正念认知疗法对受创伤黑人成人创伤后应激障碍和抑郁症状的影响:试点随机对照试验结果

Malin Au , Rebecca Lipschutz , Yara Mekawi , Emma C. Lathan , H. Drew Dixon , Sierra Carter , Rebecca Hinrichs , Bekh Bradley , Nadine J. Kaslow , Nicole R. Nugent , Abigail Powers
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引用次数: 0

摘要

低收入、居住在城市的黑人成年人受到创伤经历、创伤后应激障碍(PTSD)和抑郁症的影响尤为严重,而且在接受治疗方面也存在不平等现象。除了基于正念的认知疗法(MBCT)对抑郁症的益处外,在之前对退伍军人进行的两项试点研究中,也有初步证据表明通过 MBCT 成功减轻了创伤后应激障碍的症状。对受过创伤的黑人成年人进行的基于正念的认知疗法效果研究仍然有限,对特定创伤后应激障碍群组效果的研究几乎不存在。我们在一项试点随机对照试验(RCT)中考察了改编 MBCT 与候补对照(WLC)对创伤后应激障碍和抑郁症状的初步疗效。我们从一家城市公立医院招募了多次遭受创伤、创伤后应激障碍和抑郁症筛查呈阳性的黑人成年人(人数=80;86.10% 为女性),并随机安排他们接受为期 8 周的改编 MBCT 或 WLC 治疗。在治疗前和治疗后,使用临床医师管理的创伤后应激障碍量表 DSM-5(CAPS-5)和贝克抑郁量表-II(BDI-II)测量症状。采用意向治疗方法进行了混合模型分析,研究了随着时间的推移,MBCT 和 WLC 在创伤后应激障碍和抑郁评分方面的变化。在创伤后应激障碍和抑郁症状的总变化方面,MBCT 和 WLC 之间没有明显差异。CAPS-5回避症状在MBCT组有明显减少(F[1, 68.10] = 5.98, p = .017;t[71.60] = 3.61, p <.001)。研究结果表明,创伤后应激障碍和抑郁症并发的黑人成人中,MBCT 可能有助于解决回避症状。虽然这项研究缺乏得出治疗效果最终结论的力量,但它提供的初步数据表明,未来进行完全有效的试验非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The effect of mindfulness-based cognitive therapy on PTSD and depression symptoms in trauma-exposed black adults: Pilot randomized controlled trial results
Low-income, urban-dwelling Black adults are disproportionately affected by traumatic experiences, posttraumatic stress disorder (PTSD), and depression and encounter inequities in treatment access. In addition to the benefits Mindfulness-Based Cognitive Therapy (MBCT) for depression, there is preliminary evidence of successful symptom reduction in PTSD via MBCT across two prior pilot studies in veterans. Studies examining the effects of MBCT among trauma-exposed Black adults remains limited, and examination of effects across specific PTSD clusters is almost nonexistent. We examined the preliminary efficacy of adapted MBCT versus waitlist control (WLC) on PTSD and depression symptoms in a pilot randomized controlled trial (RCT). Black adults (N = 80; 86.10 % women) with repeated trauma exposure, who screened positive for PTSD and depression, were recruited from an urban public hospital and randomized to 8-week adapted MBCT or WLC. Symptoms were measured pretreatment and posttreatment with the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and the Beck Depression Inventory-II (BDI-II). Mixed model analyses were conducted with an intent-to-treat approach, examining change in PTSD and depression scores between MBCT and WLC over time. There was no significant difference in total PTSD and depression symptom change between MBCT and WLC. CAPS-5 avoidance symptoms showed a nominally significant decrease in the MBCT group (F[1, 68.10] = 5.98, p = .017; t[71.60] = 3.61, p < .001). Findings suggest MBCT might be helpful for addressing avoidance symptoms among Black adults with comorbid PTSD and depression. Although lacking power to draw final conclusions about treatment efficacy, this study provides preliminary data suggesting the importance of future fully powered trials.
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来源期刊
Journal of mood and anxiety disorders
Journal of mood and anxiety disorders Applied Psychology, Experimental and Cognitive Psychology, Clinical Psychology, Psychiatry and Mental Health, Psychology (General), Behavioral Neuroscience
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