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Relationship impairment due to PTSD and depression has opposite effect on treatment-seeking in men and women


January 23, 2019

By Tristan Horrom
VA Research Communications

When women had greater relationship impairment, they were more likely to seek mental health treatment. In men, the effect was the opposite.

Relationship problems stemming from PTSD and depression could have opposite effects on men and women in terms of their seeking mental health treatment, found a VA Boston Healthcare System study. In a study of post-9/11 Veterans, relationship dysfunction was linked to increased rates of mental health care use in women, but lower rates of use for men.

The results appeared in the January 2019 issue of the journal Psychiatry Research. The findings “underscore the importance of attending to the role of relationship impairment in Veterans’ treatment-seeking,” write the authors.

PTSD and depression are known to cause functional impairment in Veterans. Functional impairment refers to interference in a person’s ability to effectively manage in various areas of everyday life, such as relationships, family, and work.

Does that functional impairment affect treatment-seeking differently in male and female Veterans?

To answer this question, researchers surveyed 363 Veterans of the post-9/11 conflicts. Participants were surveyed five years after their military separation, and then again nine months later. Each participant was assessed for depression, PTSD, and functional impairment.

Among women, relational problems spur treatment

The results showed some expected associations. PTSD and depression symptoms were linked to increased use of mental health services in both men and women. Symptoms were also linked to increased relationship and work impairment.

But when the researchers looked at the connection between functional impairment and treatment-seeking, they found an interesting result: When women had greater relationship impairment, they were more likely to seek mental health treatment. When men had greater relationship impairment, they were less likely to seek treatment.

Work impairment did not affect treatment-seeking in the same way as did relationship impairment.

The researchers offer several possible explanations for this difference. According to Dr. Dawne Vogt, the lead investigator for the study: “It could be that for men, the lack of a supportive partner to encourage them to seek treatment could lead to less care use. For women, perhaps the negative impact of their condition on relationships could serve as a signal that help is needed.”

Gender-based social norms may affect treatment-seeking

The difference may reflect the different role that relationships play in men’s and women’s lives, say the researchers. Women have been shown to have a greater attunement to and emphasis on relationships than do men, so they may react differently to problems in this area. Social norms that emphasize stoicism and emotional control in men may affect whether they seek treatment.

The results show the importance of engaging patients on the functional consequences of mental health conditions rather than just focusing on symptom management, says Vogt. Different approaches may be needed to address relationship impairment in men and women. For example, for men, treatment may include bolstering other sources of support beyond intimate relationships to enhance their engagement in treatment. For women, efforts could focus on how treatment may help in preserving relationships.

The researchers also suggest that it could be helpful for both men and women to be offered PTSD and depression treatment that involves a loved one, which could increase Veterans’ motivation and engagement in treatment.

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