Taft Casey T, Macdonald Alexandra, Creech Suzannah K, Monson Candice M, Murphy Christopher M
VA Boston Healthcare System (116B-4), 150 South Huntington Ave, Boston, MA 02130.
National Center for PTSD, VA Boston Healthcare System, and Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.
J Clin Psychiatry. 2016 Sep;77(9):1168-1175. doi: 10.4088/JCP.15m10020.
We evaluated the efficacy of the Strength at Home Men's Program (SAH-M), a trauma-informed group intervention based on a social information processing model to end intimate partner violence (IPV) use in a sample of veterans/service members and their partners. To date, no randomized controlled trial has supported the efficacy of an IPV intervention in this population.
Participants included 135 male veterans/service members and 111 female partners. Recruitment was conducted from February 2010 through August 2013, and participation occurred within 2 Department of Veterans Affairs hospitals. Male participants completed an initial assessment that included diagnostic interviews and measures of physical and psychological IPV using the Revised Conflict Tactics Scales and were randomly assigned to an enhanced treatment as usual (ETAU) condition or SAH-M. Those randomized to SAH-M were enrolled in this 12-week group immediately after baseline. Those randomized to ETAU received clinical referrals and resources for mental health treatment and IPV services. All male participants were reassessed 3 and 6 months after baseline. Female partners completed phone assessments at the same intervals that were focused both on IPV and on the provision of safety information and clinical referrals.
Primary analyses using hierarchical linear modeling indicated significant time-by-condition effects such that SAH-M participants compared with ETAU participants evidenced greater reductions in physical and psychological IPV use (β = -0.135 [SE = 0.061], P = .029; β = -0.304 [SE = 0.135], P = .026; respectively). Additional analyses of a measure that disaggregated forms of psychological IPV showed that SAH-M, relative to ETAU, reduced controlling behaviors involving isolation and monitoring of the partner (β = -0.072 [SE = 0.027], P = .010).
Results provide support for the efficacy of SAH-M in reducing and ending IPV in male veterans and service members.
ClinicalTrials.gov Identifier: NCT01435512.
我们评估了居家力量男性项目（SAH-M）的疗效，该项目是一种基于社会信息处理模型的创伤知情团体干预措施，旨在终止退伍军人/现役军人及其伴侣中的亲密伴侣暴力（IPV）行为。迄今为止，尚无随机对照试验支持针对该人群的IPV干预措施的疗效。
参与者包括135名男性退伍军人/现役军人和111名女性伴侣。招募工作于2010年2月至2013年8月进行，参与在2家退伍军人事务部医院内开展。男性参与者完成了初始评估，包括诊断访谈以及使用修订版冲突策略量表对身体和心理IPV的测量，并被随机分配到强化常规治疗（ETAU）组或SAH-M组。随机分配到SAH-M组的参与者在基线后立即参加这个为期12周的团体项目。随机分配到ETAU组的参与者获得了心理健康治疗和IPV服务的临床转诊及资源。所有男性参与者在基线后3个月和6个月接受重新评估。女性伴侣在相同时间间隔完成电话评估，评估重点是IPV以及安全信息的提供和临床转诊。
使用分层线性模型的主要分析表明存在显著的时间×条件效应，因此与ETAU组参与者相比，SAH-M组参与者在身体和心理IPV行为方面的减少更为显著（β = -0.135 [标准误 = 0.061]，P = 0.029；β = -0.304 [标准误 = 0.135]，P = 0.026）。对一项分解心理IPV形式的测量指标进行的额外分析表明，与ETAU组相比，SAH-M组减少了涉及隔离和监视伴侣的控制行为（β = -0.072 [标准误 = 0.027]，P = 0.010）。
结果为SAH-M在减少和终止男性退伍军人及现役军人中的IPV行为方面的疗效提供了支持。
ClinicalTrials.gov标识符：NCT01435512。
