Trauma and couples: mechanisms in dyadic functioning

Research traditionally has focused on the development of symptoms in those who experienced trauma directly but overlooked the impact of trauma on the families of victims. In recent years, researchers and clinicians have begun to examine how individual exposure to traumatic events affects the spouses/partners, children, and professional helpers of trauma survivors. The current study reports data from a larger mixed-methodology study that includes qualitative interview data from 17 individuals, coded to identify the mechanisms that may affect the couple's interpersonal functioning when there is a history of trauma exposure in one or both partners. The following primary themes were identified: role in the relationship, boundary issues, intimacy problems, triggers, and coping mechanisms. Areas for future research and clinical implications also are identified.     

Traumatic Stress and Affect Management in Military Families

The war-time deployment of a service member creates significant stress for the family system that supports that person’s transition into combat, combat duty, and readjustment into civilian and family life upon return. The stressors associated with the deployment cycle are significant and can lead to depression, anxiety, and behavioral concerns for all family members including the children and partners. A family’s adaptation to these stressors can also impact the functioning of the service member during the phases of mobilization, deployment, sustainment, and reintegration. Social work interventions that offer support to the military family can reduce levels of distress within and between the members and improve overall family functioning. A case vignette will be presented that highlights some of the salient interpersonal challenges that can develop in a military family when a veteran returns home with posttraumatic stress that is left untreated. Recommendations for interventions will be considered through the application of psychoeducational approaches for managing traumatic stress in families.     

Systemic traumatic stress: the couple adaptation to traumatic stress model

Research traditionally has focused on the development of symptoms in those who experienced trauma directly but overlooked the impact of trauma on the families of victims. In recent years, researchers and clinicians have begun to examine how individual exposure to traumatic stress affects the spouses/partners, children, and professional helpers of trauma survivors. However, empirically supported, theory-based literature that identifies the mechanisms by which interpersonal or "secondary trauma" occurs in response to traumatic events is limited. Here, we present the Couple Adaptation to Traumatic Stress Model, a systemic model of the development of interpersonal symptoms in the couple dyad based on empirical literature. Potential mechanisms and clinical vignettes are included to describe the systemic processes that occur with trauma couples. Areas for future research and clinical implications also are identified.     

Conversations of Care: A Narrative Review of Collaborative Care Systems for Foster and Kinship Care

This paper reviews the literature on human relational factors and their impact on complex care systems for a highly vulnerable population of children and young people in out‐of‐home care (OOHC). Factors contributing to the functioning of collaborative OOHC systems are reviewed from theoretical and contextual perspectives. The authors posit that secondary traumatic stress and vicarious trauma are central to understanding the impact of relational trauma and the experience of individuals, families, teams, and the wider ecology of collaborative care systems. Given the challenges of working collaboratively across interpersonal, family, and systems boundaries to support traumatised children in OOHC, further research is required.     

Systemic effects of trauma in clinic couples: an exploratory study of secondary trauma resulting from childhood abuse

Clinical literature suggests that those close to a trauma survivor may experience intrapersonal and interpersonal distress because of indirect or secondary effects of the trauma. The focus of this study is on the association between reported childhood physical and sexual abuse and current individual stress symptoms, relationship satisfaction, and family adjustment. The participants included 96 clinic couples who reported a history of childhood physical or sexual abuse in one or both partners and 65 clinic couples in which neither partner reported such abuse. Couples in which one or both partners reported childhood abuse reported significantly lower marital satisfaction, higher individual stress symptoms, and lower family cohesion than couples with no abuse history. No significant differences were found between individuals who reported a history of abuse and their partners who reported no history of childhood abuse, suggesting support for secondary trauma theory. Clinical and future research implications are discussed.     

Further understanding the systemic effects of childhood sexual abuse: a comparison of two groups of clinical couples

This study addressed the impact of traumatic experiences on dyadic relationships by comparing general stress and trauma symptoms and relationship impairment measures between two clinical groups: female childhood sexual abuse (CSA) survivors (n=15) and their male partners, and a control group of couples who reported no CSA (n=17). Both female CSA survivors and their partners reported higher symptoms of stress, suggesting support for the theory of secondary traumatic stress. Relationship impairment results did not support the hypothesis that CSA would negatively impact the dyadic functioning of couples. Clinical implications and recommendations for future research are provided.     

An Examination of the Association Between Relationship Mindfulness and Psychological and Relational Well-being in Committed Couples

Relationship mindfulness is the degree to which individuals tend to be mindful during interactions with romantic partners. In this study, we examined both the intrapersonal and interpersonal links between relationship mindfulness and psychological and relationship functioning in a sample of 219 couples who had been in their relationship for at least 1 year. Even when accounting for the general tendency to be mindful, relationship mindfulness was linked with markers of relationship well-being and psychological functioning, both intrapersonally and interpersonally. The findings bring to light the importance of considering relationship mindfulness in clinical work with couples that focuses on addressing deficiencies in relationship or psychological well-being.     

The risk of Telling: A Dyadic Perspective on Romantic Partners’ Responses to Child Sexual Abuse Disclosure and Their Associations with Sexual and Relationship Satisfaction

Among 70 community couples who reported childhood sexual abuse (CSA) and disclosure to their partner, this study examined associations between survivors’ perception of partner responses to their disclosure, and both partners’ sexual and relationship satisfaction. Participants completed self‐report questionnaires online. Results of path analyses within an actor–partner interdependence model indicated that survivors’ perceived partner responses of emotional support to disclosure were associated with their own and their partners’ higher sexual satisfaction. Survivors’ perceived responses of being stigmatized/treated differently by the partner were associated with their own and their partners’ poorer relationship satisfaction. Findings suggest that survivor‐perceived partner responses to the disclosure of CSA can have a positive and a negative impact on the sexual and relationship satisfaction of both partners.     

Child Sexual Abuse,Sexual Anxiety,and Sexual Satisfaction: The Role of Self-Capacities

Research indicates that child sexual abuse produces lasting alterations in interpersonal relatedness, identity, and affect regulation, often referred to as self-capacity disturbance. Child sexual abuse also has been shown to negatively impact sexual functioning. This study examined the role of altered self-capacities in mediating the relationship between child sexual abuse and sexual responses. Path analysis revealed that child sexual abuse was related to sexual anxiety and decreased sexual satisfaction through its association with reduced self-awareness and a propensity to be involved in difficult interpersonal relationships.     

Career Adaptability of Trauma Survivors: The Moderating Role of Posttraumatic Growth

Impaired functioning in occupational domains is a diagnostic characteristic of posttraumatic stress disorder, and yet the interactions between trauma and career remain understudied. This study examined the relationships between trauma symptoms, posttraumatic growth, and career adaptability in college students who identified as trauma survivors (N = 215). Results indicated that (a) trauma symptoms and posttraumatic growth were both significantly predictive of career adaptability and (b) posttraumatic growth moderated the relationship between trauma and career adaptability. The impact of demographic factors and implications for career counselors and counselor educators are also discussed.     

A Dyadic Perspective on Childhood Maltreatment for Women With Provoked Vestibulodynia and Their Partners: Associations With Pain and Sexual and Psychosocial Functioning

Childhood maltreatment is robustly associated with adult-onset vulvodynia, a common form of female genito-pelvic pain/penetration disorder. However, little is known about the impact of childhood maltreatment on current sexual, psychological, and relationship adaptation for couples with provoked vestibulodynia (PVD). This study examined the associations between childhood maltreatment and sexual and psychosocial functioning and pain in women with PVD, the most common subtype of vulvodynia, and their partners. A total of 49 couples (M_age women = 27.80, SD = 6.05; M_age men = 30.04; SD = 6.48) with PVD completed the Childhood Trauma Questionnaire (CTQ), as well as measures of sexual functioning, couple satisfaction, and anxiety. Women also reported on their pain during intercourse. Analyses were guided by the actor–partner interdependence model. Women’s higher reports of childhood maltreatment were associated with their lower sexual functioning and higher anxiety. Partners’ higher reports of childhood maltreatment were associated with their lower sexual functioning, lower couple satisfaction, and higher anxiety, as well as women’s lower couple satisfaction and higher anxiety. Both women’s and partners’ higher reports of childhood maltreatment were associated with higher affective pain for women. Findings suggest childhood maltreatment experienced by women with PVD and their partners should be considered as part of treatment planning.     

Life Course Social Science Perspectives on the GLBT Family

Abstract

The life course perspective in the social sciences focuses on the place of generation-cohorts in understanding social life. Emphasizing shared understanding of self and society among a group of persons born in some adjacent birth years (often a decade) and the impact of the experience of certain events (a reminiscence bump) taking place across the early adult years, this approach to the study of social life and social change emphasizes social timing and role changes in understanding the course of life. The life course perspective is used in this discussion in understanding sexual minority families including both families in which an offspring self-defines as GLBT across the years of young adulthood, and families in which a parent self-identifies as GLBT, and which includes offspring of one or both partners. Issues in family formation and morale of family members are explored from this life course perspective emphasizing time, social change and the role of the state as factors influencing sexual minority families.     

The Influence of Child Sexual Abuse on the Self from Adult Narrative Perspectives

The impact of child sexual abuse on the adult self is not yet clearly understood. We explored adult perspectives through the use of narrative interviews (N = 30). Three key themes or views of self were identified in all narratives to varying degrees: the worthless self, the self as unknown, and the potential/developing self. Ambivalence and tension were present in all narratives. Individuals were challenged to integrate the sexual abuse experience in a constructive way and develop a more coherent perception of the self. The narrative method highlighted the dynamic nature of peoples’ experiences at the same time recognizing that the narratives themselves are in progress. Reactions to disclosure, social support, and interpersonal connections are crucial at every turn.     

Correlates of Human Immunodeficiency Virus/Sexually Transmitted Infection (HIV/STI) Testing and Disclosure Among HIV-Negative Collegiate Men Who Have Sex With Men

Abstract

Objective: To determine the extent to which personal, behavioral, and environmental factors are associated with human immunodeficiency virus/sexually transmitted infection (HIV/STI) testing and disclosure. Participants: Nine hundred thirty HIV-negative collegiate men who have sex with men (MSM) who completed an online survey about alcohol use and sexual behavior. Methods: Correlates of testing and disclosure significant in bivariate analyses (p < .05) were grouped into personal, behavioral, or environmental factors and entered into multivariable logistic regression models. Results: About half of participants tested for HIV (51.9%) and for STIs (45.8%) at least annually. Over half (57.8%) of participants always/almost always discussed HIV status with new sex partners; 61.1% with new unprotected sex partners. Personal and behavioral factors (age and outness) explained differences in testing, and the behavioral factor (routine testing) explained differences in disclosure. Conclusions: Collegiate MSM should be supported in coming out, encouraged to engage in routine testing, and counseled on discussing HIV/STI status with potential sex partners.     

Are Gay and Lesbian cohabiting couples really different from heterosexual married couples?

Both partners from gay and lesbian cohabiting couples without children were compared longitudinally with both partners from heterosexual married couples with children (N at first assessment = 80, 53, and 80 couples, respectively) on variables from 5 domains indicative of relationship health. For 50% of the comparisons, gay and lesbian partners did not differ from heterosexual partners. Seventy‐eight percent of the comparisons on which differences were found indicated that gay or lesbian partners functioned better than heterosexual partners did. Because the variables that predicted concurrent relationship quality and relationship stability for heterosexual parents also did so for gay and lesbian partners, I conclude that the processes that regulate relationship functioning generalize across gay, lesbian, and heterosexual couples.     

Vetting and Letting: Cohabiting Stepfamily Formation Processes in Low‐Income Black Families

The authors examined cohabiting union formation processes by analyzing in‐depth interview data collected from 30 individuals in cohabiting relationships: 15 low‐income Black mothers of adolescents and their partners. Prior research suggests that cohabiting union formation is a gradual, nondeliberative process. In contrast, most couples in this study described a gradual but highly deliberative process. Mothers focused primarily on vetting their partners to ensure child well‐being and less on when and how their partners officially came to live with them, a process the authors call vetting and letting. Mothers delineated 4 strategies to ensure their child's well‐being when vetting their partners, and their partners reported that they understood the importance of participating in this process. The authors argue that vetting and letting is a child‐centered family formation process, not a partner‐centered union formation process, and that cohabiting union processes may vary substantially by subpopulation.     

Urgent engagement in 9/11 pregnant widows and their infants: Transmission of trauma

The potential effects of maternal trauma on mother–infant interaction remain insufficiently studied empirically. This study examined the effects of the September 11, 2001, trauma on mother–infant interaction in mothers who were pregnant and widowed on 9/11, and their infants aged 4–6 months. Split‐screen videotaped interaction was coded on a one‐second basis for infant gaze, facial affect, and vocal affect; and mother gaze, facial affect, and touch. We examined the temporal dynamics of communication: self‐contingency and interactive contingency of behavior by time‐series methods. We documented heightened maternal and infant efforts at engagement in the 9/11 (vs. control) dyads. Both partners had difficulty tolerating moments of looking away as well as moments of negative behavior patterns. Heightened efforts to maintain a positive visual engagement may be adaptive and a potential source of resilience, but these patterns may also carry risk: working too hard to make it work. A vigilant, hyper‐contingent, high‐arousal engagement was the central mode of the interpersonal transmission of the trauma to these infants, with implications for intervention.     

The Effect of the Primary Caretaker's Distress on the Sexually Abused Child: A Comparison of Biological and Foster Parents

Secondary trauma experienced by sexually abused children has only recently been explored in the literature. The scant findings suggest that out-of-home placement, the family's reaction to disclosure, and the emotional functioning of mothers may impact upon the emotional well-being of the sexually abused child. This study reports findings of data collected from 26 biological and 45 non-relative primary caretakers of molested children (n = 71). The data indicate significant differences between the two groups of caretakers with regard to maternal distress and support, and a strong relationship between the distress of the caretaker and symptomatology of the child. Significant predictors of child symptomatology and maternal support are reported, and recommendations for practice and policy applications are discussed.