Efficacy of Structured Approach Therapy in Reducing PTSD in Returning Veterans: A Randomized Clinical Trial
Efficacy of Structured Approach Therapy in Reducing PTSD in Returning Veterans: A Randomized Clinical Trial
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DOI：
10.1037/ser0000032
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发表时间：
2015-08-01
影响因子：
2.3
通讯作者：
Vaught, Amanda S.
中科院分区：
文献类型：
--
作者：
Sautter, Frederic J.;Glynn, Shirley M.;Vaught, Amanda S.
部署在支持伊拉克自由行动（OIF）和持久自由行动（OEF）的美国军队显示出创伤后应激障碍（PTSD）以及关系，伴侣和养育压力的高比率。鉴于战斗相关的创伤后应激障碍对退伍军人及其亲人的影响，研究人员开发了一种基于夫妇的治疗方法，结构化方法治疗（SAT），以减少创伤后应激障碍，同时减少关系和伴侣的痛苦。本研究提供了一项随机临床试验（RCT）的治疗结果数据，该试验比较了SAT（一种手动的12节新颖的基于夫妇的PTSD治疗）和手动的12节基于夫妇的教育干预（PTSD家庭教育[PFE]）。数据收集自57名符合《精神疾病诊断与统计手册》（第四版，文本修订版; DSM-IV-TR）PTSD标准的退伍军人及其同居伴侣;数据收集安排在治疗前、治疗后和3个月随访。一项意向性治疗分析的结果显示，接受SAT的退伍军人在自我评价方面表现出更大的下降。（PTSD检查表; p < .0006）和临床医生管理的PTSD量表（CAPS）评定的PTSD（p < .0001）通过3个月的随访，与接受PFE的退伍军人相比; 29名接受SAT的退伍军人中有15名（52%）和28名接受PFE的退伍军人中有2名（7%）不再符合DSM-IV-TR的PTSD标准。此外，SAT与退伍军人关系调整，依恋回避和状态焦虑的显着改善相关。伴侣的依恋焦虑显著降低。这种以夫妻为基础的治疗与战斗有关的创伤后应激障碍似乎对最近返回的退伍军人与战斗有关的创伤后应激障碍有很强的治疗效果。
The U.S. military deployed in support to Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) show high rates of posttraumatic stress disorder (PTSD) and relationship, partner, and parenting distress. Given the pervasive effect of combat-related PTSD on returning veterans and its effect on their loved ones, the investigators have developed a couples-based treatment, structured approach therapy (SAT), to reduce PTSD while simultaneously decreasing relationship and partner distress. This study presents treatment outcome data measuring PTSD and relationship outcomes from a randomized clinical trial (RCT) comparing SAT, a manualized 12-session novel couples-based PTSD treatment, to a manualized 12-session couples-based educational intervention (PTSD Family Education [PFE]). Data were collected from 57 returning veterans meeting Diagnostic and Statistical Manual of Mental Disorders (fourth edition, text revision; DSM-IV-TR) criteria for PTSD and their cohabiting partners; data collection was scheduled for pretreatment, posttreatment, and 3-month follow-up. Findings from an intent-to-treat analysis revealed that veterans receiving SAT showed significantly greater reductions in self-rated (PTSD Checklist; p < .0006) and Clinician-Administered PTSD Scale (CAPS)-rated PTSD (p < .0001) through the 3-month follow-up compared with veterans receiving PFE; 15 of 29 (52%) veterans receiving SAT and 2 of 28 (7%) receiving PFE no longer met DSM-IV-TR criteria for PTSD. Furthermore, SAT was associated with significant improvements in veteran relationship adjustment, attachment avoidance, and state anxiety. Partners showed significant reductions in attachment anxiety. This couples-based treatment for combat-related PTSD appears to have a strong therapeutic effect on combat-related PTSD in recently returned veterans.