Durham Veterans Affairs Medical Center, NC, USA.
VISN 6 Mental Illness Research, Education and Clinical Center, Durham, NC, USA.
J Interpers Violence. 2021 Oct;36(19-20):NP10276-NP10300. doi: 10.1177/0886260519873335. Epub 2019 Sep 6.
Difficulty controlling anger is a significant concern among combat veterans with posttraumatic stress disorder (PTSD), yet few controlled studies have examined the efficacy of anger treatments for this population. This study examined the effects of a group cognitive behavioral therapy (CBT) intervention compared with a group present-centered therapy (PCT) control condition in male and female combat veterans with PTSD. Thirty-six combat veterans with PTSD and anger difficulties began group treatment (CBT, = 19; PCT, = 17). Separate multilevel models of self-rated anger, PTSD symptoms, and disability were conducted using data from baseline, each of 12 treatment sessions, posttreatment, and 3- and 6-month follow-up time points. Significant decreases in anger and PTSD symptoms were observed over time, but no significant differences between CBT and PCT were observed on these outcomes. A significant interaction of therapy by time favoring the PCT condition was observed on disability scores. Gender differences were observed in dropout rates (i.e., 100% of female participants dropped out of CBT). Findings suggest that both CBT and PCT group therapy may be effective in reducing anger in combat veterans with PTSD. Results also highlight potential gender differences in response to group anger treatment.
难以控制愤怒是患有创伤后应激障碍（PTSD）的退伍军人的一个重要问题，但很少有对照研究检验过针对这一人群的愤怒治疗的疗效。本研究比较了团体认知行为疗法（CBT）干预与团体以当下为中心疗法（PCT）对照条件对 PTSD 退伍军人的影响。36 名患有 PTSD 和愤怒问题的男性和女性退伍军人开始了团体治疗（CBT，n=19；PCT，n=17）。使用基线、12 次治疗疗程中的每次疗程、治疗后以及 3 个月和 6 个月随访时间点的自我评估愤怒、PTSD 症状和残疾的数据，分别进行了自我评估愤怒、PTSD 症状和残疾的多层模型分析。随着时间的推移，愤怒和 PTSD 症状显著下降，但 CBT 和 PCT 之间在这些结果上没有显著差异。在残疾评分上，观察到治疗与时间的显著交互作用有利于 PCT 条件。在退出率方面观察到性别差异（即，CBT 组的所有女性参与者都退出了）。研究结果表明，CBT 和 PCT 团体治疗可能都能有效减少 PTSD 退伍军人的愤怒。结果还强调了对团体愤怒治疗的反应中可能存在的性别差异。
