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

Abstract

The primary goal of the present study was to investigate whether pre-treatment relationship satisfaction predicted treatment drop-out and posttraumatic stress disorder (PTSD) symptom outcomes within a trial of cognitive-behavioral conjoint therapy (CBCT) for PTSD (Monson & Fredman, 2012). Additionally, we examined the influence of pre-treatment 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 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. Neither patients' nor partners' pre-treatment relationship satisfaction, nor their interaction, predicted treatment drop-out (ORs = .97-1.01) or completing patients' post-treatment PTSD symptom severity (sr2 ≤ .03). However, participants who were in distressed relationships prior to treatment made greater gains in relationship satisfaction compared with those who began treatment in more satisfied relationships (g = 1.02). Among patients receiving CBCT for PTSD, treatment drop-out and improvements in PTSD symptoms may be independent of pre-treatment relationship functioning, whereas improvements in relational functioning may be greater among those distressed prior to treatment.