Intensive, Multi-Couple Group Therapy for PTSD: A Nonrandomized Pilot Study With Military and Veteran Dyads
Intensive, Multi-Couple Group Therapy for PTSD: A Nonrandomized Pilot Study With Military and Veteran Dyads
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DOI：
10.1016/j.beth.2019.10.003
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发表时间：
2020-09-01
期刊：
影响因子：
3.7
通讯作者：
Peterson, Alan L.
中科院分区：
文献类型：
--
作者：
Fredman, Steffany J.;Macdonald, Alexandra;Peterson, Alan L.
认知-行为联合治疗创伤后应激障碍(CBCT治疗创伤后应激障碍；Monson&Fredman，2012)在改善创伤后应激障碍夫妇的创伤后应激障碍症状和调整关系方面有效。然而，需要更有效的交付格式，以最大限度地提高参与度和保留率，并在多个领域实现更快的成果。这项非随机试验旨在试行简化的、密集的、多夫妇小组版本的创伤后应激障碍CBCT(AIM-CBCT for PTSD)，在一个周末为24对夫妇提供服务，其中包括一名患有创伤后应激障碍的现役军人或退伍军人，他们在2001年9月11日后被部署支持作战行动。所有夫妇都完成了治疗。临床评估员在干预1个月和3个月后进行的评估显示，与基线相比，临床医生评定的创伤后应激障碍症状(DS=-0.77和-0.98)以及患者自报的创伤后应激障碍(DS=-0.73和-1.17)、抑郁(DS=-0.60和-0.75)、焦虑(DS=-0.63和-0.73)和愤怒(DS=-0.45和-0.60)等症状显著减少。在3个月的随访中，伴侣报告说，与基线相比，患者的创伤后应激障碍症状显著减少(d=-0.56)，而他们自己的抑郁症状(d=-0.47)、焦虑(d=-0.60)和关系满意度(d=0.53)显著改善。通过简短、密集的多夫妇小组形式为创伤后应激障碍提供CBCT，可能是改善患有创伤后应激障碍的军人和退伍军人夫妇的患者、伴侣和关系幸福感的有效策略。
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 domains. This nonrandomized trial was designed to pilot an abbreviated, intensive, multi-couple group version of CBCT for PTSD (AIM-CBCT for PTSD) delivered over a single weekend for 24 couples that included an active-duty service member or veteran with PTSD who had deployed in support of combat operations following September 11, 2001. All couples completed treatment. Assessments conducted by clinical evaluators 1 and 3 months after the intervention revealed significant reductions in clinician-rated PTSD symptoms (ds = -0.77 and -0.98, respectively) and in patients' self-reported symptoms of PTSD (ds = -0.73 and -1.17, respectively), depression (ds = -0.60 and -0.75, respectively), anxiety (ds = -0.63 and -0.73, respectively), and anger (ds = -0.45 and -0.60, respectively), relative to baseline. By 3-month follow-up, partners reported significant reductions in patients' PTSD symptoms (d = -0.56), as well as significant improvements in their own depressive symptoms (d = -0.47), anxiety (d = -0.60), and relationship satisfaction (d = 0.53), relative to baseline. Delivering CBCT for PTSD through an abbreviated, intensive multi-couple group format may be an efficient strategy for improving patient, partner, and relational wellbeing in military and veteran couples with PTSD.