患者偏好,期望和耻辱之间的相互作用有助于创伤后应激障碍治疗结果
John C Moring1, Alan L Peterson1,2,3, Casey L Straud1,2,3
1Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
Journal of traumatic stress
|October 26, 2023
概括
认知处理疗法 (CPT) 有效治疗创伤后应激障碍 (PTSD). 解决感知到的耻辱感和对治疗方式的满意度可以提高患者在PTSD中CPT的结果.
科学领域:
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
- 心理健康治疗 心理健康治疗
背景情况:
- 认知处理疗法 (CPT) 是创伤后应激障碍 (PTSD) 的领先治疗方法.
- 个体患者的因素可以影响治疗的有效性,需要对可修改的变量进行调查.
- 了解这些因素对于优化PTSD治疗患者的结果至关重要.
研究的目的:
- 检查CPT模式 (家庭内,办公室内,远程医疗) 的满意度,感知到的耻辱感,期望和治疗师信誉如何不同.
- 调查这些因素对创伤后应激障碍治疗结果的影响.
- 测试假设,这些变量的贡献取决于患者的偏好,并预测治疗的成功.
主要方法:
- 一个三臂,平衡分层的随机化临床试验.
- 在随机化之前,患者偏好被适应到家庭,办公室或远程医疗CPT模式.
- 分析的重点是满意度,耻辱感,期望和信誉的差异,以及它们对减轻PTSD症状的预测价值.
主要成果:
- 较低的感知耻辱与在远程医疗和在办公室的CPT中更大的PTSD症状减少相关.
- 与其他方式相比,对家庭治疗方式的满意度较低与PTSD症状减少程度较大有关.
- 对治疗的不满并没有阻碍整体治疗的成功,这突显了CPT的稳定性.
结论:
- 临床医生应该优先解决感知到的耻辱感,然后才开始对PTSD进行CPT.
- 患者对治疗方式的满意度虽然是一个因素,但并不一定阻碍基于证据的PTSD疗法的有效性.
- 定制干预措施和解决患者特有的障碍,如耻辱感,可以改善创伤后应激障碍治疗的结果.
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