根据文章的背景资料：“有充分的记录显示，PTSD与亲密关系问题——包括关系窘迫和侵犯——之间是有联系的，而研究证明某一方存在PTSD症状与另一方的照顾者负担和心理困扰有关。”
加拿大多伦多瑞尔森大学的Candice M. Monson, Ph.D.及其同事开展了一项研究对PTSD采取一种旨在检验认知-行为结合疗法（CBCT）对PTSD的功效，该疗法是为了治疗PTSD及其症状并增进配偶间亲密关系尔设计的。这一在2008-2012年间开展的随机对照试验包括了异性及同性配偶（n = 40 名配偶; n = 80 名个人）；根据临床医生执行的PTSD量表，这些配偶中有一方符合PTSD的标准。评估者在研究开始时、治疗中（中位数[中点]为基线状态之后8周）及治疗后（中位数为基线状态后16周）收集了有关PTSD症状、并发疾病及关系满意度等数据。一个没有对照的为期3个月的随访也得以完成。配偶被随机分配立刻参加15次的按照PTSD规程进行的认知-行为结合治疗(n = 20) 或被列在治疗的等待名单上（n = 20）。
研究人员发现，与等待名单上者相比，参加配偶治疗者的PTSD症状的严重性和病人的亲密关系满意度得到了更为显著的改善。同时，与等待治疗名单上者相比，变化比率（其计算为：将从治疗前至治疗后的接受CBCT者的情况改变除以同期的在等待名单上的人的情况改变）表明，接受CBCT者从治疗前至治疗后的PTSD症状的严重性下降了几乎3倍多，而病人报告的关系满意度增加了4倍多。
相对于等待名单上的人，接受CBCT者的抑郁症、一般性焦虑及愤怒表达症状等继发性后果也得到了更多的改善。
文章的作者写道：“这一随机对照的试验提供了配偶疗法可有效治疗PTSD和伴发症状，以及改善亲密关系满意度的证据。这些改善出现在一个配偶样本中，在该样本中的患者在有关性、经历的创伤类型及性取向上都不相同。对PTSD及伴发症状治疗效果大小的估计与那些接受PTSD个别心理治疗者相比，其效果相当或更好。此外，病人报告的关系满意度的改善与先前尝试配偶疗法的关系窘迫配偶的改善情况一致或更好，且比那些旨在增进非关系窘迫配偶关系运作的干预治疗的改善情况更强。”（生物谷Bioon.com)
doi:10.1001/jama.2012.9307
PMC:
PMID:
Effect of Cognitive-Behavioral Couple Therapy for PTSD
Candice M. Monson, Steffany J. Fredman, Alexandra Macdonald, Nicole D. Pukay-Martin, Patricia A. Resick, Paula P. Schnurr
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.
