Five years of support are requested through the RFA entitled Family and Dyadic Focused Interventions to Prevent Intimate Partner Violence (U49). The purpose of the proposed project is to develop and test a couples based relationship enhancement group intervention for married or partnered Operation Enduring Freedom (OEF) / Operation Iraqi Freedom (OIF) veterans to prevent the perpetration of intimate partner aggression (IPA). This intervention will incorporate components of several interventions for PTSD and IPA and will target mechanisms implicated in the PTSD-IPA association. The intervention approach has been labeled PTSD Focused Relationship Enhancement Therapy (PF-RET). Participants will be randomly assigned to receive PFRET for supportive therapy (ST), both in a conjoint group format, and will be followed for 12 months post-intervention. Consistent with recommendations for the prevention of mental health problems (Mrazek & Haggerty, 1994), the intervention will target empirically-supported risk factors implicated in the development of IPA (proximal targets) to prevent IPA (distal targets). Specifically, the proximal targets of PF-RET include PTSD symptoms, anger, social problem solving skills, anger-related cognitive distortions, relationship satisfaction, generalized aggression, and conflicts related to power in relationships. The distal targets of the intervention include reduced incidence and frequency of intimate partner physical assault and psychological aggression. Participants will consist of 400 couples that are at risk for the development of IPA due to the presence of a male in the couple with PTSD, as well as high levels of marital distress. However, consistent with a secondary prevention approach (National Advisory Mental Health Council Workgroup on Mental Disorders Prevention Research, 1998), participants will be excluded on the basis of histories of IPA.
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