Couple's therapy appears to reduce PTSD symptoms

Among couples in which one partner was diagnosed with posttraumatic stress disorder, a disorder-specific couple therapy was effective in reducing PTSD symptoms vs. those placed on a wait list for the therapy, according to new research published in The Journal of the American Medical Association.

Candice M. Monson, PhD, associate professor of psychology and director of clinical training at Ryerson University in Toronto, and colleagues examined the effectiveness of cognitive-behavioral conjoint therapy specifically geared toward treating PTSD and its comorbid symptoms and enhancing intimate relationships. From 2008 to 2012, Monson and colleagues conducted a randomized trial that included 40 heterosexual and homosexual couples in which one partner met DSM-IV criteria for PTSD. Couples were randomly assigned to take part in 15 weekly sessions of the therapy or placed on a waiting list for the same amount of time.

PTSD symptom severity, comorbid symptoms and intimate relationship satisfaction were assessed at the beginning of the study, at 8 weeks and again at 16 weeks after baseline.

PTSD symptom severity (score range, 0-136) significantly improved in participants assigned to couple’s therapy vs. those on the wait list (mean change difference, –23.21; 95% CI, –37.87 to –8.55). Among those who took part in couple’s therapy, intimate relationship satisfaction was also significantly improved (mean change difference, 9.43; 95% CI, 0.04-18.83). Change ratios, calculated by dividing the change observed in couple’s therapy from pretreatment to post-treatment by the change observed in the wait list condition over the same period, indicated that PTSD symptom severity decreased almost three times more in couple’s therapy (95% CI, –47.84 to –23) vs. the wait list (95% CI, –21.51 to –2.89); and patient-reported relationship satisfaction increased more than four times more in couple’s therapy (95% CI, 5.72-18.72) vs. the wait list (95% CI, –3.95 to 9.53).

At the end of treatment, 81% of participants in couple’s therapy no longer met DSM-IV criteria for PTSD and 62% reported a clinically significant improvement in their relationship satisfaction. One hundred percent of participants assigned to couple’s therapy were classified as being satisfied in their relationship. Comorbid symptoms such as depression (P=.007), general anxiety (P=.01) and anger expression (P=.01) also improved more for participants in couple’s therapy than for those on the wait list.

“There is increasing recognition that intimate relationships play a potent role in recovery from PTSD, its comorbid symptoms and the psychosocial impairments that accompany it,” the researchers wrote. “The current investigation demonstrated that [cognitive-behavioral conjoint therapy] produced improvements in clinician-rated PTSD symptoms and a range of comorbid symptoms, as well as patient-rated relationship satisfaction.”

Disclosure: D. Monson reported receiving research funding from the CDC, Department of Defense, Canadian Institute of Health Research and National Institute of Mental Health. See study for full list of relevant financial disclosures.