A Daily Diary Study of PTSD and Interpersonal Processes

描述（由申请人提供）：战斗退伍军人患完全和亚临床PTSD的风险增加。尽管研究表明，来自恋人的社会支持与PTSD症状的缓解有关，但患有PTSD的服役人员婚姻不和和离婚的风险也在增加。创伤后应激障碍症状和婚姻不和谐之间的这种负面循环风险已经得到了广泛的研究，但对服役人员与其伴侣之间可能加剧这种循环的日常互动关注较少。拟议的调查解决了NIMH的使命，即使用“新颖的科学视角”来促进精神疾病的“预防、恢复和治疗”，通过使用经验抽样方法收集患有临床或亚临床创伤后应激障碍的服役人员及其恋人连续14天的症状和行为的自我报告数据。通过分析症状和人际行为之间的日常联系，这项研究将阐明伴侣和服役人员之间的具体互动，随着时间的推移，这些互动最有可能减少或增加PTSD症状。这项研究的长期目标是产生潜在的干预目标，旨在减少创伤后应激障碍军人夫妇的关系痛苦。为此，本研究的具体目的有三个方面。首先，本研究将评估军人创伤后应激障碍的个体症状对军人及其配偶后续人际情绪和行为的影响，以帮助澄清哪些症状与军人夫妇特定类型的人际问题特别相关。其次，本研究将评估配偶的亲密感和痛苦感对其随后向服务人员提供支持的影响，以澄清伴侣的亲密感和痛苦感是否会影响他们对PTSD症状患者的实际行为。第三，本研究将评估配偶支持提供与服役人员后续PTSD症状的关系，以确定伴侣行为对服役人员PTSD症状的实际影响。本研究收集的数据将大大增加有关战争相关PTSD患者人际关系的科学知识，并使临床科学家能够改进现有的夫妻干预措施和/或设计新的PTSD干预措施。通过设计提供的科学观点和结果的临床应用都有可能为越来越多的军人预防和治疗创伤后应激障碍做出重大贡献。拟议研究的目标将在研究培训计划中完成，旨在发展PTSD，经验抽样方法和数据分析，二元关系和军事背景方面的专业知识。培训计划包括完成相关课程，参加有针对性的讲习班，由该领域的专家进行个人监督和指导，以及科学写作和演讲经验。

DESCRIPTION (provided by applicant): Combat veterans are at an increased risk for the development of full and subclinical PTSD. Although research has shown that social support from romantic partners is implicated in the remittance of PTSD symptoms, service members with PTSD are also at increased risk of marital discord and divorce. This negative cycle of risk between PTSD symptoms and marital discord has been studied broadly, but less attention has been paid to the daily interactions between service members and their partners that may exacerbate the cycle. The proposed investigation addresses the NIMH mission to use "novel scientific perspectives" to promote "prevention, recovery, and cure" in mental illness by using experience sampling methods to collect self-report data on symptoms and behaviors from service members with clinical or subclinical PTSD and their romantic partners over 14 consecutive days. By analyzing the day-to-day associations among symptoms and interpersonal behaviors, the study will illuminate specific interactions between partners and service members that are most likely to reduce or increase PTSD symptoms over time. The long-term objective of this research is to generate potential targets for interventions that aim to reduce relationship distress in military couples with PTSD. To that end, the specific aims of the study are threefold. First, the study will evaluate the impact of individual symptoms of PTSD in service members on subsequent interpersonal emotions and behaviors in service members and their spouses, to help clarify which symptoms are particularly related to specific types of interpersonal problems in military couples. Second, the study will evaluate the impact of spouses' feelings of intimacy and distress on their subsequent provision of support to service members, to clarify whether partners' intimacy and distress impact their actual behavior toward those with PTSD symptoms. Third, the study will evaluate the relationship of spouses' support provision to subsequent PTSD symptoms in service members, to determine the actual effect of partner behaviors on service members' PTSD symptoms. Data collected in the proposed study will substantially increase scientific knowledge about the interpersonal relationships of those with combat-related PTSD, and enable clinical scientists to refine existing couple's interventions and/or design novel interventions for PTSD. The scientific perspective afforded by the design and the clinical utility of results both have the potential to contribute substantially to prevention and treatment of PTSD in a growing number of military service members. The goals of the proposed study will be accomplished within a research training program aimed at developing expertise in PTSD, experience-sampling methodology and data analysis, dyadic relationships, and the military context. The training plan includes completion of relevant courses, attendance at targeted workshops, individual supervision and mentorship by experts in the field, and scientific writing and presentation experience.