The Role of Trauma-Related Injustice in Pathways to Posttraumatic Stress Symptoms Among Conjugal Couples: A Multilevel, Dyadic Analysis in Postconflict Timor-Leste

Abstract

It is widely acknowledged that the survivor’s psychological response to the traumas of mass conflict can affect adversely other family members. Yet, the focus of past epidemiological studies in the field has been confined to the individual survivor’s posttraumatic stress symptom (PTSS) response. We report the first study of its kind in a postconflict country, in which we examine the effects of trauma exposure in one member of conjugal couples on the PTSS of the other. The study involved 677 conjugal couples drawn from a community survey ( n = 1,354) in postconflict Timor-Leste. We used culturally adapted and psychometrically tested measures of traumatic events (TEs), preoccupations with injustice, explosive anger, family conflict, and PTSS. A multilevel actor–partner interdependence model (ML-APIM) demonstrated individual pathways involving exposure to murder and atrocities, preoccupations with injustice, explosive anger, and family conflict, leading to PTSS in both men and women when examined separately, with minor variations in paths by gender. Preoccupations with injustice in male survivors contributed to PTSS in the female partner, but not vice versa. Women may have a gender-specific propensity to identify with the male partner’s preoccupations with injustice following exposure to murder and atrocities. Our findings offer novel clues to the possible factors contributing to the higher rates of PTSS among women.