创伤后应激障碍的症状改变在一个简短的强化创伤为重点的治疗方案对非退伍军人和退伍军人与战争有关的创伤后应激障碍。

IF 4.1 2区 医学 Q1 PSYCHIATRY
Kirsten M Reij, Ad de Jongh, Ernst Paul Swens, Eline M Voorendonk
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引用次数: 0

摘要

背景:有证据表明,患有创伤后应激障碍(PTSD)的退伍军人比没有经历过战争相关创伤的PTSD患者更不可能从创伤治疗中获益。然而,在创伤后应激障碍治疗方面的新进展,在短时间内结合几种以证据为基础的创伤治疗方法,可能会帮助退伍军人取得与非退伍军人相似的结果。目的:在这项回顾性队列研究中,我们研究了退伍军人和非退伍军人治疗后PTSD症状和诊断状态的变化。治疗包括为期4天或8天的以创伤为重点的强化治疗方案,包括长时间暴露、EMDR治疗、心理教育和体育活动。方法:样本由43名退伍军人和43名非退伍军人组成,根据年龄、性别、开始日期和治疗时间进行匹配。参与者在治疗前和治疗后使用临床医生管理的PTSD量表5 (CAPS-5)进行评估。CAPS-5评分随时间和组间的差异采用贝叶斯重复测量方差分析建模。我们采用贝叶斯模型平均,根据治疗反应,使用排除贝叶斯因子(BFEXCL)量化组间PTSD症状变化的差异。结果:退伍军人和非退伍军人的PTSD症状在治疗前后均有所减轻(Cohen’s d分别为2.17和1.54)。此外,我们发现中度证据表明各组之间(BFEXCL = 4.8)或各组之间随时间(BFEXCL = 4.9)的cap -5评分无差异。虽然退伍军人的可靠变化指数改善比例高于非退伍军人(分别为83.7%和74.4%),但在治疗后诊断状态丧失方面,两组间无差异(退伍军人为74.4%,非退伍军人为76.7%)。结论:本研究提供的证据表明,患有战争相关创伤后应激障碍的退伍军人可以从短期强化、以创伤为重点的治疗中获益,而不支持退伍军人在这种情况下需要不同治疗方法的观点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

PTSD Symptoms change in response to a brief intensive trauma-focused treatment programme in non-veterans and veterans with war-related PTSD.

PTSD Symptoms change in response to a brief intensive trauma-focused treatment programme in non-veterans and veterans with war-related PTSD.

PTSD Symptoms change in response to a brief intensive trauma-focused treatment programme in non-veterans and veterans with war-related PTSD.

PTSD Symptoms change in response to a brief intensive trauma-focused treatment programme in non-veterans and veterans with war-related PTSD.

Background: Evidence suggests that veterans with post-traumatic stress disorder (PTSD) are less likely to benefit from trauma-focused treatment than are patients with PTSD who have not been exposed to war-related trauma. However, new developments in PTSD treatment that combine several evidence-based trauma-focused therapies within a short time frame may help veterans achieve outcomes similar to those of non-veterans.Objective: In this retrospective cohort study, we examined changes in PTSD symptoms and diagnostic status after treatment between veterans and non-veterans. The treatment consisted of a four- or eight-day intensive trauma-focused treatment programme that integrated prolonged exposure, EMDR therapy, psycho-education, and physical activities.Methods: The sample consisted of 43 veterans and 43 non-veterans, matched based on age, sex, starting date, and duration of treatment. Participants were assessed pre- and post-treatment using the Clinician-Administered PTSD Scale-5 (CAPS-5). The differences in CAPS-5 scores over time and between groups were modelled using Bayesian repeated-measures ANOVA. We performed Bayesian model averaging to quantify the differences in PTSD symptom changes between groups, based on treatment response, using the exclusion Bayes factor (BFEXCL).Results: PTSD symptoms in both veterans and non-veterans decreased between pre- and post-treatment (Cohen's d = 2.17 and 1.54, respectively). Furthermore, we found moderate evidence of no differences in CAPS-5 scores between the groups (BFEXCL = 4.8) or between the groups over time (BFEXCL = 4.9). Although a greater proportion of veterans showed improvement according to the reliable change index than non-veterans (83.7% and 74.4%, respectively), there was no difference between the groups in terms of loss of diagnostic status after treatment (74.4% for veterans and 76.7% for non-veterans).Conclusion: This study provides evidence that veterans with war-related PTSD can benefit from brief intensive, trauma-focused treatment and does not support the notion that veterans need a different treatment approach in such settings.

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来源期刊
CiteScore
7.60
自引率
12.00%
发文量
153
审稿时长
18 weeks
期刊介绍: The European Journal of Psychotraumatology (EJPT) is a peer-reviewed open access interdisciplinary journal owned by the European Society of Traumatic Stress Studies (ESTSS). The European Journal of Psychotraumatology (EJPT) aims to engage scholars, clinicians and researchers in the vital issues of how to understand, prevent and treat the consequences of stress and trauma, including but not limited to, posttraumatic stress disorder (PTSD), depressive disorders, substance abuse, burnout, and neurobiological or physical consequences, using the latest research or clinical experience in these areas. The journal shares ESTSS’ mission to advance and disseminate scientific knowledge about traumatic stress. Papers may address individual events, repeated or chronic (complex) trauma, large scale disasters, or violence. Being open access, the European Journal of Psychotraumatology is also evidence of ESTSS’ stand on free accessibility of research publications to a wider community via the web. The European Journal of Psychotraumatology seeks to attract contributions from academics and practitioners from diverse professional backgrounds, including, but not restricted to, those in mental health, social sciences, and health and welfare services. Contributions from outside Europe are welcome. The journal welcomes original basic and clinical research articles that consolidate and expand the theoretical and professional basis of the field of traumatic stress; Review articles including meta-analyses; short communications presenting new ideas or early-stage promising research; study protocols that describe proposed or ongoing research; case reports examining a single individual or event in a real‑life context; clinical practice papers sharing experience from the clinic; letters to the Editor debating articles already published in the Journal; inaugural Lectures; conference abstracts and book reviews. Both quantitative and qualitative research is welcome.
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