Fredman Steffany J, Pukay-Martin Nicole D, Macdonald Alexandra, Wagner Anne C, Vorstenbosch Valerie, Monson Candice M
Department of Human Development and Family Studies, The Pennsylvania State University.
Trauma Recovery Center, Cincinnati VA Medical Center.
J Consult Clin Psychol. 2016 Jan;84(1):79-87. doi: 10.1037/ccp0000061. Epub 2015 Oct 26.
Partner accommodation of posttraumatic stress disorder (PTSD) symptoms (i.e., altering one's own behaviors to minimize patient distress and/or relationship conflict due to patients' PTSD symptoms) has been shown to be positively associated with patient and partner psychopathology and negatively associated with patient and partner relationship satisfaction cross-sectionally. However, the prognostic value of partner accommodation in treatment outcomes is unknown. The goals of the present study were to determine if partner accommodation decreases as a function of couple therapy for PTSD and if pretreatment partner accommodation moderates the efficacy of couple therapy for PTSD.
Thirty-nine patients with PTSD and their intimate partners (n = 39) were enrolled in a randomized controlled trial of cognitive-behavioral conjoint therapy (CBCT) for PTSD (Monson & Fredman, 2012) and received CBCT for PTSD immediately or after 3 months of waiting. Blinded assessors determined clinician-rated PTSD symptoms and patient-rated PTSD and depressive symptoms and relationship satisfaction at baseline, midtreatment/4 weeks of waiting, and posttreatment/12 weeks of waiting.
Contrary to expectation, partner accommodation levels did not change over time for either treatment condition. However, baseline partner accommodation significantly moderated treatment outcomes. Higher levels of partner accommodation were associated with greater improvements in PTSD, depressive symptoms, and relationship satisfaction among patients receiving CBCT for PTSD compared with waiting list. At lower levels of partner accommodation, patients in both groups improved or remained at low levels of these outcomes.
Individuals with PTSD who have more accommodating partners may be particularly well-suited for couple therapy for PTSD.
创伤后应激障碍（PTSD）症状的伴侣迁就（即改变自己的行为，以尽量减少因患者的PTSD症状而导致的患者痛苦和/或关系冲突）已被证明与患者和伴侣的精神病理学呈正相关，与患者和伴侣的关系满意度呈负相关。然而，伴侣迁就对治疗结果的预后价值尚不清楚。本研究的目的是确定伴侣迁就是否会随着PTSD夫妻治疗而减少，以及治疗前的伴侣迁就是否会调节PTSD夫妻治疗的疗效。
39名患有PTSD的患者及其亲密伴侣（n = 39）参加了一项针对PTSD的认知行为联合疗法（CBCT）的随机对照试验（Monson & Fredman，2012），并立即或在等待3个月后接受了PTSD的CBCT治疗。不知情的评估者在基线、治疗中期/等待4周以及治疗后/等待12周时确定临床医生评定的PTSD症状、患者评定的PTSD和抑郁症状以及关系满意度。
与预期相反，两种治疗条件下的伴侣迁就水平均未随时间变化。然而，基线时的伴侣迁就显著调节了治疗结果。与等待名单相比，接受PTSD的CBCT治疗的患者中，较高水平的伴侣迁就与PTSD、抑郁症状和关系满意度的更大改善相关。在较低水平的伴侣迁就情况下，两组患者在这些结果上有所改善或保持在较低水平。
有更迁就伴侣的PTSD患者可能特别适合接受PTSD的夫妻治疗。
