2 - (SYM 4) Benchmarking Improvements in Intimate Relationship and Psychosocial Functioning to Dyadic PTSD Treatment Outcomes

Posttraumatic stress disorder (PTSD) negatively impacts interpersonal relationships and psychosocial functioning. Dyadic treatments for PTSD have been shown to improve both PTSD symptoms and intimate relationship satisfaction. But how much improvement in PTSD symptomatology is needed to achieve meaningful improvements in intimate relationship satisfaction and psychosocial functioning? Using data from a randomized clinical trial of two brief dyadic treatments for PTSD (i.e., brief Cognitive Behavioral Conjoint Therapy for PTSD or PTSD Family Education) among 137 military veterans and their intimate partners, we examined how veterans’ symptom change, categorized first as No Response (n = 70) vs. Response (n = 67) and then differentiating Response Only (n = 30) from Loss of Diagnosis (n = 37), predicted clinically meaningful improvement and good endpoint on intimate relationship satisfaction (measured with the Couples Satisfaction Index) and psychosocial functioning (measured with the Brief Inventory of Psychosocial Functioning). Per Schnurr et al., 2022, Response was defined as an improvement of at least 10 points on the Clinician-Administered PTSD Scale for DSM-5 and Loss of Diagnosis was defined as Response, plus no longer meeting DSM-5 symptom criteria and severity less than 25. These secondary analyses were pre-registered on the Open Science Forum before hypotheses were tested (https://doi.org/10.17605/OSF.IO/WKF34). Veteran Response was associated with meaningful change in both partners’ relationship satisfaction (odds ratio [OR] = 2.55 for veterans, 2.50 for partners) and veteran psychosocial function (OR = 4.14), but not good endpoint on any outcome. Veteran Loss of Diagnosis had added value over Response with respect to veterans’ good endpoint on relationship satisfaction (OR = 5.34) and partners’ meaningful change in relationship satisfaction (OR = 3.75). Results suggest a treatment response is associated with meaningful improvements in these outcomes, but achieving a loss of PTSD diagnosis may be necessary to improve veterans' relationship distress to non-clinical levels.