Cognitive-Behavioral Couples Therapy for Posttraumatic Stress Disorder

创伤后应激障碍的认知行为夫妻疗法

• 批准号: 7305341
• 负责人: CANDICE M. MONSON
• 金额: $ 17.01万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7305341
• 关键词: Address; Anger; Anxiety; Arts; Attention; Behavioral; Chronic; Cognitive; Communication; Communities; Condition; Couples; Couples Therapy; Crime; Diagnosis; Disease; Distress; Dropout; Elements; Ensure; Ethnic Origin; Feedback; Funding; Goals; Grant; Guilt; Impairment; Individual; Intervention; Interview; Love; Maintenance; Manuals; Measures; Mental Health; Military Personnel; Modification; Motor Vehicles; Natural Disasters; Numbers; Outcome; Patient Self-Report; Patients; Personal Satisfaction; Persons; Phase; Post-Traumatic Stress Disorders; Prevalence; Protocols documentation; Public Health; Randomized; Randomized Controlled Trials; Range; Rate; Reporting; Research; Research Personnel; Research Project Grants; Sampling; Series; Societies; Staging; Survivors; Symptoms; Terrorism; Testing; Trauma; Traumatic Stress Disorders; Treatment Effectiveness; Treatment Efficacy; Veterans; Waiting Lists; Wife; Work; base; compliance behavior; cost; depressive symptoms; experience; follow-up; functional disability; improved; member; psychoeducation; psychosocial; sex; sexual assault; size

DESCRIPTION (provided by applicant): Posttraumatic stress disorder (PTSD) is a highly prevalent and pernicious disorder, with a frequently chronic course. There are far-reaching and devastating interpersonal relationship problems associated with chronic PTSD than can maintain or aggravate its course. These problems can also interfere with successful treatment delivery, and may be addressed to improve treatment compliance, efficacy of treatment, and maintenance of gains. A number of clinicians and researchers have called for the inclusion of significant others in PTSD treatment because of these reasons. In an effort to improve upon the treatment of chronic PTSD and its broader functional impairments, the overall goal of this R34 Exploratory Research Grant is to refine and adapt a manualized Cognitive-Behavioral Couples Therapy (CBCT) for PTSD, and to test it against a delayed treatment condition. Phase 1 of the project aims to (1) refine the existing CBCT for PTSD manual; (2) develop a treatment fidelity measure; and (3) finalize the assessment protocol by treating a series of 10 couples in which one member of the couple is diagnosed with chronic PTSD. This phase would ensure that the treatment is sufficiently flexible to address a range of traumatized individuals and couples, and that it has the necessary elements for conducting a controlled trial. Phase 2 of the project consists of a randomized controlled trial of the refined therapy to determine its efficacy and estimate other intervention parameters. The sample will consist of 40 community couples including one person diagnosed with chronic PTSD. The couples will be randomized to receive the therapy immediately or be placed on a waiting list to receive the treatment. The primary hypothesis is that CBCT for PTSD will be more efficacious than the delayed treatment control in reducing overall PTSD symptoms, as measured by clinician interview, across treatment. Secondary and exploratory hypotheses relate to improved self-reported PTSD symptoms, co-morbid conditions, partner outcomes, and relationship functioning in the CBCT for PTSD immediately versus delayed treatment condition. An uncontrolled follow-up assessment of the immediate CBCT for PTSD condition at three months, and a replication of the primary results in the delayed treatment group are planned. The longer-term goal of this line of research is to conduct a Stage III trial of CBCT for PTSD compared to state-of-the-art individual PTSD treatment through an R01 grant-funded study. Posttraumatic Stress Disorder (PTSD) is highly prevalent, and comes at great cost to individuals, their loved ones, and society. The current project aims to develop a couples treatment for PTSD that would decrease individual PTSD symptoms, as well as improve the survivor's intimate relationship functioning and the well- being of their intimate partner. It is hoped that this treatment will ultimately decrease the prevalence and burden of this significant and growing public health problem.

描述（由申请人提供）：创伤后应激障碍（PTSD）是一种高度流行和有害的疾病，经常慢性病程。与慢性创伤后应激障碍相关的人际关系问题影响深远，破坏性很大，可以维持或加剧其进程。这些问题也可能干扰成功的治疗递送，并且可以被解决以改善治疗依从性、治疗功效和收益的维持。由于这些原因，许多临床医生和研究人员呼吁将重要他人纳入PTSD治疗。为了改善慢性创伤后应激障碍及其更广泛的功能障碍的治疗，这项R34探索性研究资助的总体目标是改进和调整创伤后应激障碍的手动认知行为夫妇疗法（CBCT），并针对延迟治疗条件进行测试。该项目的第一阶段旨在（1）完善现有的CBCT用于PTSD手册;（2）制定治疗保真度措施;（3）通过治疗一系列10对夫妇，其中一对夫妇被诊断患有慢性PTSD，最终确定评估方案。这一阶段将确保治疗具有足够的灵活性，以应对一系列受到创伤的个人和夫妇，并确保治疗具有进行对照试验的必要要素。该项目的第二阶段包括一项精细治疗的随机对照试验，以确定其疗效并估计其他干预参数。样本将由40对社区夫妇组成，其中包括一名被诊断患有慢性创伤后应激障碍的人。这些夫妇将被随机分配立即接受治疗或被列入等待名单接受治疗。主要假设是，CBCT治疗PTSD在减少总体PTSD症状方面比延迟治疗对照更有效，如通过临床医生访谈测量的。次要和探索性假设涉及改善自我报告的PTSD症状，共病条件，合作伙伴的结果，以及CBCT中PTSD立即与延迟治疗条件的关系功能。计划在三个月时对PTSD状况的即时CBCT进行非对照随访评估，并在延迟治疗组中复制主要结果。这一系列研究的长期目标是通过R 01赠款资助的研究进行CBCT治疗PTSD的III期试验，与最先进的个体PTSD治疗进行比较。创伤后应激障碍（PTSD）非常普遍，给个人、他们的亲人和社会带来了巨大的代价。目前的项目旨在开发一种治疗PTSD的夫妻治疗方法，以减少个体PTSD症状，并改善幸存者的亲密关系功能及其亲密伴侣的福祉。希望这种治疗方法最终能降低这一重大且日益严重的公共卫生问题的流行率和负担。