Partner accommodation moderates treatment outcomes for couple therapy for posttraumatic stress disorder.
OBJECTIVE
Partner accommodation of posttraumatic stress disorder (PTSD) symptoms (i.e., altering one's own behaviors to minimize patient distress and/or relationship conflict due to patients' PTSD symptoms) has been shown to be positively associated with patient and partner psychopathology and negatively associated with patient and partner relationship satisfaction cross-sectionally. However, the prognostic value of partner accommodation in treatment outcomes is unknown. The goals of the present study were to determine if partner accommodation decreases as a function of couple therapy for PTSD and if pretreatment partner accommodation moderates the efficacy of couple therapy for PTSD.


METHODS
Thirty-nine patients with PTSD and their intimate partners (n = 39) were enrolled in a randomized controlled trial of cognitive-behavioral conjoint therapy (CBCT) for PTSD (Monson & Fredman, 2012) and received CBCT for PTSD immediately or after 3 months of waiting. Blinded assessors determined clinician-rated PTSD symptoms and patient-rated PTSD and depressive symptoms and relationship satisfaction at baseline, midtreatment/4 weeks of waiting, and posttreatment/12 weeks of waiting.


RESULTS
Contrary to expectation, partner accommodation levels did not change over time for either treatment condition. However, baseline partner accommodation significantly moderated treatment outcomes. Higher levels of partner accommodation were associated with greater improvements in PTSD, depressive symptoms, and relationship satisfaction among patients receiving CBCT for PTSD compared with waiting list. At lower levels of partner accommodation, patients in both groups improved or remained at low levels of these outcomes.


CONCLUSIONS
Individuals with PTSD who have more accommodating partners may be particularly well-suited for couple therapy for PTSD.
Department of Human Development and Family Studies, The Pennsylvania State University.
Steffany J
SJ
Fredman
Trauma Recovery Center, Cincinnati VA Medical Center.
Nicole D
ND
Pukay-Martin
Women's Health Sciences Division, National Center for PTSD.
Alexandra
A
Macdonald
Department of Psychology, Ryerson University.
Anne C
AC
Wagner
Eating Disorders Program, Homewood Health Centre.
Valerie
V
Vorstenbosch
Department of Psychology, Ryerson University.
Candice M
CM
Monson
D000223:Adaptation, Psychological; D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D019546:Couples Therapy / Q000379:methods*; D054541:Family Conflict / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018454:Spouses / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D016896:Treatment Outcome