Steffany J Fredman

• Ph.D.
• Professor (Associate) at Pennsylvania State University

Black/African American individuals experience high rates of posttraumatic stress disorder (PTSD), which is frequently chronic and undertreated in this population. Intimate relationships are a salient resource for Black/African American adults’ psychological well-being. To help advance health equity, this study serves as an initial, proof-of-concept...

This chapter describes an intensive couple-based intervention for the treatment of posttraumatic stress disorder. Intensive formats can potentially capitalize on the momentum afforded by more frequent or extended sessions to facilitate change in a shorter period of time. These formats decrease dropout from therapy and are attracting increased atten...

Spillover from interparental conflict (IPC) to the parent–child relationship is a risk factor for adolescent emotional, social, and behavioral maladjustment. Parental depression increases the risk for more frequent and intense IPC over periods of months to years, but relatively little is known about whether parental depressive symptoms increase the...

Background: Symptom accommodation by family members (FMs) of individuals with posttraumatic stress disorder (PTSD) includes FMs’ participation in patients’ avoidance/safety behaviours and constraining self-expression to minimise conflict, potentially maintaining patients’ symptoms. The Significant Others’ Responses to Trauma Scale (SORTS) is the on...

Cognitive behavioral conjoint therapy for posttraumatic stress disorder (CBCT for PTSD; Monson & Fredman, 2012) is associated with improvements in patients’ and partners’ mental health and relationship satisfaction. Some pretreatment relationship characteristics have predicted CBCT for PTSD outcomes for patients, but findings were limited to a sing...

We assessed the interrater reliability, convergent validity, and discriminant validity of the Self-Injurious Thoughts and Behaviors Interview-Short Form (SITBI-SF) in a sample of 1,944 active duty service members and veterans seeking services for posttraumatic stress disorder (PTSD) and related conditions. The SITBI-SF demonstrated high interrater...

Objective: Interview assessments of intimate partner violence (IPV) may provide more accurate behavior frequency estimates than self-report questionnaires. However, concerns have been raised about whether participants underreport IPV during interviews due to an emotional response to the interviewer. Method: Participants were 42 mixed-gender communi...

Existing disparities regarding Black Americans’ psychological health warrant further investigation of socioecological factors that may be associated with negative and positive dimensions of psychological health in this population. Romantic relationship functioning and neighborhood context are two domains relevant to Black Americans’ mental health....

Financial well-being may be an important context for daily emotional reactivity to relationship tension (e.g., arguments) whose salience varies across historical time or as a function of exposure to economic downturns. This study investigated how emotional reactivity, operationalized as daily fluctuations in negative and positive affect associated...

In the context of service member posttraumatic stress disorder (PTSD) symptoms, intimate partners may experience pressure to take over parenting roles and run interference between the service member and the children; that is, to engage in partner accommodation focal to parenting. The current study quantitatively assessed potential pressures to enga...

This study investigated the associations between momentary emotion dynamics and posttraumatic stress disorder (PTSD) symptoms. Using a sample of 61 couples (N = 122 individuals) in which all individuals were trauma-exposed and at least one partner screened positive for PTSD, we examined the intra- and interpersonal regulation of vocally encoded emo...

The association between symptoms of posttraumatic stress disorder (PTSD) in adults and difficulties in intimate relationships is well documented. Growing literature suggests that interpersonally-oriented therapies, such as couple and family interventions, may lead to improvements in both PTSD symptoms and intimate relationship functioning. However,...

Romantic partners’ accommodation of trauma survivors’ posttraumatic stress disorder (PTSD) symptoms (e.g., participating in avoidance and safety behaviors, not expressing one’s thoughts and feelings) is a putative mechanism linking PTSD symptoms and partner distress, but this hypothesis has never been empirically tested. The current study investiga...

Cognitive behavioral conjoint therapy (CBCT) for posttraumatic stress disorder (PTSD) is a 15-session conjoint treatment for PTSD designed to improve PTSD symptoms and enhance intimate relationship functioning. Numerous studies of CBCT for PTSD document improvements in patient PTSD and comorbid symptoms, partner mental health, and relationship adju...

Cognitive-behavioral conjoint therapy (CBCT) for posttraumatic stress disorder (PTSD) has demonstrated efficacy for improving PTSD and comorbid symptoms and relationship adjustment. To enhance treatment efficiency and scalability, we developed a 2-day, abbreviated, intensive, multicouple group version of CBCT for PTSD (AIM-CBCT for PTSD). Prior wor...

The STRONG STAR Consortium (South Texas Research Organizational Network Guiding Studies on Trauma and Resilience) and the Consortium to Alleviate PTSD are interdisciplinary and multi-institutional research consortia focused on the detection, diagnosis, prevention, and treatment of combat-related posttraumatic stress disorder (PTSD) and comorbid con...

When military service members (SMs) experience symptoms of posttraumatic stress disorder (PTSD), intimate partners may respond by accommodating these symptoms. Although prior research has found that this type of accommodation, as self-reported by the partner, is associated with individual and relationship distress for both members of the intimate d...

Increasing attention has been paid to the influence of family contextual factors in predicting infant attachment security. However, little is known about the influence of coparenting quality on attachment. The goal of the present study was to examine the associations among parental perceptions of coparenting quality, quality of mothering (as indexe...

An increasing body of work documents the roles of religion and spirituality in Black American marriages. We built on this research to examine religious coping as a potential cultural resource for Black marriages using a dyadic analytic approach with longitudinal data. Specifically, we investigated the effects of positive (i.e., sense of spiritual c...

Cognitive-behavioral conjoint therapy for posttraumatic stress disorder (CBCT for PTSD) is associated with improvements in patients' PTSD symptoms, partners' psychological distress, and relationship satisfaction. However, little is known about whether CBCT for PTSD is associated with changes in other relationship domains that have theoretical and c...

Relationship difficulties are common during the transition to parenthood and may persist for years. Strategies that enhance couples' daily relational experiences early in the parenting years may serve a protective role. In general, engaging in a capitalization attempt (i.e., sharing personal good news) with one's romantic partner and perceiving the...

When service members manifest symptoms of posttraumatic stress disorder (PTSD), intimate partners may engage in behaviors to accommodate their partners’ experiences (e.g., helping service members avoid situations that could make them uncomfortable, not expressing own thoughts and feelings to minimize PTSD‐related conflict), which may inadvertently...

In general, a sense of understanding and connection is an important aspect of marital relationships. In the context of military couples in which a service member may have symptoms of PTSD, spouses' understanding of the nature and causes of service member PTSD symptoms may be protective for both partners' marital satisfaction. However, partners may...

Emerging research reinforces the importance of partner accommodation in the interpersonal context of posttraumatic stress disorder (PTSD). A better understanding of partners' motivations for accommodation is needed to help refine or design interventions that target accommodation. To explore partners' motivations, we created the Reasons for Accommod...

Cognitive-behavioral conjoint therapy for posttraumatic stress disorder (CBCT for PTSD; Monson & Fredman, 2012) is efficacious in improving PTSD symptoms and relationship adjustment among couples with PTSD. However, there is a need for more efficient delivery formats to maximize engagement and retention and to achieve faster outcomes in multiple do...

Associations between depressive symptoms and relationship distress are well-established, but little is known about these linkages among Black couples, or about the role of sociocultural factors in these processes. In this study, we applied a dyadic analytic approach, Actor-Partner Interdependence Modeling (APIM), to address 2 goals: to assess the p...

Cross-sectional research has suggested that posttraumatic stress disorder (PTSD) symptom severity may be an important predictor of family violence perpetration; however, causal inference is limited by the absence of studies designed to prospectively predict family violence by PTSD symptoms. In the current study, PTSD symptoms were assessed among 25...

Background: Posttraumatic stress disorder (PTSD) symptoms are associated with parental aggression towards children, but little is known about the relation between parents' PTSD symptoms and their risk for perpetrating child physical abuse during the early parenting years, when the potential for prevention of abuse may be highest. Objective: To e...

The couple and coparenting relationships are demonstrated to be prospectively and bidirectionally associated over months to years during the early parenting years. However, little is known about these associations at the daily level within the first year of parenthood, when coparenting first emerges. The goal of the current study was to examine the...

Objective: Large numbers of United States service members and veterans are enrolling in colleges and universities. Many are experiencing posttraumatic stress symptoms secondary to their military service, and these symptoms are associated with academic dysfunction. However, little is known about the mechanism(s) through which posttraumatic stress i...

Posttraumatic stress disorder (PTSD) symptoms are associated with disruptions in both couple functioning and parenting, and limited research suggests that, among military couples, perceptions of couple functioning and parenting stress are a function of both one’s own and one’s partner’s mental health symptoms. However, this work has not been genera...

The current study examined parenting stress (disaggregated into personal distress and child rearing stress) at 12 months postpartum as a mediator of the longitudinal association between parental negative affectivity at 6 months postpartum and harsh parenting at 3 years postpartum for first-time parents with a child transitioning from late toddlerho...

There are well-documented associations between PTSD symptoms and intimate relationship impairments, including dysfunctional communication at times of relationship conflict. To date, the extant research on the associations between PTSD symptom severity and conflict communication has been cross-sectional and focused on military and veteran couples. N...

Relationships with parents have significant implications for well-being throughout the lifespan. At midlife, these ties are situated within both developmental and family contexts that often involve the adult offspring's spouse. Yet, it is not known how ties with aging parents are related to psychological well-being within middle-aged couples. This...

Posttraumatic growth (PTG) is defined as a positive psychological change that can emerge following a traumatic life event. Although documented in noninterventional studies of traumatized individuals, there are scant data on the potential for therapy to induce or improve PTG. Thus, the primary goal of this study was to examine changes in PTG in a co...

Opinion statement Research has consistently documented a bidirectional association between posttraumatic stress disorder (PTSD) symptoms and intimate relationship functioning. PTSD symptoms are associated with greater relationship distress, higher likelihood of divorce, decreased emotional intimacy, and increased sexual dysfunction. Conversely, spe...

Numerous studies document an association between posttraumatic stress disorder (PTSD) and impairments in intimate relationship functioning, and there is evidence that PTSD symptoms and associated impairments are improved by cognitive-behavioral conjoint therapy for PTSD (CBCT for PTSD; Monson & Fredman, 2012). The present study investigated changes...

Objective: The primary goal of the present study was to investigate whether pre-treatment relationship satisfaction predicted treatment drop-out and posttraumatic stress disorder (PTSD) symptom outcomes within a trial of cognitive-behavioral conjoint therapy (CBCT) for PTSD (Monson & Fredman, 2012). Additionally, we examined the influence of pre-t...

Objective: Partner accommodation of posttraumatic stress disorder (PTSD) symptoms (i.e., altering one's own behaviors to minimize patient distress and/or relationship conflict due to patients' PTSD symptoms) has been shown to be positively associated with patient and partner psychopathology and negatively associated with patient and partner relati...

In this chapter, we discuss cognitive behavioral couple therapy (CBCT), an empirically supported, time-limited intervention for the treatment of relationship distress. We provide an overview of maladaptive interactional patterns, affect dysregulation, and unhelpful cognitions that can contribute to relationship distress and frequently characterize...

This article describes the three-generation family systems health care model developed at the Veteran and Family Clinic of the Home Base Program, a partnership between the Red Sox Foundation and Massachusetts General Hospital designed to improve treatment engagement of veterans with posttraumatic stress disorder (PTSD) and related conditions, and t...

Objective: The "critical comments" dimension of the expressed emotion (EE) construct has been found to predict the illness course of patients with bipolar disorder, but less is known about the "emotional overinvolvement" component. The goal of this study was to evaluate whether relatives' observed appropriate and inappropriate emotional involvemen...

There is increasing recognition that combat-related posttraumatic stress disorder (PTSD) affects the service member or veteran who experienced the trauma, his or her partner, and their relationship more broadly. Reactions by partners and other loved ones can also serve as impediments to, or facilitators of, recovery in the wake of trauma exposure....

A number of studies have documented that posttraumatic stress disorder (PTSD) symptoms in “one” partner are negatively associated with their intimate partner's psychological functioning. The present study investigated intimate partners’ mental health outcomes (i.e., depression, anxiety, and anger) in a sample of 40 partners of individuals with PTSD...

This chapter reviews the extant literature on the interpersonal aspects of posttraumatic stress disorder (PTSD), with a focus on couple and family models of PTSD. Topics include the association of PTSD with a variety of family relationship problems in a range of traumatized populations. The role of relevant interpersonal constructs in the developme...

Posttraumatic stress disorder (PTSD) is a prevalent condition associated with intimate relationship problems, and intimate relationship factors have been shown to affect individual PTSD treatment outcomes. To compare cognitive-behavioral conjoint therapy for PTSD (a manualized couple therapy delivered to patients with PTSD and their significant oth...

This study examined concordance between physiological arousal and subjective distress during a laboratory challenge task. Data were collected during the multisite VA Cooperative Study 334 in the early 1990s examining psychophysiological arousal among combat-exposed Vietnam veterans with (n = 775) and without (n = 369) posttraumatic stress disorder...

Cognitive-behavioral conjoint therapy for posttraumatic stress disorder (CBCT for PTSD) is designed to improve PTSD symptoms and enhance intimate relationship adjustment. Phase 1 includes psychoeducation about the reciprocal influences of PTSD symptoms and relationship functioning, exercises to promote positive affect and behaviors, and conflict ma...

Previous research indicates that men are affected when their female partners have breast cancer. However, little is known about what predicts men's psychological well-being in this context. The current investigation involved couples in which the woman had early stage breast cancer and explored the degree to which men's positive and negative well-be...

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Several studies showed associations among marital variables and panic disorder with agoraphobia (PDA) symptomatology. However, very few explored this issue using behavioural coding of couples’ interactions. We conducted this study to investigate whether observed marital interaction patterns would predict PDA severity. Cross-sectional, pre-treatment...

As the newest generation of veterans returns home from the fronts in Afghanistan and Iraq, increased attention is being paid to their postdeployment mental health adjustment as well as the interpersonal sequelae of posttraumatic stress disorder (PTSD) and other mental health conditions. The Department of Defense has begun to invest in relationship-...

Seven couples participated in an uncontrolled trial of cognitive-behavioral conjoint therapy for posttraumatic stress disorder (PTSD). Among the 6 couples who completed treatment, 5 of the patients no longer met criteria for PTSD and there were across-treatment effect size improvements in patients' total PTSD symptoms according to independent clini...

This study examined associations among disaster characteristics, relationship adjustment, and posttraumatic stress disorder (PTSD) symptomatology 9 months postdisaster in 205 women exposed to extensive flooding. Bivariately, threat/harm and loss exposure dimensions were related to each other but differentially related to relationship adjustment and...

This study had two goals. First, it investigated marital interaction variables as predictors of treatment outcome in panic disorder with agoraphobia (PDA) in sixty-five couples with one spouse suffering from PDA. Second, it analyzed the impact of PDA improvement, following therapy, on marital interaction patterns of both spouses. The partners were...

Posttraumatic stress disorder (PTSD) is a relatively common mental health condition that can occur after exposure to a traumatic event. The lifetime prevalence of the disorder in the general population is about 8%, with a 2:1 prevalence of the disorder in women (10%) compared with men (5%; Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995). Although...

Military operations in Iraq and Afghanistan have brought heightened awareness of military related PTSD, as well as the intimate relationship problems that accompany the disorder and can influence the course of veterans' trauma recovery. In this paper, we review recent research that documents the association between PTSD and intimate relationship pr...

Despite mounting evidence supporting the use of psychosocial interventions to promote adaptation to cancer, enrolling participants into these interventions is challenging. This is particularly salient for couple-based interventions, and newer, more targeted recruitment strategies to increase enrollment are needed. However, there have been few publi...

Although women's breast cancer affects both women and their male partners, as well as their relationships, few interventions have been developed to work with couples confronting breast cancer. The current investigation presents the pilot results from a new couple-based intervention program for breast cancer that teaches couples how to minimize nega...

As the newest generation of veterans returns home from their duties abroad, many face the individual and interpersonal aftereffects of duty-related traumatic experiences. Despite the established association between posttraumatic stress disorder (PTSD) and relationship problems, there is a lack of evidence-based conjoint treatments that target both...

Many studies have examined the construct validity of the criticism component of expressed emotion, but little work has been done on clarifying the emotional overinvolvement (EOI) construct. In a sample of 115 recently episodic patients with bipolar disorder, the authors of the present study examined the construct validity of an observational coding...

IntroductionChildhood anxiety disordersTemperament: focus on behavioral inhibitionGenetic influences on anxiety disorders and anxiety-related traitsHypothesized cognitive risk factorsParentingLife eventsPeersSummary of hypothesized risk factors and tentative etiological modelClinical implications

The objective of this preliminary study was to assess whether problem solving in marital interactions within couples with a spouse suffering from panic disorder with agoraphobia (PDA), and the non-PDA spouse’s (NPS) emotional over-involvement (EOI), would predict PDA symptom severity, and see how those symptoms would affect in return the problem so...

The present study investigated the reliability and construct validity of a behavioral observation coding system of emotional overinvolvement (EOI), an index of intrusive, excessively self-sacrificing, or exaggeratedly emotional behavior displayed by the relative of a psychiatric patient. Separate behavioral ratings of relatives' intrusiveness, exce...

Many patients treated for major depression require more than one antidepressant trial to achieve or sustain response. However, the literature provides few treatment algorithms or effectiveness studies that empirically support "next-step" options available to clinicians. We conducted a survey of psychiatrists and other medical specialists who treat...

Background: Many patients treated for major depression require more than one antidepressant trial to achieve or sustain response. However, the literature provides few treatment algorithms or effectiveness studies that empirically support next-step options available to clinicians. We conducted a survey of psychiatrists and other medical specialists...

A sample of 78 U.S. students carried beepers for 1 week and reported in situ on their awareness of gender and race. The participants to whom gender and race were more important were more aware of those characteristics, and their awareness of gender and race was more variable across situations. Awareness was higher in public than in private settings...

Clinical research has established that depression is frequently a recurrent disorder;1-3 50% of persons who have one episode of major depression will have a second, and 80-90% of those with a second will have a third.4 Bolstered by the testimony of leading experts on affective disorders, recent media attention has been aimed at emphasizing depressi...

Typescript. Thesis (B.A. with honors)--Amherst College, 1996. Includes bibliographical references (leaves 98-102).

Thesis (M.A.)--University of North Carolina at Chapel Hill, 2002. Includes bibliographical references (leaves 51-56).