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创伤后应激障碍症状可预测亲密伴侣攻击行为的创伤知情治疗效果。

PTSD symptoms predict outcome in trauma-informed treatment of intimate partner aggression.

作者信息

Creech Suzannah K, Macdonald Alexandra, Benzer Justin K, Poole Gina M, Murphy Christopher M, Taft Casey T

机构信息

VISN 17 Center of Excellence for Research on Returning War Veterans, Central Texas Veterans Health Care System.

Department of Psychology, The Citadel, The Military College of South Carolina.

出版信息

J Consult Clin Psychol. 2017 Oct;85(10):966-974. doi: 10.1037/ccp0000228. Epub 2017 Jul 20.

Abstract

OBJECTIVE

This study sought to extend findings from a randomized controlled trial of the Strength at Home Men's Program (SAH-M) for intimate partner aggression (IPA) in military veterans by examining the impact of pretreatment posttraumatic stress disorder (PTSD) symptoms on treatment efficacy, and by examining new data on postintervention follow-up for individuals who received SAH-M after completing the enhanced treatment as usual (ETAU) wait-list control condition.

METHOD

Using data from 125 male veterans who attended the SAH-M program immediately after an intake assessment or after waiting 6-month in the ETAU condition, this study used generalized linear modeling to examine predictors of physical and psychological IPA over a 9-month period of time.

RESULTS

PTSD symptoms at intake significantly predicted both physical and psychological IPA use, even after accounting for the effects of treatment condition, time, and number of sessions attended. PTSD had a strong association with both physical and psychological IPA. An interaction between PTSD and SAH-M was observed for psychological IPA but not physical IPA, and the magnitude of the effect was not clinically significant. There was a significant effect of SAH-M in reducing IPA in the full sample, including previously unanalyzed outcome data from the ETAU condition.

CONCLUSION

The study results suggest that while SAH-M does not need to be modified to address the interaction between PTSD and treatment, outcomes could be enhanced through additional direct treatment of PTSD symptoms. Results extend prior analyses by demonstrating the effectiveness of SAH-M in reducing use of IPA in both the treatment and ETAU conditions. (PsycINFO Database Record

摘要

目的

本研究旨在扩展一项关于居家力量男性项目(SAH-M)对退伍军人亲密伴侣攻击行为(IPA)的随机对照试验的结果,方法是检验创伤后应激障碍(PTSD)症状预处理对治疗效果的影响,并检验在完成强化常规治疗(ETAU)等待名单对照条件后接受SAH-M治疗的个体干预后随访的新数据。

方法

本研究使用了125名男性退伍军人的数据,这些退伍军人在进行摄入评估后或在ETAU条件下等待6个月后立即参加了SAH-M项目,使用广义线性模型来检验9个月期间身体和心理IPA的预测因素。

结果

即使在考虑了治疗条件、时间和参加疗程数量的影响后,摄入时的PTSD症状仍能显著预测身体和心理IPA的使用。PTSD与身体和心理IPA都有很强的关联。在心理IPA方面观察到PTSD与SAH-M之间存在交互作用,但在身体IPA方面未观察到,且效应大小在临床上不显著。SAH-M在整个样本中对减少IPA有显著效果,包括ETAU条件下以前未分析的结果数据。

结论

研究结果表明,虽然SAH-M不需要为解决PTSD与治疗之间的相互作用而进行修改,但通过对PTSD症状进行额外的直接治疗,可以提高治疗效果。结果扩展了先前的分析,证明了SAH-M在治疗和ETAU条件下减少IPA使用的有效性。(PsycINFO数据库记录)

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