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The association between symptoms of posttraumatic stress disorder (PTSD) in adults and difficulties in intimate relationships is well documented. Growing literature suggests that interpersonally-oriented therapies, such as couple and family interventions, may lead to improvements in both PTSD symptoms and intimate relationship functioning. However, it is unknown how individual PTSD treatments compare to couple/family interventions in relational outcomes. The present study was a systematic review and meta-analysis of individual and couple/family treatments to examine changes in PTSD symptoms and intimate relationship functioning. Twelve couple treatment studies with 13 unique samples and 7 individual treatment studies with 9 unique samples met inclusion criteria. No family-based treatments were identified. Meta-analytic findings indicated moderate to large reductions in PTSD symptoms for both couple and individual studies. Small but significant improvements in intimate relationship functioning across individual and couple studies were observed. Moderation analysis suggested that across both individual and couple treatment formats, trauma-focused treatments had larger effects on PTSD symptoms. Trauma-focused treatments had larger effects on intimate relationship functioning for individual studies. Military status did not moderate outcomes. This study supports the utility of both individual and couple treatment formats for treating PTSD and provides preliminary support for these modalities for also enhancing intimate relationship functioning.

Emerging research reinforces the importance of partner accommodation in the interpersonal context of posttraumatic stress disorder (PTSD). A better understanding of partners’ motivations for accommodation is needed to help refine or design interventions that target accommodation. To explore partners’ motivations, we created the Reasons for Accommodation of PTSD Scale (RAPS) and evaluated it in 263 female partners of male Army soldiers who had returned from a deployment within the past 2 years. Soldiers completed a measure of military-related PTSD, and partners completed a measure of accommodation and the newly created RAPS. Factor analysis of the RAPS yielded a clear, 3-factor solution suggesting the following reasons for accommodating: (1) Relationship & Obligation, or a desire for positive relationship outcomes and a sense of duty or responsibility; (2) Helping Recovery, or a belief that avoidance was helpful for the service member; and (3) Conflict Avoidance/Helplessness, or a desire to avoid conflict or simply not knowing what else to do. Analyses of these factors in relation to soldiers’ PTSD clusters indicated that hyperarousal symptoms were uniquely associated with relationship and obligation motivations, re-experiencing symptoms were uniquely associated with helping recovery motivations, and emotional numbing symptoms were uniquely associated with conflict avoidance and helplessness motivations. Furthermore, conflict avoidance and helplessness accounted for the greatest variance in partners’ accommodation frequency and distress. Assessment of partners’ accommodative behaviors, as well as their motivations for engaging in accommodation, may aid in treatment planning and enhance outcomes for couples in which one individual has PTSD.

Posttraumatic stress disorder (PTSD) is associated with myriad relationship problems and psychological distress in partners of individuals with PTSD. This study sought to develop a self-report measure of partner accommodation to PTSD (i.e., ways in which partners alter their behavior in response to patient PTSD symptoms), the Significant Others' Responses to Trauma Scale (SORTS), and to investigate its reliability and construct validity in 46 treatment-seeking couples. The SORTS demonstrated strong internal consistency and associations with individual and relationship distress. Accommodation was positively correlated with partners' ratings of patients' PTSD symptoms, patient self-reported depressive and trait anger severity, and partner self-reported depressive and state anger severity. Accommodation was negatively correlated with patient and partner relationship satisfaction and partners' perceived social support received from patients. Findings suggest that accommodation may be an attempt to adapt to living with a partner with PTSD but may have negative implications for patient and partner well-being.