Associations between distress tolerance and posttraumatic stress symptoms among combat veterans and their parents: The mediating role of parents’ accommodation

Objective: Combat-related posttraumatic stress disorder (PTSD) might negatively impact the mental health of veterans’ family members. Nevertheless, nearly no research has examined secondary PTSD symptoms (PTSS) in veterans’ parents, and still to be explored are the mechanisms by which distress tolerance (DT) contributes to veterans’ PTSS and parents’ secondary PTSS (SPTSS). In the present study, we aimed to use a dyadic approach to explore the association between veterans’ and parents’ DT and their PTSS/SPTSS, as well as to examine the mediating role of parents’ accommodation of veterans’ behaviors in these associations. Method: A volunteer sample of 102 dyads of Israeli combat veterans and their parents responded to online validated self-report questionnaires in a cross-sectional study. Analysis included actor–partner interdependence modeling (APIM) and mediation analyses. Results: Veterans’ PTSS was positively correlated with parents’ SPTSS. Moreover, veterans’ DT and parents’ DT negatively predicted their own PTSS and SPTSS, respectively. Furthermore, veterans’ DT negatively predicted their parents’ SPTSS. Importantly, parents’ accommodation mediated the links between veterans’ DT and both veterans’ PTSS and parents’ SPTSS, as well as between parents’ DT and veterans’ PTSS with parents’ SPTSS. Conclusion: Parents of combat veterans might be indirectly traumatized by their offspring’s military experiences and suffer from secondary PTSS. Among both veterans and parents, low DT is associated with higher levels of parents’ accommodation, which in turn is related to more posttraumatic symptoms.