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Symposia

Couples / Close Relationships

Getting better together: Couple interventions for individual psychopathology

2 - (SYM 36) An Initial Examination of Couple Therapy for PTSD Outcomes Among Black Americans: Findings from an Uncontrolled Trial of Intensive, Multi-couple Group Treatment for PTSD in Military Dyads

Friday, November 15, 2024
12:30 PM – 2:00 PM EST
Location: Grand Ballroom K/L, Level 5, Downtown Marriott
Abstract Body

The lifetime prevalence of posttraumatic stress disorder (PTSD; APA, 2013) among Black Americans is high, with estimates ranging from 9-33% (Alim et al., 2006; Roberts et al., 2011). Among Black Americans, PTSD also tends to be chronic (Sibrava et al., 2019) and undertreated (Roberts et al., 2011; Nobles et al., 2016), with work underscoring the roles of social disadvantage and systemic racism in Black Americans’ trauma exposure and PTSD development, prevalence, course, and undertreatment (MacIntyre et al., 2023). Family relationships play a salient role in Black Americans’ ability to cope with stress and trauma (Kelly et al., 2020; McNeil Smith & Landor, 2018; Nyugen et al., 2016), with romantic relationships serving as a resource for Black Americans’ psychological well-being (Lincoln & Chae, 2010; Taylor et al., 2001; 2012). Thus, treating PTSD using a couple-based approach may be a culturally relevant strategy for promoting health equity in this population. Cognitive-behavioral conjoint therapy (CBCT) for PTSD (Monson & Fredman, 2012), a 15-session couple-based treatment for PTSD, has demonstrated efficacy in reducing PTSD symptoms and enhancing relationships (Monson et al., 2012; in press). However, there are no studies examining CBCT for PTSD or other disorder-specific couple/family-based treatments for PTSD among Black Americans.

This study is a secondary analysis of CBCT for PTSD treatment outcomes within a racially homogeneous subsample of Black patients (n = 7) who participated in an uncontrolled trial of an abbreviated, intensive, multi-couple group version of CBCT for PTSD delivered in a 2-day weekend retreat format to active duty military and veteran couples (N = 24; [redacted]). Most patients (n = 6; 85.7%) were male with female spouses. There were significant and large decreases in patients’ PTSD symptoms based on clinicians’ and patients’ ratings (ds -1.37 and -1.36, respectively) by 3-month follow-up relative to baseline. There were also significant and large decreases in patients’ comorbid depressive, anxiety, and anger symptoms (ds -1.39 to -1.93) and large decreases in insomnia (p = .083; d = -0.85). Patients reported non-significant, moderate increases in relationship satisfaction (p = .146; d = 0.68) and large increases in joint dyadic coping (p = .069; d = 0.90).

Findings offer preliminary evidence that treating PTSD within a couple context is a relevant strategy to reduce PTSD and comorbid symptoms among partnered Black Americans and a promising approach to enhance relationships. Future directions will be discussed.