PTSD-Focused Relationship Enhancement Therapy for Returning Veterans & their Part

说明(由申请人提供)：通过题为《以家庭和二元为重点的干预措施以防止亲密伴侣暴力》的RFA请求提供五年的支持(U49)。拟议项目的目的是为已婚或结伴的持久自由行动(OEF)/伊拉克自由行动(OIF)退伍军人制定和测试一个以伴侣为基础的关系加强小组干预，以防止亲密伴侣侵犯行为(IPA)。这一干预措施将包括针对创伤后应激障碍和IPA的几种干预措施的组成部分，并将针对与PTSD-IPA关联有关的机制。这种干预方法被贴上了创伤后应激障碍重点关系增强疗法(PF-RET)的标签。参与者将被随机分配到接受PFRET以进行支持性治疗(ST)，这两种治疗都是联合组的形式，并将在干预后跟踪12个月。 符合预防精神健康问题的建议(Mrazek& Haggerty，1994)，干预措施将针对在IPA(近端目标)的发展中牵连的经验性支持的风险因素，以预防IPA(远端目标)。具体地说，PF-RET的近端目标包括创伤后应激障碍症状、愤怒、社交问题解决技能、愤怒相关的认知扭曲、关系满意度、一般性攻击性和与关系中的权力相关的冲突。干预的远端目标包括减少亲密伴侣身体攻击和心理攻击的发生率和频率。参与者将包括400对夫妇，由于患有创伤后应激障碍的夫妇中有一名男性，以及高水平的婚姻痛苦，这些夫妇有患上IPA的风险。然而，与二级预防办法相一致(国家咨询精神卫生理事会精神卫生工作组 疾病预防研究，1998)，参与者将根据IPA的历史被排除在外。

DESCRIPTION (provided by applicant): Five years of support are requested through the RFA entitled Family and Dyadic Focused Interventions to Prevent Intimate Partner Violence (U49). The purpose of the proposed project is to develop and test a couples based relationship enhancement group intervention for married or partnered Operation Enduring Freedom (OEF) / Operation Iraqi Freedom (OIF) veterans to prevent the perpetration of intimate partner aggression (IPA). This intervention will incorporate components of several interventions for PTSD and IPA and will target mechanisms implicated in the PTSD-IPA association. The intervention approach has been labeled PTSD Focused Relationship Enhancement Therapy (PF-RET). Participants will be randomly assigned to receive PFRET for supportive therapy (ST), both in a conjoint group format, and will be followed for 12 months post-intervention. Consistent with recommendations for the prevention of mental health problems (Mrazek & Haggerty, 1994), the intervention will target empirically-supported risk factors implicated in the development of IPA (proximal targets) to prevent IPA (distal targets). Specifically, the proximal targets of PF-RET include PTSD symptoms, anger, social problem solving skills, anger-related cognitive distortions, relationship satisfaction, generalized aggression, and conflicts related to power in relationships. The distal targets of the intervention include reduced incidence and frequency of intimate partner physical assault and psychological aggression. Participants will consist of 400 couples that are at risk for the development of IPA due to the presence of a male in the couple with PTSD, as well as high levels of marital distress. However, consistent with a secondary prevention approach (National Advisory Mental Health Council Workgroup on Mental Disorders Prevention Research, 1998), participants will be excluded on the basis of histories of IPA.