Assessing interpersonal impact of veterans with PTSD and moral injury: A case study of how significant others perceive veterans undergoing a positive psychology intervention

Given the risk for PTSD and moral injury to negatively impact relationships of veterans, researchers have increasingly focused on social functioning assessment. However, extant studies have often relied on self-report methods and relatively broad relational measures. To better understand the dynamic process of social functioning, it is important to determine how others perceive those veterans and their interactions. Interpersonal circumplex assessments, such as the Impact Message Inventory-Circumplex (IMI-C), may provide that perspective by asking others to rate observations of veterans’ social behaviors on a circular pattern of eight octants representing unique blends of two orthogonal dimensions: affiliation (cold-warm) and control (dominant-submissive). This case study demonstrated how the IMI-C can be used to examine significant others’ perceptions of veterans with PTSD and moral injury in the context of a novel positive psychology treatment focused on inducing moral elevation. Using a fine-grained analysis of interpersonal behaviors, this study described two cases of veterans who demonstrated notable pre-post changes in how they were perceived by others, providing contextual information including quantitative changes in PTSD symptoms, moral injury, and quality of life, as well as qualitative reports of interpersonal changes. Clinical and research implications are discussed.