创伤性记忆再巩固(rtm)治疗创伤后应激障碍:一种有效的治疗方法

Richard Gray
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引用次数: 0

摘要

“创伤后应激障碍的治疗涉及五个系统层面——化学、生物、神经生理、现象和认知。药理学治疗是化学和生物水平的桥梁。它们的效果往往不精确,而毒品意味着破碎。直接的神经生理手法包括星状神经节阻滞、深部脑刺激、经颅磁刺激等。这些都是新的,通常是侵入性的,并且很少得到证实。EMDR和RTM对内部图像进行图像处理。认知操作与意识反应一起起作用。认知干预可能会使患者暴露于文化问题,特别是在群体环境中进行时。这些包括过度男性化的期望,军事文化,羞耻感作为自责等等。EMDR、认知和药理学方法显示出相同的疗效。RTM会修改创伤记忆的想象结构,将它们重新想象成没有威胁性的过去事件。RTM可以在不披露创伤内容的情况下使用。我们假设图像的改变通过再巩固更新机制直接而持久地影响神经学。将介绍四项已发表的RTM随机对照试验以及第五项未发表的受训者结果研究的信息。所有研究都发现,效应值超过0.08个smd,患者满意度就很高。”
本文章由计算机程序翻译,如有差异,请以英文原文为准。
THE RECONSOLIDATION OF TRAUMATIC MEMORIES (RTM) PROTOCOL FOR PTSD: A TREATMENT THAT WORKS
"PTSD treatments occupy five systemic levels—chemical, biological, neurophysiological, phenomenal, and cognitive. Pharmacological treatments bridge the chemical and biological levels. They are often imprecise in effect, and drugs imply brokenness. Direct neurophysiological manipulations include Stellate ganglion block, deep brain stimulation, transcranial magnetic stimulation, etc. These are new, often invasive, and sparsely attested. EMDR and RTM employ imaginal manipulation of internal images. Cognitive manipulations work with conscious responses. Cognitive interventions may expose patients to cultural issues, especially when performed in a group context. These include hyper-masculinized expectations, military culture, shame as self-blame, etc. EMDR, cognitive, and pharmacological approaches have shown equivalent efficacy. RTM modifies the imaginal structure of trauma memories, reimagining them as nonthreatening, past events. RTM may be employed without disclosure of trauma content. We hypothesize that changes to imaginal images directly and lastingly impact neurology via the reconsolidation updating mechanism. Four published RCTs of RTM will be presented with information about a fifth unpublished study of trainee results. All studies found effect sizes exceeding 0.08 SMDs with high patient satisfaction."
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