受伤的德军士兵有道德伤害 - 基于价值的认知行为小组治疗治疗与战争有关的羞耻感
Caroline Diekmann1,2, Leonie Issels1, Christina Alliger-Horn1
1Department of Psychiatry, Psychotherapy and Psychotraumatology, Military Hospital Berlin, Berlin, Germany.
Frontiers in psychiatry
|August 3, 2023
概括
这项研究表明,以价值为基础的认知行为小组治疗有效地减少了士兵遭受道德伤害的羞耻感和不适应应对. 这些发现支持将此类干预措施纳入军事创伤护理.
科学领域:
- 心理学 心理学 心理学
- 军事医学 军事医学
- 创伤护理 创伤护理
背景情况:
- 士兵在部署期间面临道德上有害的事件,导致羞耻和内等心理痛苦.
- 道德伤害是一个重大问题,但有效的治疗干预措施仍然不清楚.
- 现有的治疗方法可能无法完全解决道德伤害的独特方面.
研究的目的:
- 为了检查一种基于价值的新型认知行为小组治疗对道德伤害的有效性.
- 评估干预后的耻辱和适应不良应对策略的变化.
- 为军事环境中量身定制的创伤护理提供证据.
主要方法:
- 一项对照性研究,比较干预组 (n=45) 与等候名单对照组 (n=40).
- 使用"耻辱之指南针"尺度对治疗前后症状进行评估.
- 采用了为期三周的住院小组治疗方案,结合了CBT,ACT,精神护理和适应性披露.
主要成果:
- 与对照组相比,干预组显示羞耻相关的不适应策略 (攻击自我,退出,攻击他人) 显著减少 (p <0.05).
- 耻辱指南针尺度的特定子尺度表明了显著的改进.
- 效应大小 (科恩的f) 从0.27到0.36不等,表明中度效应.
结论:
- 基于价值观的认知行为小组治疗可以有效地改变基于羞耻的不适应行为,以应对道德伤害.
- 培养自我同情和宽恕的治疗方法是解决道德伤害机制的关键.
- 这些干预应该被认为是军事人员的标准创伤护理.
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