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Background: The mutual maintenance model proposes that post-traumatic stress disorder (PTSD) symptoms and chronic physical symptoms have a bi-directional temporal relationship. Despite widespread support for this model, there are relatively few empirical tests of the model and these have primarily examined patients with a traumatic physical injury. Objective: To extend the assessment of this model, we examined the temporal relationship between PTSD and physical symptoms for military personnel deployed to combat (i.e., facing the risk of death) who were not evacuated for traumatic injury. Methods: The current study used a prospective, longitudinal design to understand the cross-lagged relationships between PTSD and physical symptoms before, immediately after, 3 months after, and 1 year after combat deployment. Results: The cross-lagged results showed physical symptoms at every time point were consistently related to greater PTSD symptoms at the subsequent time point. PTSD symptoms were related to subsequent physical symptoms, but only at one time-point with immediate post-deployment PTSD symptoms related to physical symptoms at three months after deployment. Conclusion: The findings extend prior work by providing evidence that PTSD and physical symptoms may be mutually maintaining even when there is not a severe traumatic physical injury. * We followed soldiers from before to after combat and found a high comorbidity of PTSD and physical symptoms.* PTSD and physical symptoms were mutually maintaining among soldiers who did not experience a traumatic injury resulting in hospitalization.

This study sought to understand how patients' perceptions of the nature and manner of communication with dental health professionals may impact their health self-management quality and habits in the context of preventable illness. Specifically, this study investigated the distinct and overlapping impacts of (a) communication based in the Common Sense Self-Regulation Model (CSM; Leventhal et al., 1980), and (b) the interpersonal relationship between the patient and the dental health professional provider on patients’ oral hygiene quality and habits.It was hypothesized that the interpersonal relationship would positively moderate a positive relation between CSM-based communication and patients' oral health self-management and strength of oral health self-management habits. A sample (N = 471) of participants were recruited via Amazon’s Mechanical Turk (MTurk) to answer questions about their most recent dental appointment. Participants were largely suburban-dwelling, Caucasian women with a mean age of 35.27 (SD = 11.47) and mean individual income of over $50,000. The findings suggest that dental professionals are regularly having CSM-based communication with their patients, and patients are regularly enacting oral health self-management. Interestingly, contrary to predictions, regression analyses indicated that whereas better dental professional-patient interpersonal relationships predicted better oral health self-management quality, more CSM-based communication at their appointment did not. Future research should focus on populations with less consistently practiced oral health self-management.