Post traumatic stress disorder (PTSD) is a serious anxiety disorder that can develop after exposure to a traumatic event that often involves actual or threatened death. PTSD in men is most commonly seen in war veterans whereas PTSD in women is most commonly seen in victims of rape. Victims of PTSD often experience difficulties in day-to-day functioning and numerous research studies have explored the link between PTSD and relationship issues.
It is clear from the research in this area that the families and partners of those with PTSD can suffer greatly and that the effects of these problems can extend from one generation to another. However, it is important to note that the problems discussed here are not seen in all families where a member has PTSD. There is substantial variance in the pervasiveness and severity of the problems experienced by families in which a member has PTSD.
Relationship Issues Reported by Veterans with PTSD
Most research into the effects of PTSD has been carried out with war veterans. Good research will compare the problems faced by war veterans with PTSD with war veterans without PTSD. This shows that the problems are caused by PTSD and not just by the experiences faced by all war veterans. Difficulties resulting from combat-related PTSD include difficulties with family cohesion and expressiveness, problems with intimacy, sociability, self-disclosure, aggression, relationship adjustment and deficiencies in interpersonal problem solving skills. War veterans with PTSD were significantly more likely to report marital problems, parenting problems, poor family adjustment and extremely poor family functioning. In addition, veterans with PTSD were less likely to be married to their partners and their relationships were on average 6 years shorter than their veteran counterparts without PTSD. This suggests that PTSD has an effect on the veteran's ability to commit.
PTSD and Relationship Issues: Problems Experienced by Spouses of Veterans
The spouses of war veterans have been found to have increased levels of stress; they express feelings of worthlessness and have been subjected to violence. The most commonly reported problems experienced by spouses are loneliness, social isolation, feelings of confusion, being overwhelmed and feeling a loss of identity and control over one's life and coping with the veteran's problems.
They report lower levels of happiness and life satisfaction and some comment that it felt like they were going to have a nervous breakdown. Spouses of veterans with PTSD also reported significantly more marital problems; suggesting that the issues are not simply problems that are perceived by the veteran. Interestingly, both the veterans and the spouses of the veterans with PTSD committed significantly more acts of violence towards one another compared to veterans without PTSD and their spouses.
Problems Experienced by the Children of Veterans with PTSD
The children of war veterans of PTSD have also been found to have significantly more problems than the children of veterans without PTSD or children in the general population. The most commonly reported problems for the children of veterans with PTSD are low self-esteem, aggressiveness, developmental difficulties, impaired social relationships and symptoms mirroring those of the veteran. They are also more likely to have behavioural problems in the clinical range.
Are All Relationship Issues Caused by PTSD?
Some research suggests that assortative mating tends to occur among those with mental health disorders. That is to say, they enter relationships with people who also have mental health problems. This could account for the relationship problems within families where a member has PTSD. However, research has also found that the spouses of veterans with PTSD do not differ significantly on a variety of sociodemographic and background characteristics compared to the spouses of veterans without PTSD. This suggests that PTSD is the cause of these relationship problems.
Similarly a number of background variables have been shown to contribute to the development of PTSD. These variables, which include childhood behavioural problems and psychiatric disorders, childhood residential instability, early childhood family disruption, quality of parental relationships, frequency of parental affection, parental violence and abuse, and criminal, psychiatric and substance abuse problems of family members, may also contribute to the family problems that are experienced by veterans with PTSD.
However, studies have also revealed that these variables make only a small contribution to family problems and that PTSD is likely to be the major source.
Treating Relationship Issues Caused by PTSD
Given the myriad of family problems that can arise from a member suffering from PTSD it is important that sufferers of PTSD have access to a comprehensive treatment plan and are treated early. Cognitive-behavioural therapy is an effective treatment for PTSD as it teaches skills in problem solving, anger management, assertiveness and stress reduction. Family and couples counseling may also be beneficial in tackling the relationship issues caused by PTSD as would individual counseling for family members.
Jordan, B.K. et al. (1992) Problems in families of male Vietnam veterans with post traumatic stress disorder. Journal of Consulting and Clinical Psychology, 60, 6, 916-926.
Kring, A.M., Davison, G.C., Neale, J.M. & Johnson, S.L. (2007) Abnormal Psychology. USA: John Wiley & Sons.