Posttraumatic stress disorder (PTSD) is a highly prevalent and pernicious disorder, with a frequently chronic course. There are far-reaching and devastating interpersonal relationship problems associated with chronic PTSD than can maintain or aggravate its course. These problems can also interfere with successful treatment delivery, and may be addressed to improve treatment compliance, efficacy of treatment, and maintenance of gains. A number of clinicians and researchers have called for the inclusion of significant others in PTSD treatment because of these reasons. In an effort to improve upon the treatment of chronic PTSD and its broader functional impairments, the overall goal of this R34 Exploratory Research Grant is to refine and adapt a manualized Cognitive-Behavioral Couples Therapy (CBCT) for PTSD, and to test it against a delayed treatment condition. Phase 1 of the project aims to (1) refine the existing CBCT for PTSD manual; (2) develop a treatment fidelity measure; and (3) finalize the assessment protocol by treating a series of 10 couples in which one member of the couple is diagnosed with chronic PTSD. This phase would ensure that the treatment is sufficiently flexible to address a range of traumatized individuals and couples, and that it has the necessary elements for conducting a controlled trial. Phase 2 of the project consists of a randomized controlled trial of the refined therapy to determine its efficacy and estimate other intervention parameters. The sample will consist of 40 community couples including one person diagnosed with chronic PTSD. The couples will be randomized to receive the therapy immediately or be placed on a waiting list to receive the treatment. The primary hypothesis is that CBCT for PTSD will be more efficacious than the delayed treatment control in reducing overall PTSD symptoms, as measured by clinician interview, across treatment. Secondary and exploratory hypotheses relate to improved self-reported PTSD symptoms, co-morbid conditions, partner outcomes, and relationship functioning in the CBCT for PTSD immediately versus delayed treatment condition. An uncontrolled follow-up assessment of the immediate CBCT for PTSD condition at three months, and a replication of the primary results in the delayed treatment group are planned. The longer-term goal of this line of research is to conduct a Stage III trial of CBCT for PTSD compared to state-of-the-art individual PTSD treatment through an R01 grant-funded study. Posttraumatic Stress Disorder (PTSD) is highly prevalent, and comes at great cost to individuals, their loved ones, and society. The current project aims to develop a couples treatment for PTSD that would decrease individual PTSD symptoms, as well as improve the survivor's intimate relationship functioning and the well- being of their intimate partner. It is hoped that this treatment will ultimately decrease the prevalence and burden of this significant and growing public health problem. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Planning Grant (R34)
Project #
1R34MH076813-01A2
Application #
7305341
Study Section
Interventions Committee for Adult Mood and Anxiety Disorders (ITMA)
Program Officer
Heinssen, Robert K
Project Start
2007-09-01
Project End
2010-06-30
Budget Start
2007-09-01
Budget End
2008-06-30
Support Year
1
Fiscal Year
2007
Total Cost
$170,100
Indirect Cost
Name
Boston University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
604483045
City
Boston
State
MA
Country
United States
Zip Code
02118
Shnaider, Philippe; Sijercic, Iris; Wanklyn, Sonya G et al. (2017) The Role of Social Support in Cognitive-Behavioral Conjoint Therapy for Posttraumatic Stress Disorder. Behav Ther 48:285-294
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Fredman, Steffany J; Pukay-Martin, Nicole D; Macdonald, Alexandra et al. (2016) Partner accommodation moderates treatment outcomes for couple therapy for posttraumatic stress disorder. J Consult Clin Psychol 84:79-87
Wagner, Anne C; Torbit, Lindsey; Jenzer, Tiffany et al. (2016) The Role of Posttraumatic Growth in a Randomized Controlled Trial of Cognitive-Behavioral Conjoint Therapy for PTSD. J Trauma Stress 29:379-83
Shnaider, Philippe; Pukay-Martin, Nicole D; Sharma, Shankari et al. (2015) A Preliminary Examination of the Effects of Pretreatment Relationship Satisfaction on Treatment Outcomes in Cognitive-Behavioral Conjoint Therapy for PTSD. Couple Family Psychol 4:229-238
Shnaider, Philippe; Pukay-Martin, Nicole D; Fredman, Steffany J et al. (2014) Effects of cognitive-behavioral conjoint therapy for PTSD on partners' psychological functioning. J Trauma Stress 27:129-36
Fredman, Steffany J; Vorstenbosch, Valerie; Wagner, Anne C et al. (2014) Partner accommodation in posttraumatic stress disorder: initial testing of the Significant Others' Responses to Trauma Scale (SORTS). J Anxiety Disord 28:372-81
Monson, Candice M; Fredman, Steffany J; Macdonald, Alexandra et al. (2012) Effect of cognitive-behavioral couple therapy for PTSD: a randomized controlled trial. JAMA 308:700-9
Brown-Bowers, Amy; Fredman, Steffany J; Wanklyn, Sonya G et al. (2012) Cognitive-behavioral conjoint therapy for posttraumatic stress disorder: application to a couple's shared traumatic experience. J Clin Psychol 68:536-47
Monson, Candice M; Macdonald, Alexandra; Brown-Bowers, Amy (2012) Couple/family therapy for posttraumatic stress disorder: review to facilitate interpretation of VA/DOD Clinical Practice Guideline. J Rehabil Res Dev 49:717-28

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