适应性披露增强的受控试验,以改善功能和治疗创伤后应激障碍
Brett T Litz1, Julie Yeterian2, Danielle Berke3
1VA Boston Healthcare System.
Journal of consulting and clinical psychology
|February 15, 2024
概括
增强适应性披露 (AD-E) 心理治疗改善了与创伤相关的损失和道德伤害的退伍军人的功能和PTSD症状,而不是以现在为中心的治疗 (PCT). 然而,这些好处在随访时没有持续.
科学领域:
- 精神病学和行为科学
- 临床心理学 临床心理学
- 创伤研究 创伤研究
背景情况:
- 退伍军人的创伤后应激障碍 (PTSD) 通常与创伤性损失 (TL) 和道德伤害 (MI) 相关.
- 现有的心理治疗可能无法完全解决与TL/MI相关的PTSD的复杂性.
- 适应性披露 (AD) 是一种心理治疗,旨在解决不同类型的创伤.
研究的目的:
- 为了比较增强适应性披露 (AD-E) 与以现在为中心的治疗 (PCT) 的疗效,用于TL/MI相关的退伍军人.
- 评估AD-E对心理社会功能和PTSD症状严重性的影响.
- 评估随访间隔治疗效果的维持情况.
主要方法:
- 一项随机对照试验 (NCT03056157) 涉及174名与TL/MI相关的PTSD退伍军人.
- 参与者接受了12次AD-E或12次PCT.
- 主要结局包括希恩残疾量表 (SDS) 和临床医生管理的PTSD量表 (CAPS-5),在基线,治疗后和3个月和6个月的随访中进行评估.
主要成果:
- 与PCT (d = 0.15) 相比,AD-E从基线到治疗后的SDS得分在统计学上显著地有了更大的改善.
- 在AD-E组中,21%的参与者在SDS上实现了临床显著的变化.
- 从基线到治疗后,AD-E对CAPS-5 (d = 0.39) 也显示出更大的疗效,但这些效应在随访时没有持续.
结论:
- 这项研究是首次显示AD-E优于PCT对于TL/MI相关PTSD的退伍军人在功能和PTSD症状方面具有优越性.
- 观察到的差异效应大小为小到中等.
- 随访间隔没有维持治疗收益,这表明需要进一步研究长期疗效.
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