Couple and family therapies for post-traumatic stress disorder (PTSD)

Suomi, Aino; Evans, Lynette; Rodgers, Bryan; Taplin, Stephanie; Cowlishaw, Sean

doi:10.1002/14651858.cd011257.pub2

Cited by 12 publications

(12 citation statements)

References 104 publications

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“…However, they suggest that the strategies of noticing and responding to early indications of anger and momentary changes in anger, as in CBCT for PTSD, are likely to be effective in reducing the overall variability of anger if they are successful in reducing the intensity of anger outbursts. Overall, the present findings support clinical strategies to simultaneously address symptom accommodation and PTSD symptoms as well as strategies to increase emotional disclosure in the service of reducing symptoms like emotional numbing and avoidance, as used in dyadic treatments for PTSD (Suomi et al., 2019).…”

Section: Discussionsupporting

confidence: 76%

A daily diary study of the romantic partner relationship dynamics associated with anger and other posttraumatic stress disorder symptoms

Hyatt

Halvorson

Campbell

2023

Journal of Traumatic Stress

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Posttraumatic stress disorder (PTSD) is linked to negative relationship outcomes, but the relational processes that link specific PTSD symptoms to these outcomes over granular periods are not well understood. The current study used a daily diary methodology to investigate the associations between specific PTSD symptoms (i.e., anger, avoidance, reexperiencing, hyperarousal, and numbing) and proximal indices of relationship functioning (i.e., accommodation behaviors, disclosure, intimacy). Participants were members of 64 couples, each comprising a male service member (SM) and female romantic partner (RP), who completed daily assessments of PTSD symptoms and indices of relationship functioning for 2 weeks. The results suggest a somewhat unique role of anger on relationship dynamics: Although mean levels of PTSD symptom clusters were associated with negative relationship outcomes at the bivariate level, daily fluctuations in anger were uniquely related to accommodation behaviors and SM‐ and RP‐reported intimacy in multilevel models, Bs = −0.08–0.50). These findings highlight the importance of considering the differential role of specific PTSD symptoms, like anger, in dyadic interventions for PTSD; several strategies for doing so in the context of contemporary evidence‐based treatments are discussed.

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Section: Discussionsupporting

confidence: 76%

A daily diary study of the romantic partner relationship dynamics associated with anger and other posttraumatic stress disorder symptoms

Hyatt

Halvorson

Campbell

2023

Journal of Traumatic Stress

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“…ANGER AND PTSD AMONG VETERANS 341 targets for novel PTSD treatments (Suomi et al, 2019). The findings would seem to have implications for treatment and suggest that veterans with anger problems would benefit from a preliminary phase addressing anger; for example, via cognitive-behavioral anger interventions (Lee & DiGiuseppe, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, it seems likely that anger would increase negative interactions with others and reduce social resources that can promote symptom change. Such resources may include qualities of the therapeutic alliance with treatment providers (Chemtob et al, 1997) as well as family relationships that provide important “recovery environments” (Johnson & Williams-Keeler, 1998) and targets for novel PTSD treatments (Suomi et al, 2019). The findings would seem to have implications for treatment and suggest that veterans with anger problems would benefit from a preliminary phase addressing anger; for example, via cognitive-behavioral anger interventions (Lee & DiGiuseppe, 2018).…”

Section: Discussionmentioning

confidence: 99%

Cross-lagged analyses of anger and PTSD symptoms among veterans in treatment.

Cowlishaw¹,

Metcalf²,

Little³

et al. 2022

Psychological Trauma: Theory, Research, Practice, and Policy

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Objective: Anger is a salient feature of posttraumatic mental health which is linked to posttraumatic stress disorder (PTSD) and may have implications for treatment. However, the nature of associations involving anger and PTSD remains unclear. The aim of the present study was to examine bidirectional influences involving anger and International Classification of Diseases (ICD)-11 PTSD symptom clusters over time among treatment-seeking veterans. Method: Current or ex-serving members (n = 742; 92.4% male) who participated in an accredited outpatient PTSD treatment program were administered measures of PTSD symptoms (PTSD checklist for Diagnostic and Statistical Manual of Mental Disorders, 5th edition [PCL-5]) and anger (Dimensions of Anger Reactions Scale-5 [DAR-5]) at treatment intake, discharge, and three-month followup. Bidirectional influences were assessed using cross-lagged panel analyses. Results: The majority of participants (78%) exhibited significant anger problems at intake. Cross-lagged analyses showed anger was associated with relative increases in PTSD symptoms of intrusive reexperiencing and avoidance at posttreatment, whereas no reverse effects of any PTSD symptoms on anger were observed. Anger continued to influence changes in heightened sense of threat and avoidance symptoms at three-months posttreatment. Conclusions: Anger influences change in specific PTSD symptoms over time among military veterans in treatment and may interfere with treatments for PTSD. Veterans who present to clinical services with anger problems may benefit from anger interventions prior to commencing trauma-focused treatment. The findings have additional implications for conceptual models of the relationship between anger and PTSD. Clinical Impact StatementThe findings of this study indicate that significant anger problems are common issues among Australian current and ex-serving military members who seek treatment for posttraumatic stress disorder (PTSD). Furthermore, anger can influence change in PTSD symptoms, and particularly avoidance symptoms, across both treatment and posttreatment follow-up. This suggests that anger is clinically important and may undermine the extent and maintenance of benefits of routine PTSD treatments. Treatment services and providers should consider routinely assessing and addressing anger in the context of treatment for military-related PTSD.

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“…Furthermore, emerging data suggest that PTSD affects not only the victims' physical and mental health but also those of their friends and family members. It was shown that families with a member suffering from PTSD experienced low relationship pleasure, incidents of familial violence and a negative effect on the family members' mental health [39]. This issue and other important issues of diverse PTSD such as late-onset PTSD (PTSD that primarily erupts six-months or more after the occurrence of the traumatic event) [40] and complex PTSD (PTSD that occurs as a result of exposure to chronic, multiple or repeated traumas, that an escape from them is considered difficult or even impossible) [41] should also be tested for the effect of PARP inhibition.…”

Section: Discussionmentioning

confidence: 99%

Modulation of PARP-1 Activity in a Broad Time Window Attenuates Memorizing Fear

Elharrar

Dikshtein

Meninger-Mordechay

et al. 2021

IJMS

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The amygdala plays a critical role in the acquisition and consolidation of fear-related memories. Recent studies have demonstrated that ADP-ribosylation of histones, accelerated by PARPs, affects the chromatin structure and the binding of chromatin remodeling complexes with transcription factors. Inhibition of PARP-1 activity during the labile phase of re-consolidation may erase memory. Accordingly, we investigated the possibility of interfering with fear conditioning by PARP-1 inhibition. Herein, we demonstrate that injection of PARP-1 inhibitors, specifically into the CeA or i.p., in different time windows post-retrieval, attenuates freezing behavior. Moreover, the association of memory with pharmacokinetic timing of PARP inhibitor arrival to the brain enabled/achieved attenuation of a specific cue-associated memory of fear but did not hinder other memories (even traumatic events) associated with other cues. Our results suggest using PARP-1 inhibitors as a new avenue for future treatment of PTSD by disrupting specific traumatic memories in a broad time window, even long after the traumatic event. The safety of using these PARP inhibitors, that is, not interfering with other natural memories, is an added value.

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Couple and family therapies for post-traumatic stress disorder (PTSD)

Cited by 12 publications

References 104 publications

A daily diary study of the romantic partner relationship dynamics associated with anger and other posttraumatic stress disorder symptoms

A daily diary study of the romantic partner relationship dynamics associated with anger and other posttraumatic stress disorder symptoms

Cross-lagged analyses of anger and PTSD symptoms among veterans in treatment.

Modulation of PARP-1 Activity in a Broad Time Window Attenuates Memorizing Fear

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