Examining the impact of brief couples-based posttraumatic stress disorder treatments on anger and psychological aggression in veterans and their partners.

Abstract

Anger can adversely impact functioning in veterans. Psychological aggression, which is related to but distinct from anger, is particularly detrimental to veterans' mental health. Research examining anger and psychological aggression following individual therapy for posttraumatic stress disorder (PTSD) has demonstrated small effect sizes. Treatments that directly target conflict management and interpersonal functioning, both regarding content and delivery to veterans and their loved ones (e.g., couples-based PTSD treatments), may be more effective in alleviating anger symptoms. This study examined whether larger reductions in anger and psychological aggression would be observed in a couples-based intervention compared to an active comparator at posttreatment and follow-up. Data were derived from a randomized trial comparing brief cognitive-behavioral conjoint therapy for PTSD (bCBCT) and PTSD family education (PFE). Participants were 137 veterans and their intimate partners (bCBCT: n = 92, PFE: n = 45). We observed within-condition significant reductions in angry temperament, d = -0.47, p < .001, and angry reaction, d = -0.26, p = .004, among veterans in bCBCT but not PFE, |d|s = 0.13-0.17, ps = .166-.268. Veterans and partners in both conditions reported reductions in psychological aggression, |d|s = 1.09-1.46, ps < .001. There were no significant differences between the treatment conditions on any outcome, ps = .103-.443, and there were no significant changes in anger between posttreatment and follow-up, |d|s = 0.07-0.24, ps = .052-.582. Couples-based interventions for PTSD, including bCBCT and PFE, can be effective in improving aspects of anger among veterans and their intimate partners.