Prolonged exposure for posttraumatic stress disorder following spinal cord injury: A randomized controlled trial.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-08-29 DOI:10.1037/rep0000580

Megan E Douglas, Monica Bennett, Kirstie A Jones, Jamie R Pogue, Gregory V Chauvette, Seema Sikka, Simon Driver, Rita Hamilton, Nicholas Curcio, Sarita Patel, Andrea Wierzchowski, Maris Adams, Estrella V Thomas, Emma Turner, Kiara Leonard, Emily Carl, Michael Foreman, Ann Marie Warren, Mark B Powers

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引用次数: 0

Abstract

Purpose/objective: Individuals with a spinal cord injury (SCI) may experience posttraumatic stress disorder (PTSD) at a higher rate, which is associated with worse psychiatric comorbidity, decreased quality of life, and greater disability. Yet, effective PTSD interventions remain understudied for individuals with SCI. We conducted the first randomized controlled trial (RCT) of an evidence-based psychotherapy (prolonged exposure [PE]) with survivors of SCI during acute rehabilitation. We examined the efficacy, feasibility, and secondary outcomes.

Research method/design: Participants (n = 29) were adults recruited from 2018 to 2021 1-month postinjury with PTSD randomized into either PE therapy or treatment as usual. The primary outcome was PTSD assessed at baseline, 6, 10, and 32 weeks postenrollment.

Results: An overall group-by-time interaction was not statistically significant (p = .102), but effect sizes demonstrated moderate and large improvements in PTSD for the PE group at 6 (-19.4 vs. -9.7) and 10 (-25.8 vs. -5.7), respectively. Similarly, moderate to large effect sizes were observed for depression, maladaptive posttraumatic cognitions, disruptive nocturnal behaviors, SCI-related quality of life, and risky alcohol consumption. Low rates of enrollment (50%) and treatment completion (25%) suggest feasibility challenges; however, treatment completers did report high satisfaction (100%).

Conclusions/implications: Results suggest that individuals who received PE had a quicker and clinically meaningful reduction in PTSD symptoms, but delivery during acute rehabilitation is not feasible for many individuals. Future research should examine abbreviated versions of PE for PTSD to enhance the feasibility of treatment in this setting. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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长期暴露治疗脊髓损伤后创伤后应激障碍：随机对照试验。

目的/目标：脊髓损伤（SCI）患者患创伤后应激障碍（PTSD）的比例较高，这与精神疾病合并症加重、生活质量下降和残疾程度加深有关。然而，针对 SCI 患者的有效创伤后应激障碍干预措施仍未得到充分研究。我们对急性康复期间的 SCI 幸存者进行了首次基于证据的心理疗法（长期暴露疗法 [PE]）随机对照试验（RCT）。研究方法/设计：参与者（n = 29）是2018年至2021年招募的伤后1个月患有创伤后应激障碍的成年人，他们被随机分配到PE疗法或常规治疗中。主要结果是在基线、注册后6周、10周和32周评估创伤后应激障碍：各组与时间之间的总体交互作用无统计学意义（P = .102），但效果大小显示，PE 组在 6 周（-19.4 vs. -9.7）和 10 周（-25.8 vs. -5.7）时的创伤后应激障碍分别有中度和大幅改善。同样，在抑郁、创伤后不良认知、扰乱性夜间行为、与 SCI 相关的生活质量和危险饮酒方面也观察到了中等至较大的效应大小。入学率（50%）和治疗完成率（25%）较低，这表明在可行性方面存在挑战；不过，治疗完成者确实报告了较高的满意度（100%）：研究结果表明，接受创伤后应激障碍心理治疗的患者的创伤后应激障碍症状减轻得更快、更有临床意义，但在急性康复期进行治疗对许多人来说并不可行。未来的研究应研究针对创伤后应激障碍的简易PE疗法，以提高在这种情况下进行治疗的可行性。(PsycInfo Database Record (c) 2024 APA，保留所有权利）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.