Schumm Jeremiah A, Monson Candice M, O'Farrell Timothy J, Gustin Nancy G, Chard Kathleen M
Trauma Recovery Center, Cincinnati VA Medical Center, Cincinnati, Ohio, USA.
Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA.
J Trauma Stress. 2015 Jun;28(3):247-52. doi: 10.1002/jts.22007. Epub 2015 May 12.
We studied 13 U.S. male military veterans and their female partners who consented to participate in an uncontrolled trial of couple treatment for alcohol use disorder and posttraumatic stress disorder (CTAP). CTAP is a 15-session, manualized therapy, integrating behavioral couples therapy for alcohol use disorder (AUD) with cognitive-behavioral conjoint therapy for posttraumatic stress disorder (PTSD). Due to ineligibility (n = 1) and attrition (n = 3), 9 couples completed the study, and 7 completed 12 or more sessions. There were 8 veterans who showed clinically reliable pre- to posttreatment reduction of PTSD outcomes. There were also significant group-level reductions in clinician-, veteran-, and partner-rated PTSD symptoms (d = 0.94 to 1.71). Most veterans showed clinically reliable reductions in percentage days of heavy drinking. Group-level reduction in veterans' percentage days of heavy drinking was significant (d = 1.01). There were 4 veterans and 3 partners with clinically reliable reductions in depression, and group-level change was significant for veterans (d = 0.93) and partners (d = 1.06). On relationship satisfaction, 3 veterans and 4 partners had reliable improvements, and 2 veterans and 1 partner had reliable deterioration. Group-level findings were nonsignificant for veteran relationship satisfaction (d = 0.26) and for partners (d = 0.52). These findings indicate that CTAP may be a promising intervention for individuals with comorbid PTSD and AUD who have relationship partners.
我们研究了13名美国男性退伍军人及其女性伴侣，他们同意参与一项针对酒精使用障碍和创伤后应激障碍（CTAP）的夫妻治疗非对照试验。CTAP是一种为期15节的手册化治疗方法，将针对酒精使用障碍（AUD）的行为夫妻治疗与针对创伤后应激障碍（PTSD）的认知行为联合治疗相结合。由于不符合条件（1例）和失访（3例），9对夫妻完成了研究，其中7对完成了12节或更多节的治疗。有8名退伍军人在治疗前后PTSD结果出现了临床上可靠的降低。在临床医生、退伍军人和伴侣评定的PTSD症状方面，也出现了显著的组水平降低（d = 0.94至1.71）。大多数退伍军人在重度饮酒天数百分比上出现了临床上可靠的降低。退伍军人重度饮酒天数百分比的组水平降低具有显著性（d = 1.01）。有4名退伍军人和3名伴侣在抑郁方面出现了临床上可靠的降低，退伍军人（d = 0.93）和伴侣（d = 1.06）的组水平变化具有显著性。在关系满意度方面，3名退伍军人和4名伴侣有可靠的改善，2名退伍军人和1名伴侣有可靠的恶化。退伍军人关系满意度（d = 0.26）和伴侣关系满意度（d = 0.52）的组水平结果无显著性。这些发现表明，对于患有PTSD和AUD合并症且有伴侣的个体，CTAP可能是一种有前景的干预措施。
