems and physical pain as moderators of the relationship between PTSD symptoms and aggression in returning veterans.

OBJECTIVE: This study investigated sleep problems and physical pain as moderators of the relationship between PTSD symptoms and aggression among returning veterans. Prior research has demonstrated associations between PTSD symptoms and aggression, but little work has sought to identify moderators of this relationship. Sleep problems and physical pain are both common clinical problems among veterans and have theoretical links to aggression. METHOD: Participants were 103 returning service members and veterans recruited from the greater Boston area and enrolled in the VA Translational Research Center for Traumatic Brain Injury (TBI) and Stress Disorders (TRACTS). Aggression outcomes included physical and psychological intimate partner aggression (IPA), as well as physical and psychological general aggression (GA). Variables were measured via self-report questionnaires, with the exception of PTSD symptoms, which were assessed via clinician interview. RESULTS: Bivariate correlations revealed significant associations between PTSD symptoms, sleep problems, physical pain, and aggression outcomes. Both sleep problems and physical pain significantly moderated the relationship between PTSD symptoms and physical GA, such that this relationship became stronger at higher levels of these moderator variables. However, moderation was not found for the other aggression outcomes. CONCLUSIONS: Findings suggest that sleep problems and physical pain strengthen the relationship between veterans' PTSD symptoms and physical aggression toward others. Although further replication and elucidation is needed, these factors may disinhibit aggression among those at higher risk due to their PTSD symptoms. (PsycINFO Database Record

Social skills deficits as a mediator between PTSD symptoms and intimate partner aggression in returning veterans.

This study examined social skills deficits as a mediator of the relationship between posttraumatic stress disorder (PTSD) symptoms and use of intimate partner aggression (IPA) among returning veterans. Prior research with veterans has focused on PTSD-related deficits at the decoding stage of McFall's (1982) social information processing model, and the current study adds to this literature by examining social skills deficits at the decision stage. Participants were 92 male veterans recruited from the greater Boston area. PTSD symptoms were assessed through clinician interview, IPA use was assessed through self- and partner report, and social skills deficits were assessed in a laboratory task in which veterans listened to a series of problematic marital situations and responded with what they would say or do in the situation. Responses were coded for social competency. Bivariate correlations revealed several significant associations among PTSD symptoms, social skills deficits, and use of IPA. When all PTSD symptom clusters were entered into a regression predicting social skills deficits, only emotional numbing emerged as a unique predictor. Finally, social skills deficits significantly mediated the relationship between veterans' PTSD symptoms and use of psychological (but not physical) IPA. Findings extend prior research on McFall's (1982) social information processing model as it relates to veterans' PTSD symptoms and use of IPA. More research is needed to understand the associations between PTSD symptoms and deficits at each individual step of this model. (PsycINFO Database Record

Mistrust of others as a mediator of the relationship between trauma exposure and use of partner aggression.

OBJECTIVE: Prior research indicates a connection between the experience of trauma and use of intimate partner aggression (IPA), but little work has focused on core cognitive schemas that can be influenced by trauma. In the current study, we examine the cognitive schema of mistrust in others as a mediator of the relationship between trauma exposure and IPA use. This schema may lead to IPA through distorted social information processing that can escalate relationship conflict. METHOD: The sample consisted of 83 heterosexual community couples. All variables were assessed via written questionnaires, and IPA frequency was calculated by incorporating both partners' reports on each member of the couple. RESULTS: For males, mistrust significantly mediated the relationships between trauma exposure and both physical and psychological IPA use. For females, mistrust did not mediate the significant relationship between trauma exposure and IPA use. In analyses using the actor-partner interdependence model, both actor and partner mistrust uniquely predicted physical and psychological IPA use. CONCLUSIONS: The findings of the study suggest the importance of examining core schemas that may underlie trauma reactions and use of IPA. (PsycINFO Database Record

Veterans' PTSD symptoms and their partners' desired changes in key relationship domains.

There is a growing literature investigating the connection between veterans' posttraumatic stress disorder (PTSD) symptoms and intimate relationship problems. Little to no work, however, has examined the connection between veterans' PTSD symptoms and their partners' perceptions of specific relationship areas in need of change. We examined associations between overall PTSD symptoms and symptom cluster scores with partners' desired changes in the areas of intimacy, shared activities, and responsibilities. The sample consisted of 249 male veterans of different service eras and their female partners. Results indicated that veterans' PTSD symptoms were associated with greater desired changes from their partners in the veterans' intimacy behaviors and participation in shared activities. When examining the contribution of each symptom cluster individually, only the veterans' emotional numbing symptoms emerged as a significant unique predictor and were associated with partners' desired changes in intimacy. The findings suggest that intimacy and shared activities may be relevant areas to address in PTSD treatment for veterans and their partners and highlight the particular significance of emotional numbing symptoms to intimacy in veterans' relationships.

Agreement between veteran and partner reports of intimate partner aggression.

We examined intimate partner aggression (IPA) reporting concordance between veterans and their partners and investigated relationship satisfaction, posttraumatic stress disorder (PTSD) symptoms, and relationship attributions as correlates of IPA reporting discrepancies. The sample consisted of 239 veterans of different service eras and their intimate partners. Veterans and partners reported their physical and psychological IPA perpetration and victimization over the past 6 months. Methodological improvements over prior concordance studies included the use of clinician-assessed PTSD symptoms and the assessment of relationship attributions via observational coding of couples' conflict interactions. Results suggested low to moderate levels of agreement between veterans and partners and indicated that relationship satisfaction was associated with reporting less IPA than one's partner reported, replicating prior concordance findings. Previous concordance findings with self-reported PTSD symptoms were also reproduced in the current study using clinician-assessed PTSD symptoms. Veterans' PTSD symptoms were associated with reporting less IPA than their partners reported and partners' PTSD symptoms were associated with reporting more IPA than the veterans reported. Additionally, we found an association between relationship attributions and reporting discrepancies. For both dyad members, making more positive and less negative relationship attributions was associated with reporting less IPA than one's partner reported. Findings underscore the difficulty of obtaining objective self-reports of adverse behavior and highlight factors that may influence such reports. Clinically, this information could be used to better identify cases in which obtaining collateral reports of IPA are particularly warranted.

Examining intimate partner aggression assessment among returning veterans and their partners.

There is a growing research base focusing on intimate partner aggression (IPA) in combat veterans, although little work has focused on IPA assessment. In the current study, the authors investigated IPA assessment among 65 male Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) combat veterans and their female partners. Specifically, we compared overall levels of veteran- and partner-perpetrated IPA, conducted concordance analyses to examine the degree of interpartner agreement on IPA occurrence and frequency, and investigated both veterans' and partners' relationship satisfaction and posttraumatic stress disorder (PTSD) symptoms as correlates of concordance. Results indicated that female partners perpetrated higher levels of physical IPA than did the male veterans, according to both veteran and combined reports. Concordance analyses revealed low to moderate levels of agreement between veterans and their partners on the perpetration of physical and psychological IPA, with particularly low agreement on the veterans' physical IPA. Female partners' relationship satisfaction was associated with reporting less of the veterans' and their own IPA relative to the veterans' reports, and their PTSD symptoms were associated with reporting more of the veterans' and their own IPA. In contrast, the veterans' PTSD symptoms were associated with reporting less of their own IPA relative to their partners' reports. The findings emphasize the need for those researching and treating IPA among military couples to assess IPA perpetrated by both members of the relationship and to consider possible factors that might impact the accuracy of IPA reporting.