Expert Commentary

Returning soldiers’ intimate relationships: Emotions, PTSD and alcohol

2010 study by the University of Minnesota Medical School and Duke University Medical Center on relationship problems among returning Iraq and Afghanistan soldiers.

Marines returning
(DoD / Lance Cpl. Michael S. Cifuentes)

Since the Iraq and Afghanistan wars began a decade ago, more than 2 million Americans have served in these conflicts. Many have children and partners who are affected by their absence, and even when they do return home, their experiences may severely impact their relationships. According to a 2009 study in the Journal of Clinical Psychiatry, more than 40% of Iraq and Afghanistan veterans who underwent Veterans Affairs behavioral health evaluations indicated that they felt like a “guest in their household,” and more than 50% reported “shouting, pushing or shoving” incidents with a partner.

A 2010 study published in the Journal of Traumatic Stress, “Intimate Relationships Among Returning Soldiers: The Mediating and Moderating Roles of Negative Emotionality, PTSD Symptoms and Alcohol Problems,” examines the association between war-related problems and relationship distress among soldiers who served in Iraq. The authors, from the University of Minnesota Medical School and Duke University Medical Center, sought to better understand the contribution of preexisting emotional issues and problem drinking to post-deployment PTSD symptoms and relationship issues.

Among men with symptoms of PTSD, the most common disorder is alcohol abuse or dependence. Negative emotionality, also associated with PTSD, is defined as “the tendency to experience negative emotional states such as anxiety or irritability, react poorly to stress, and respond out of proportion to circumstances.” Participants for this study were drawn from a longitudinal study of 522 Army National Guard soldiers deployed to Iraq.

The study’s findings include:

  • Of the study participants, 16% screened positive for probable PTSD, 22% for relationship distress and 31% for hazardous levels of alcohol consumption.
  • Soldiers with who showed signs of PTSD were more likely to experience relationship distress than those without probable PTSD (33% versus 20%).
  • Those who showed evidence of hazardous drinking were more likely to screen positive for PTSD (37% versus 29%) but did not display significantly more relationship distress than those without alcohol issues.
  • Higher levels of preexisting negative emotionality were associated with higher levels of PTSD symptoms after deployment. In addition, post-deployment PTSD symptoms were associated with lower relationship quality, even after accounting for prior exposure to trauma and preexisting PTSD symptoms.

The authors note that “a feedback loop may exist between postdeployment PTSD symptoms and relationship quality, such that PTSD symptoms increase problems in intimate relationships, and relationship dissatisfaction exacerbates PTSD.” They recommend additional study of how PTSD and relationship quality interact.

A related 2012 study in the American Journal of Public Health found that, across a sample of nearly 600 Iraq and Afghanistan veterans, 39% screened for probable alcohol abuse.

Tags: PTSD, war, veterans, mental health

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