Efficacy of Behavioral Couples Therapy Versus Individual Recovery Counseling for Addressing Posttraumatic Stress Disorder Among Women With Drug Use Disorders.
Efficacy of Behavioral Couples Therapy Versus Individual Recovery Counseling for Addressing Posttraumatic Stress Disorder Among Women With Drug Use Disorders.
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行为夫妻疗法与个人康复咨询对于解决患有吸毒障碍的女性创伤后应激障碍的疗效。
DOI：
10.1002/jts.22415
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发表时间：
2019
影响因子：
3.3
通讯作者：
Muchowski,Patrice
中科院分区：
文献类型：
--
作者：
Schumm,JeremiahA;O'Farrell,TimothyJ;Murphy,MarieM;Muchowski,Patrice
物质使用障碍的行为伴侣疗法（BCT）与经验支持的创伤后应激障碍（PTSD）的伴侣疗法具有相似的干预策略。与基于夫妇的PTSD疗法一样，BCT包括可能有助于改善PTSD的干预措施，例如增加积极的行为交流和改善沟通。研究尚未检查BCT是否有效改善物质相关结果，是否有效减少PTSD。我们对一项随机临床试验进行了二次分析，该试验比较了个体化治疗（IBT）与BCT + IBT（BCT+IBT）治疗药物使用障碍女性的效果。这两种情况下的妇女在13周内接受了26次治疗。女性在基线、治疗后和1年随访期间每季度完成PTSD诊断量表。在61名随机接受治疗的女性中，51名（83.6%）报告了终身创伤事件。在50名认同“最严重创伤事件”的女性中，25名（50.0%）有基线PTSD诊断。治疗在基线PTSD严重程度或诊断方面没有差异。接受BCT+IBT治疗的女性从基线到四次治疗后随访的每一次，PTSD严重程度均显著降低，ds = 0.34-0.80; IBT组无变化。广义估计方程结果显示，接受BCT+IBT的女性在随访期间的PTSD严重程度显著低于接受IBT的女性，d= 0.35。治疗后被诊断为PTSD的参与者比例没有差异。这是第一项表明BCT+IBT可有效减少药物使用障碍女性的PTSD的研究。
Behavioral couples therapy (BCT) for substance use disorder shares similar intervention strategies with empirically supported couples therapies for posttraumatic stress disorder (PTSD). Like couples‐based PTSD therapies, BCT includes interventions that may help to improve PTSD, such as increasing positive behavioral exchanges and improving communication. Studies have yet to examine whether BCT, which has demonstrated efficacy for improving substance‐related outcomes, is efficacious for reducing PTSD. We conducted a secondary analysis of a randomized clinical trial comparing individually based treatment (IBT) to BCT plus IBT (BCT+IBT) for women with drug use disorders. Women in both conditions received 26 therapy sessions over 13 weeks. Women completed the PTSD Diagnostic Scale at baseline, posttreatment, and quarterly during the 1‐year follow‐up. Of the 61 women who were randomized to treatment, 51 (83.6%) reported a lifetime traumatic event. Of the 50 women who endorsed a “worst traumatic event,” 25 (50.0%) had a baseline PTSD diagnosis. The treatments did not differ on baseline PTSD severity or diagnosis. Women who received BCT+IBT had significant reductions in PTSD severity from baseline to each of four posttreatment follow‐ups,ds = 0.34–0.80; there were no changes in the IBT group. Generalized estimating equation results showed that women who received BCT+IBT had significantly lower PTSD severity during follow‐up versus those who received IBT,d= 0.35. There were no differences in the proportion of participants diagnosed with PTSD following treatment. This was the first study to show that BCT+IBT is efficacious for reducing PTSD among women with drug use disorders.
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Grant, Bridget F.;Saha, Tulshi D.;Ruan, W. June;Goldstein, Rise B.;Chou, S. Patricia;Jung, Jeesun;Zhang, Haitao;Smith, Sharon M.;Pickering, Roger P.;Huang, Boji;Hasin, Deborah S.
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