(PS4-D97) Associations of Service Members' PTSD Symptoms, Alcohol Use, and Partner Accommodation in Military Couples

     Partner accommodation of posttraumatic stress disorder (PTSD) — the ways in which partners of people with PTSD change their own behavior in response to the symptoms of the disorder — has become an increasingly important area of research related to the cognitive-behavioral interpersonal theory of PTSD (Monson et al., 2010). Among couples that include a male military service member (SM) and a female partner, higher SM PTSD scores have been associated with higher accommodation scores (Allen et al., 2021). Moreover, cognitive-behavioral conjoint therapy (CBCT) for PTSD has been shown to be particularly effective for couples with higher baseline levels of accommodation (Fredman et al., 2016). Accommodation has also been studied in relation to other disorders and has some overlap with the concept of enabling in the literature of alcohol use disorder, AUD (e.g. Asher & Brissett, 1988). A complex functional association between AUD and PTSD has been posited (Biehn et al., 2016; Straus et al., 2018), and it may be that SM alcohol use creates additional demands for partner accommodation, above and beyond PTSD symptoms, which can be picked up even on a PTSD-specific accommodation measure. This study examines whether AUD — as well as less severe, but still hazardous, alcohol use — in male SMs predicts accommodation in their partners even when controlling for PTSD symptoms.

     Data were from the initial time point of a longitudinal study of military couples (N = 564 pairs) comprised of a male Army soldier and his civilian female partner. SM alcohol use was self-reported on the Alcohol Use Disorders Identification Test (AUDIT; Saunders et al., 1993), and SM PTSD symptoms were self-reported using the PTSD Checklist-Military measure (PCL-M; Weathers et al., 1993). Partners separately self-reported their levels of accommodation of SM PTSD symptoms on the Significant Others' Responses to Trauma Scale (SORTS; Fredman et al., 2014). Based on SM AUDIT scores, couples were grouped into three categories: low-risk consumption, hazardous consumption, and potential AUD. Partner accommodation in the SM AUD group (M = 27.3, n = 33) was significantly greater (p < .01) than in the low-risk group (M = 16.7, n = 412). However, when controlling for SM PCL-M scores, no significant differences in partner accommodation were observed among the three groups. Of note, PCL-M scores of the AUD group (M = 37.3, n = 33) were significantly higher (p < .05) than those of the low-risk group (M = 30.0, n = 420); self-reported PTSD severity for the hazardous group (M = 35.3, n = 127) was also significantly higher (p < .01) than for the low-risk group.

     Although partners of SMs with self-reports suggesting AUD did report higher levels of accommodation behaviors, this difference was not found to be significant after adjusting for the PTSD symptom levels of the SMs. This study does provide further evidence of a link between AUD (and possibly hazardous drinking) and PTSD. It also suggests that, in military couples seeking conjoint treatment for PTSD, special consideration might be given to those in which the SM presents with signs of AUD (e.g. Schumm et al., 2015). Additional research on the burden which SM AUD may place on a partner, measured independently of PTSD-specific accommodation, may be of value.