Couple's conflict among veterans seeking PTSD treatment

There are established links between posttraumatic stress disorder (PTSD) and greater conflict among couples with a veteran partner. While there is literature on couples' conflict generally, few studies have identified different conflict themes for veteran couples where one member is seeking treatment for PTSD. This study aimed to explore specific conflict themes among these couples and potential dyadic concordance in conflict themes. The current study examined self-reported themes of conflict among 137 veterans seeking PTSD treatment and their romantic partners (61 matched dyads and 15 unmatched individuals). Thematic analysis of qualitative responses identified 23 unique conflict themes, with categories related to relationship dynamics (e.g. communication, trust) and PTSD and mental health (e.g. hypervigilance, substance use). The five most frequently reported conflict themes were finances, communication, parenting and family, emotion regulation and expression, and anger. Concordance analyses demonstrated most couples matched on either one (47.3%) or two (23.6%) themes, with only 3.6% matching on all three and 25.5% of couples with zero matches. Couples demonstrated good reliability with one another on frequency of arguments (ICC = .74), but poor reliability (ICC = .41) on agreement as to whether their arguments were related to PTSD. Findings contribute to our understanding of how couples with a veteran partner may perceive conflict in the context of PTSD. Given all veterans were treatment seeking, these conflict themes between couples may be highly relevant to address in trauma-focused treatment. Clinically, conflict management skills and PTSD-focused psychoeducation could be beneficial in reducing couple conflict.