Skip to main content
Journal cover image

Effect of cognitive-behavioral couple therapy for PTSD: a randomized controlled trial.

Publication ,  Journal Article
Monson, CM; Fredman, SJ; Macdonald, A; Pukay-Martin, ND; Resick, PA; Schnurr, PP
Published in: JAMA
August 15, 2012

CONTEXT: Posttraumatic stress disorder (PTSD) is a prevalent condition associated with intimate relationship problems, and intimate relationship factors have been shown to affect individual PTSD treatment outcomes. OBJECTIVE: To compare cognitive-behavioral conjoint therapy for PTSD (a manualized couple therapy delivered to patients with PTSD and their significant others to simultaneously treat PTSD symptoms and enhance relationship satisfaction) with a wait-list condition. DESIGN, SETTING, AND PARTICIPANTS: Randomized controlled trial of heterosexual and same-sex couples (n = 40 couples; n = 80 individuals) in which one partner met criteria for PTSD according to the Clinician-Administered PTSD Scale, conducted from 2008 to 2012 in a Department of Veterans Affairs outpatient hospital setting in Boston, Massachusetts, and a university-based research center in Toronto, Ontario, Canada. Symptoms of PTSD, comorbid conditions, and relationship satisfaction were collected by blinded assessors at baseline, at mid treatment (median, 8.00 weeks [range, 1.71-20.43 weeks] after baseline), and at posttreatment (median, 15.86 weeks [range, 7.14-38.57 weeks] after baseline). An uncontrolled 3-month follow-up (median, 38.21 weeks [range, 28.43-50.57 weeks] after baseline) was also completed. INTERVENTION: Couples were randomly assigned to take part in the 15-session cognitive-behavioral conjoint therapy for PTSD protocol immediately (n = 20) or were placed on a wait list for the therapy (n = 20). MAIN OUTCOME MEASURES: Clinician-rated PTSD symptom severity was the primary outcome and was assessed with the Clinician-Administered PTSD Scale. Intimate relationship satisfaction, assessed with the Dyadic Adjustment Scale, patient- and partner-rated PTSD symptoms, and comorbid symptoms were secondary outcomes. RESULTS: PTSD symptom severity (score range, 0-136) was significantly more improved in the couple therapy condition than in the wait-list condition (mean change difference, -23.21; 95% CI, -37.87 to -8.55). Similarly, patients' intimate relationship satisfaction (score range, 0-151) was significantly more improved in couple therapy than in the wait-list condition (mean change difference, 9.43; 95% CI, 0.04-18.83). The time × condition interaction effect in the multilevel model predicting PTSD symptoms (t37.5 = -3.09; P = .004) and patient-reported relationship satisfaction (t68.5 = 2.00; P = .049) revealed superiority of the couple therapy compared with the wait list. Treatment effects were maintained at 3-month follow-up. CONCLUSION: Among couples in which one partner was diagnosed as having PTSD, a disorder-specific couple therapy, compared with a wait list for the therapy, resulted in decreased PTSD symptom severity and patient comorbid symptom severity and increased patient relationship satisfaction. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00669981.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

JAMA

DOI

EISSN

1538-3598

Publication Date

August 15, 2012

Volume

308

Issue

7

Start / End Page

700 / 709

Location

United States

Related Subject Headings

  • Waiting Lists
  • Treatment Outcome
  • Stress Disorders, Post-Traumatic
  • Severity of Illness Index
  • Outpatients
  • Middle Aged
  • Male
  • Interpersonal Relations
  • Humans
  • General & Internal Medicine
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Monson, C. M., Fredman, S. J., Macdonald, A., Pukay-Martin, N. D., Resick, P. A., & Schnurr, P. P. (2012). Effect of cognitive-behavioral couple therapy for PTSD: a randomized controlled trial. JAMA, 308(7), 700–709. https://doi.org/10.1001/jama.2012.9307
Monson, Candice M., Steffany J. Fredman, Alexandra Macdonald, Nicole D. Pukay-Martin, Patricia A. Resick, and Paula P. Schnurr. “Effect of cognitive-behavioral couple therapy for PTSD: a randomized controlled trial.JAMA 308, no. 7 (August 15, 2012): 700–709. https://doi.org/10.1001/jama.2012.9307.
Monson CM, Fredman SJ, Macdonald A, Pukay-Martin ND, Resick PA, Schnurr PP. Effect of cognitive-behavioral couple therapy for PTSD: a randomized controlled trial. JAMA. 2012 Aug 15;308(7):700–9.
Monson, Candice M., et al. “Effect of cognitive-behavioral couple therapy for PTSD: a randomized controlled trial.JAMA, vol. 308, no. 7, Aug. 2012, pp. 700–09. Pubmed, doi:10.1001/jama.2012.9307.
Monson CM, Fredman SJ, Macdonald A, Pukay-Martin ND, Resick PA, Schnurr PP. Effect of cognitive-behavioral couple therapy for PTSD: a randomized controlled trial. JAMA. 2012 Aug 15;308(7):700–709.
Journal cover image

Published In

JAMA

DOI

EISSN

1538-3598

Publication Date

August 15, 2012

Volume

308

Issue

7

Start / End Page

700 / 709

Location

United States

Related Subject Headings

  • Waiting Lists
  • Treatment Outcome
  • Stress Disorders, Post-Traumatic
  • Severity of Illness Index
  • Outpatients
  • Middle Aged
  • Male
  • Interpersonal Relations
  • Humans
  • General & Internal Medicine