Symptoms of post-traumatic stress disorder, severe psychological distress, explosive anger and grief amongst partners of survivors of high levels of trauma in post-conflict Timor-Leste.
Little is known about the mental health of partners of survivors of high levels of trauma in post-conflict countries.



We studied 677 spouse dyads (n = 1354) drawn from a community survey (response 82.4%) in post-conflict Timor-Leste. We used culturally adapted measures of post-traumatic stress disorder (PTSD), psychological distress, explosive anger and grief.



Latent class analysis identified three classes of couples: class 1, comprising women with higher trauma events (TEs), men with intermediate TEs (19%); class 2, including men with higher TEs, women with lower TEs (23%); and class 3, comprising couples in which men and women had lower TE exposure (58%) (the reference group). Men and women partners of survivors of higher TE exposure (classes 1 and 2) had increased symptoms of explosive anger and grief compared with the reference class (class 3). Women partners of survivors of higher TE exposure (class 2) had a 20-fold increased rate of PTSD symptoms compared with the reference class, a pattern that was not evident for men living with women exposed to higher levels of trauma (class 1).



Men and women living with survivors of higher levels of trauma showed an increase in symptoms of grief and explosive anger. The manifold higher rate of PTSD symptoms amongst women living with men exposed to high levels of trauma requires replication. It is important to assess the mental health of partners when treating survivors of high levels of trauma in post-conflict settings.
Academic Mental Health Unit and Ingham Institute,University of New South Wales and South Western Sydney Local Health District,Level 2, Mental Health Centre,Liverpool Hospital,Sydney, NSW 2170,Australia.
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Silove
Academic Mental Health Unit and Ingham Institute,University of New South Wales and South Western Sydney Local Health District,Level 2, Mental Health Centre,Liverpool Hospital,Sydney, NSW 2170,Australia.
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Tay
St John of God Richmond Hospital,School of Psychiatry,University of New South Wales,North Richmond,NSW 2754,Australia.
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Steel
Academic Mental Health Unit and Ingham Institute,University of New South Wales and South Western Sydney Local Health District,Level 2, Mental Health Centre,Liverpool Hospital,Sydney, NSW 2170,Australia.
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Tam
Alola Foundation,Dili, Timor-Leste.
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Soares
Alola Foundation,Dili, Timor-Leste.
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Soares
Alola Foundation,Dili, Timor-Leste.
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Dos Reis
Alola Foundation,Dili, Timor-Leste.
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Alves
Academic Mental Health Unit and Ingham Institute,University of New South Wales and South Western Sydney Local Health District,Level 2, Mental Health Centre,Liverpool Hospital,Sydney, NSW 2170,Australia.
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Rees
D000328:Adult; D000786:Anger / Q000502:physiology*; D005260:Female; D006117:Grief; D006801:Humans; D008297:Male; D008875:Middle Aged; D000067073:Psychological Trauma / Q000453:epidemiology / Q000503:physiopathology*; D018454:Spouses / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000503:physiopathology*; D013315:Stress, Psychological / Q000453:epidemiology / Q000503:physiopathology*; D017741:Survivors / Q000706:statistics & numerical data; D049648:Timor-Leste / Q000453:epidemiology; D000067453:War Exposure / Q000706:statistics & numerical data
Anger; grief; post-conflict; post-traumatic stress disorder; trauma