睡眠障碍和PTSD:在密集治疗计划中确定失眠反应的基线预测因素
Philip Held1, Ashby Boland1, Sarah A Pridgen1
1Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.
European journal of psychotraumatology
|June 23, 2025
概括
在2周的强化PTSD计划中,退伍军人表现出适度的失眠改善,但许多人仍然在睡眠方面扎. 基线PTSD和抑郁症严重程度预测睡眠结果较差,表明需要有针对性的干预措施.
科学领域:
- 精神病学是一个精神病学.
- 睡眠医学 睡眠医学
- 创伤心理学 创伤心理学
背景情况:
- 失眠是退伍军人患有创伤后应激障碍 (PTSD) 的常见并发症.
- 基于认知处理疗法 (CPT) 的强化PTSD治疗计划 (ITP) 旨在减少PTSD症状,但它们对失眠的影响需要进一步调查.
- 确定可能受益于额外的以睡眠为中心的干预措施的退伍军人对于综合护理至关重要.
研究的目的:
- 确定基线人口统计和临床因素是否预测在接受基于CPT的ITP的退伍军人中,失眠症状的显著减少.
- 识别退伍军人可能需要治疗后补充睡眠干预措施.
主要方法:
- 一组449名退伍军人完成了失眠严重性指数 (ISI) 在基线,治疗后和1个月和3个月的随访.
- 线性混合模型分析了失眠轨迹和预测因素,包括PTSD严重程度,抑郁症,创伤后认知和神经行为症状.
- 机器学习模型 (神经网络,随机森林,弹性网,合体) 用于对具有临床意义的失眠改善的参与者进行分类.
主要成果:
- 退伍军人经历了显著的PTSD症状减少 (d=0.96),中度抑郁症减少 (d=0.57),和适度的失眠改善 (d=0.34).
- 较高的基线PTSD严重程度,抑郁症,负面创伤后认知和神经行为症状与不太有利的失眠结果有关.
- 人口和军事服务因素没有显著预测失眠轨迹;机器学习模型显示预测准确性有限 (AUC0.52-0.62).
结论:
- 虽然基于CPT的ITP导致长达3个月的持续失眠改善,但相当一部分退伍军人继续经历显著的睡眠障碍.
- 目前的自我报告变量对识别需要专门睡眠干预的退伍军人具有有限的预测能力.
- 整合生物或心理社会因素可能会增强患有PTSD的退伍军人的识别,这些退伍军人需要针对性的睡眠治疗.
关键词:
失眠是一种失眠.失眠症 (英语:insomnio) 是一种失眠症.创伤后应激障碍 (PTSD) 是一种这就是TEPTT的意思.自动学习是自动学习.认知处理疗法 认知处理疗法机器学习是机器学习.认知处理疗法 认知处理疗法退伍军人 退伍军人 退伍军人退伍军人的退伍军人更多相关视频
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