6 - (IOP 20) Examining the Heterogeneity of Psychopathology Symptoms and Relationship Satisfaction Among post-9/11 Veterans: A Latent Profile Analysis

Psychiatric comorbidity and intimate relationship distress are highly consequential problems among U.S. military veterans. Those with comorbid disorders report greater psychosocial impairment and chronic health conditions. Similarly, relationship distress among veterans has been linked to poor mental health prognosis. Despite the reciprocal nature of individual and relationship functioning, no study to date has explored the ways in which comorbid symptoms appear within veterans’ intimate relationships. Considerable research has examined the role of veterans’ PTSD in relationship impairment. Yet, to optimize interventions for this vulnerable population, it is critical to go beyond studying individual disorders to more fully characterize the heterogeneity among veterans’ symptoms and relationship quality—and to better understand which factors predict their different clinical presentations.

The current study explores the within-group patterning of veterans’ comorbid psychiatric symptoms (depression, PTSD, and alcohol use) and relationship satisfaction. Participants were 485 married U.S. veterans who completed self-report measures of mental, physical health, and relationship quality across two timepoints (baseline and 10-year follow-up) for the Post-Deployment Mental Health Study. Most were male (88%), on average 52 years-old, and identified as Black (43%) or White (48%). A latent profile analysis examined symptoms and relationship satisfaction at follow-up. Profiles were compared on military, physical health, and psychosocial factors to determine which variables prospectively predict group membership 10 years later.

A three-class solution included a Healthy group with low symptoms and high relationship satisfaction (63%), a Distressed group with clinically significant depression, PTSD symptoms, and low relationship satisfaction (31%), and a Mixed group with clinically significant depression, PTSD, and alcohol use and high relationship satisfaction (6%). Veterans with greater social support between baseline and follow-up were more likely to be in the Healthy group. Those in the Mixed group were more likely to report higher lifetime trauma exposure and physical health symptoms over time. Finally, veterans in the Distressed and Mixed groups were more likely to have used psychotherapy services at follow-up.

Our findings underscore the need to consider alternative conceptualizations of veteran psychopathology that address their comorbid conditions. Importantly, not all veterans with significant psychiatric symptoms report relationship distress; rather, our results show that some veterans may maintain well-functioning relationships despite their complex mental health problems--a finding not often reflected in the literature on veteran well-being. Thus, treatment efforts designed for at-risk veterans should continue to consider ways of enhancing social support and the integration of partners as important clinical targets.