The Association of Self-Reported Romantic Relationship Satisfaction and Anhedonia Symptoms Secondary to Posttraumatic Stress Among Trauma-Exposed Male Service Members/Veterans

Objective. Higher posttraumatic stress disorder (PTSD) symptoms are associated with poorer romantic relationship satisfaction in military samples. Studies have examined PTSD symptom clusters and their association with relationship satisfaction, but these studies are limited to the pre-Diagnostic and Statistical Manual (DSM)-5 PTSD models or samples of women. The current study explored the best fitting model of PTSD using contemporary symptoms and examined the association of symptom clusters and relationship satisfaction in a sample of partnered male service members/veterans who reported exposure to a probable Criterion A event. Method. Factor analyses of 6 competing PTSD models were compared using confirmatory factor analysis in a sample of 499 men. Path analysis was then used to examine which symptom clusters were uniquely associated with relationship satisfaction after accounting for covariates in a subsample of 217 men who reported probable Criterion A exposure. Results. The Anhedonia and Hybrid Models had the best fit to the data in both the larger sample and subsample of men reporting probable trauma exposure. Models had comparable model fit, thus symptom clusters from both models were examined as predictors of relationship satisfaction in 2 separate analyses adjusted for covariates. In both analyses, only higher anhedonia symptoms were associated with lower romantic relationship satisfaction. Conclusions. Data was cross-sectional so causality cannot be inferred, but it appears that poorer relationship satisfaction is more common when symptoms of anhedonia are high. Interventions to improve relationship satisfaction among those reporting posttraumatic stress symptoms may be most effective if they focus on reducing anhedonia. Clinical Impact Statement The Hybrid and Anhedonia Models of PTSD showed the most optimal fit to the data relative to other models of PTSD. Of the symptom clusters identified in these models, only higher anhedonia symptoms were associated with lower relationship satisfaction. Clinicians providing psychological care to male service members/veterans reporting low relationship satisfaction may consider the utility of these non-DSM-5 models of PTSD when conceptualizing their patient's distress. Therapies to improve satisfaction should focus on reducing anhedonia, which reflects the depressive components of PTSD. Behavioral activation and increasing the frequency of rewarding couples' behaviors (e.g., date night) may be particularly useful.