退伍军人领导的同伴辅导对创伤后应激障碍的影响

IF 2.4 3区 医学 Q2 PSYCHIATRY
Zeno Franco, Leslie Ruffalo, Bob Curry, Martina Gollin-Graves, Sheikh Iqbal Ahamed, Otis Winstead, Katinka Hooyer, Myah Pazdera, Lisa Rein, Jose Lizarraga Mazaba, Md Fitrat Hossain, Virginia Stoffel, Mark Flower, Praveen Madiraju, Stephen Melka, Karen Berte, Jeffrey Whittle
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引用次数: 0

摘要

同伴指导作为支持退伍军人心理健康的一种策略,显示了其前景。一个由退伍军人领导的非营利性组织和高等教育机构共同参与的社区-学术合作项目对合作开发的同伴指导干预措施进行了评估。我们使用创伤后应激障碍核对表 DSM-5(PCL-5)、部署风险和复原力量表-2、社会适应自我评估量表和行动中的价值观调查表,对创伤后应激障碍(PTSD)、部署后经历、社会功能和心理优势进行了基线、中点和 12 周出院时的评估。每周一次的简短签到调查加强了指导者的联系,并对保留情况进行了评估。样本包括 307 名退伍军人,由 17 名退伍军人同伴导师提供服务。混合效应线性模型发现,创伤后应激障碍症状变化的影响不大,PCL-5 评分平均降低了 4.04 分,95% CI [-6.44, -1.64], d = 0.44。症状较重的退伍军人受到的影响更大,平均减少了 9.03 分,95% CI [-12.11, -5.95],d = 0.77。其他结果变量没有明显发现。与较年轻的退伍军人相比,32-57 岁的退伍军人在 6 周前退出的可能性较小,aORs = 0.32-0.26。导师年龄≥ 35 岁的退学风险逐周降低,aHR = 0.62,95% CI [0.37, 1.05]。未经调整的生存率因指导员所属军种而异,p = .028,但指导员样本较少,降低了可解释性。与许多社区研究工作一样,这项研究缺乏对照组,从而限制了可以得出的推论。继续研究退伍军人同伴指导非常重要,因为这种方式通常被认为比治疗更容易忍受。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of veteran-led peer mentorship on posttraumatic stress disorder

Peer mentorship shows promise as a strategy to support veteran mental health. A community–academic partnership involving a veteran-led nonprofit organization and institutions of higher education evaluated a collaboratively developed peer mentor intervention. We assessed posttraumatic stress disorder (PTSD), postdeployment experiences, social functioning, and psychological strengths at baseline, midpoint, and 12-week discharge using the PTSD Checklist for DSM-5 (PCL-5), Deployment Risk and Resilience Inventory–2, Social Adaptation Self-evaluation Scale, and Values in Action Survey. Brief weekly check-in surveys reinforced mentor contact and assessed retention. The sample included 307 veterans who were served by 17 veteran peer mentors. Mixed-effects linear models found a modest effect for PTSD symptom change, with a mean PCL-5 score reduction of 4.04 points, 95% CI [−6.44, −1.64], d = 0.44. More symptomatic veterans showed a larger effect, with average reductions of 9.03 points, 95% CI [-12.11, -5.95], d = 0.77. There were no significant findings for other outcome variables. Compared to younger veterans, those aged 32–57 years were less likely to drop out by 6 weeks, aORs = 0.32–0.26. Week-by-week hazard of drop-out was lower with mentors ≥ 35 years old, aHR = 0.62, 95% CI [0.37, 1.05]. Unadjusted survival differed by mentor military branch, p = .028, but the small mentor sample reduced interpretability. Like many community research efforts, this study lacked a control group, limiting the inferences that can be drawn. Continued study of veteran peer mentorship is important as this modality is often viewed as more tolerable than therapy.

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来源期刊
CiteScore
5.80
自引率
6.10%
发文量
125
期刊介绍: Journal of Traumatic Stress (JTS) is published for the International Society for Traumatic Stress Studies. Journal of Traumatic Stress , the official publication for the International Society for Traumatic Stress Studies, is an interdisciplinary forum for the publication of peer-reviewed original papers on biopsychosocial aspects of trauma. Papers focus on theoretical formulations, research, treatment, prevention education/training, and legal and policy concerns. Journal of Traumatic Stress serves as a primary reference for professionals who study and treat people exposed to highly stressful and traumatic events (directly or through their occupational roles), such as war, disaster, accident, violence or abuse (criminal or familial), hostage-taking, or life-threatening illness. The journal publishes original articles, brief reports, review papers, commentaries, and, from time to time, special issues devoted to a single topic.
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