A Preliminary Examination of the Effects of Pretreatment Relationship Satisfaction on Treatment Outcomes in Cognitive-Behavioral Conjoint Therapy for PTSD

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The primary goal of the present study was to investigate whether pretreatment relationship satisfaction predicted treatment dropout and posttraumatic stress disorder (PTSD) symptom outcomes within a trial of cognitive–behavioral conjoint therapy (CBCT) for PTSD (Monson & Fredman, 2012). In addition, we examined the influence of pretreatment relationship distress on relationship outcomes. Thirty-seven patients and their intimate partners who participated in a course of CBCT for PTSD were assessed for PTSD symptoms with the Clinician-Administered PTSD Scale and PTSD Checklist, and they were assessed for intimate relationship functioning with the Dyadic Adjustment Scale. CBCT for PTSD is a conjoint therapy designed to improve PTSD symptoms and enhance relationship functioning. Patients had to meet diagnostic criteria for PTSD to be included in the study; however, couples were not required to be in distressed relationships to receive treatment. Results from the study showed that neither patients’ nor partners’ pretreatment relationship satisfaction, nor their interaction, predicted treatment dropout (odds ratios = .97–1.01) or completing patients’ posttreatment PTSD symptom severity (sr2 ≤ .03). However, participants who were in distressed relationships before treatment made greater gains in relationship satisfaction compared with those who began treatment in more satisfied relationships (g = 1.02). In conclusion, among patients receiving CBCT for PTSD, treatment dropout and improvements in PTSD symptoms may be independent of pretreatment relationship functioning whereas improvements in relational functioning may be greater among those distressed before treatment.

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