Icon Legend

This session is not in your schedule.

This session is in your schedule. Click again to remove it.

Presentation Icons

Recorded Session

Ticketed Session

Back

51 Views

ViewAttendees 2

Symposia

Couples / Close Relationships

Learning from Risk Studies in Military and Veteran Couples: Embracing Complexity Across Levels of Care

3 - (SYM 73) Exploring the Mental Health Concerns of Couples Presenting for Relationship Consultations: The Challenge of Picking a Focal Diagnosis When Treating a Trandiagnostic Problem

Saturday, November 16, 2024

10:30 AM – 11:30 AM EST

Location: Grand Ballroom K/L, Level 5, Downtown Marriott

Speaker(s)

DC

Dev Crasta, Ph.D.

Health Science Specialist
VISN 2 Center of Excellence for Suicide Prevention
Canandaigua, New York, United States

Co-author(s)

PB

Peter Britton, Ph.D. (he/him/his)

Research Psychologist
Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System
Canadaigua, New York, United States
SM

Stephen Maisto, PhD

Professor Emeritus
Department of Clinical Psychology, Syracuse University; Center of Integrated Healthcare, Syracuse VA Medical Center
Syracuse, New York, United States

Abstract Body

Background: Romantic relationship problems such as distress and intimate partner aggression (IPA) are common among U.S. military veterans presenting with mental health concerns (Sayers et al., 2009). Fortunately, a wide range of disorder-specific couple therapies have been developed to simultaneously build relationship skills and apply them to individual mental health problems (Baucom et al., 2012). However, a challenge of these conjoint approaches is that they require mutual commitment from the therapist and the couple to prioritize a single disorder for an extended period. The current study explores the potential interplay of mental health diagnoses among distressed couples seeking care to provide insight into this dilemma.

Method: We examined baseline assessments for 31 couples (n=62 individuals) recruited as part of a larger RCT examining different models of relationship consultation for veterans with concurrent relationship problems at least one positive mental health screen for depression, posttraumatic stress disorder (PTSD), heavy drinking, or suicide ideation at initial recruitment. For eligible couples, we provided full-length self-report measures and standardized interviews for these concerns to both partners.

Results: Both veterans and supporting partners had comparable rates of depression and history of suicidal behavior. In contrast, only PTSD and past-month suicidal ideation had significantly higher prevalence among veterans than partners. Although a third of veterans reported heavy drinking at initial screening, use of a measure that captured drinking consequences found a small proportion of either veterans or partners meeting thresholds for alcohol use disorders. Concordance between mental health concerns were low, meaning that although half of supporting partners met clinical thresholds for at least one mental health concern (and a larger number had subthreshold scores), it was rare that partners in a couple would be flagged for the same concerns.

Discussion: Despite the imbalanced selection criteria in our trial’s design, in many cases it was difficult to clinically justify prioritizing either partner as an “identified patient.” This challenge would likely be harder in routine clinical care, where a wider variety of mental health concerns can emerge. We discuss implications for collaboratively selecting disorder-specific couple therapies in a way that does not prioritize one partner’s care over the other. We also discuss the value of "generic" couple therapies in balancing couples' concerns.