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对黑人和非裔美国成年人创伤后应激障碍(PTSD)治疗效果的夫妻疗法初步研究:来自军事配偶非对照试验的结果

An Initial Examination of Couple Therapy for PTSD Outcomes Among Black/African American Adults: Findings from an Uncontrolled Trial with Military Dyads.

作者信息

Fredman Steffany J, Gamaldo Alyssa A, Jenkins August I C, Le Yunying, Mogle Jacqueline A, Monson Candice M, Gamaldo Charlene E, Thorpe Roland J, Hall-Clark Brittany N, Blount Tabatha H, Fina Brooke A, Buxton Orfeu M, Engeland Christopher G, Rhoades Galena K, Stanley Scott M, Macdonald Alexandra, Dondanville Katherine A, Taylor Daniel J, Pruiksma Kristi E, Litz Brett T, Young-McCaughan Stacey, Yarvis Jeffrey S, Keane Terence M, Peterson Alan L

机构信息

Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802, USA.

Department of Psychology, Clemson University, Clemson, SC 29634, USA.

出版信息

Behav Sci (Basel). 2025 Apr 16;15(4):537. doi: 10.3390/bs15040537.

Abstract

Black/African American individuals experience high rates of posttraumatic stress disorder (PTSD), which is frequently chronic and undertreated in this population. Intimate relationships are a salient resource for Black/African American adults' psychological well-being. To help advance health equity, this study serves as an initial, proof-of-concept investigation of patient outcomes among Black/African American adults who received a disorder-specific couple therapy for PTSD. Participants were a subsample of seven Black/African American adults (mean age = 40.56 years, = 10.18; 85.7% male) who participated in an uncontrolled trial of an abbreviated, intensive, multi-couple group version of cognitive-behavioral conjoint therapy for PTSD with 24 military dyads. Treatment was delivered over 2 days in a weekend retreat format. Assessments were administered at baseline, 1 month post-retreat, and 3 months post-retreat. There were large and significant decreases in patients' PTSD symptoms based on clinicians' and patients' ratings (s -1.37 and -1.36, respectively) by the 3-month follow-up relative to baseline. There were also large and significant decreases in patients' depressive, anxiety, and anger symptoms (s -1.39 to -1.93) and a large, marginally significant decrease in patients' insomnia ( = -0.85; = 0.083). Patients reported a medium, non-significant increase in relationship satisfaction ( = 0.68; = 0.146) and a large, marginally significant increase in joint dyadic coping ( = 0.90; = 0.069). Findings offer preliminary evidence that treating PTSD within a couple context is a relevant strategy to reduce PTSD and comorbid symptoms among partnered Black/African American adults and a promising approach to enhance relationships.

摘要

黑人/非裔美国人中创伤后应激障碍(PTSD)的发病率很高,且在这一人群中该疾病常常呈慢性且治疗不足。亲密关系是黑人/非裔美国成年人心理健康的重要资源。为推动健康公平,本研究对接受针对PTSD的特定疾病夫妻治疗的黑人/非裔美国成年人的患者结局进行了初步的概念验证调查。参与者是7名黑人/非裔美国成年人的子样本(平均年龄 = 40.56岁,标准差 = 10.18;85.7%为男性),他们参与了一项针对24对军人夫妻的PTSD认知行为联合治疗的简化、强化、多对夫妻组版本的非对照试验。治疗以周末静修的形式在2天内完成。评估在基线、静修后1个月和静修后3个月进行。与基线相比,到3个月随访时,根据临床医生和患者的评分,患者的PTSD症状有大幅且显著的减轻(分别为 -1.37和 -1.36)。患者的抑郁、焦虑和愤怒症状也有大幅且显著的减轻( -1.39至 -1.93),患者的失眠有大幅但边缘显著的减轻( = -0.85; = 0.083)。患者报告关系满意度有中等程度、不显著的增加( = 0.68; = 0.146),联合二元应对有大幅且边缘显著的增加( = 0.90; = 0.069)。研究结果提供了初步证据,即在夫妻关系背景下治疗PTSD是减少有伴侣的黑人/非裔美国成年人的PTSD及共病症状的相关策略,也是增强关系的有前景的方法。

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