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对 PTSD 军人对偶群体的简化、强化、多对夫妻团体认知行为联合治疗的试点研究中关系结果的更深入考察。

A Closer Examination of Relational Outcomes from a Pilot Study of Abbreviated, Intensive, Multi-Couple Group Cognitive-Behavioral Conjoint Therapy for PTSD with Military Dyads.

机构信息

Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA.

Department of Psychology, University of Miami, Coral Gables, FL, USA.

出版信息

Fam Process. 2021 Sep;60(3):712-726. doi: 10.1111/famp.12654. Epub 2021 Apr 20.

Abstract

Cognitive-behavioral conjoint therapy for posttraumatic stress disorder (CBCT for PTSD) is associated with improvements in patients' PTSD symptoms, partners' psychological distress, and relationship satisfaction. However, little is known about whether CBCT for PTSD is associated with changes in other relationship domains that have theoretical and clinical relevance to the relational context of PTSD. The current study is a secondary analysis of relational outcomes from an uncontrolled, within-group trial designed to examine whether an abbreviated, intensive, multi-couple group version of CBCT for PTSD (AIM-CBCT for PTSD) delivered in a retreat during a single weekend was associated with improvements in PTSD symptoms and relationship satisfaction. In this investigation, we examined whether AIM-CBCT for PTSD is also associated with improvements in ineffective arguing, supportive dyadic coping by partner, joint dyadic coping, and partners' accommodation of patients' PTSD symptoms. Participants were 24 couples who included a post-9/11 U.S. service member or veteran with PTSD. At 1- and 3-month follow-up, patients reported significant reductions in couples' ineffective arguing (ds = -.71 and -.78, respectively) and increases in supportive dyadic coping by partners relative to baseline (ds = .50 and .44, respectively). By 3-month follow-up, patients also reported significant increases in couples' joint dyadic coping (d = .57), and partners reported significant reductions in their accommodation of patients' PTSD symptoms (d = -.44). Findings suggest that AIM-CBCT for PTSD is associated with improvements in multiple relationship domains beyond relationship satisfaction but that these may be differentially salient for patients and partners.

摘要

认知行为联合疗法治疗创伤后应激障碍(CBCT 治疗 PTSD)与患者 PTSD 症状、伴侣心理困扰和关系满意度的改善有关。然而,对于 CBCT 治疗 PTSD 是否与其他与 PTSD 的关系背景具有理论和临床相关性的关系领域的变化有关,人们知之甚少。本研究是一项无对照、组内试验的关系结果的二次分析,旨在检验在一个周末的静修期间,是否有一个简短、密集、多对夫妻团体版本的 CBCT 治疗 PTSD(AIM-CBCT 治疗 PTSD)是否与 PTSD 症状和关系满意度的改善有关。在这项研究中,我们还探讨了 AIM-CBCT 治疗 PTSD 是否也与无效争吵、伴侣的支持性双元应对、共同的双元应对和伴侣对患者 PTSD 症状的适应能力的改善有关。参与者是 24 对夫妻,其中包括一名患有 PTSD 的 9/11 后美国现役军人或退伍军人。在 1 个月和 3 个月的随访中,与基线相比,患者报告说夫妻之间的无效争吵显著减少(ds 分别为-.71 和 -.78),而伴侣的支持性双元应对则显著增加(ds 分别为.50 和.44)。到 3 个月的随访时,患者还报告说夫妻共同的双元应对显著增加(d =.57),而伴侣报告说他们对患者 PTSD 症状的适应能力显著下降(d = -.44)。这些发现表明,AIM-CBCT 治疗 PTSD 与关系满意度以外的多个关系领域的改善有关,但这些可能对患者和伴侣有不同的重要性。

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