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，来自浪漫伴侣的社会支持与PTSD症状的缓解有关，但患有PTSD的军人也面临着婚姻不和和离婚的风险增加。创伤后应激障碍症状和婚姻不和之间的这种负面风险循环已经得到了广泛的研究，但很少有人关注服务人员及其伴侣之间的日常互动，这可能会加剧这种循环。拟议的调查地址NIMH的使命，使用“新的科学观点”，以促进“预防，恢复和治疗”的精神疾病，通过使用经验抽样方法收集自我报告的数据，症状和行为的服务成员与临床或亚临床创伤后应激障碍和他们的浪漫的合作伙伴超过14天。通过分析症状和人际行为之间的日常关联，该研究将阐明合作伙伴和服务人员之间的特定互动，这些互动最有可能随着时间的推移减少或增加PTSD症状。这项研究的长期目标是产生潜在的干预目标，旨在减少军人夫妇PTSD的关系困扰。为此，本研究报告有三个具体目标。首先，该研究将评估军人PTSD的个体症状对军人及其配偶随后的人际情感和行为的影响，以帮助澄清哪些症状与军人夫妇中特定类型的人际关系问题特别相关。其次，该研究将评估配偶的亲密和痛苦的感觉对他们随后向服务成员提供支持的影响，以澄清伴侣的亲密和痛苦是否影响他们对那些有创伤后应激障碍症状的人的实际行为。第三，本研究将评估配偶提供的支持与服役人员后续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。在拟议的研究中收集的数据将大大增加有关战斗相关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妇干预措施和/或设计新的PTSD干预措施。研究设计所提供的科学视角和研究结果的临床应用都有可能为越来越多的军人预防和治疗PTSD做出重大贡献。拟议研究的目标将在一个研究培训计划中完成，该计划旨在发展PTSD，经验采样方法和数据分析，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，由该领域专家进行个人监督和指导，以及获得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.