Effectiveness of Imagery Rescripting for Trauma-Affected Voice Hearers: An Open Trial

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL Clinical psychology & psychotherapy Pub Date : 2024-09-18 DOI:10.1002/cpp.3052

Laura Strachan, Peter McEvoy, Arnoud Arntz, Craig Steel, Georgie Paulik

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Abstract

Objective

People who hear voices (auditory verbal hallucinations) often have post-traumatic stress disorder (PTSD) symptoms. Cognitive behavioural therapies (CBT) have yielded inconsistent findings when treating voices and PTSD symptoms in voice hearers. Preliminary evidence suggests imagery rescripting (ImRs) is associated with large reductions in voice hearing and PTSD symptoms. This study replicated past studies using a larger sample to examine the effectiveness of ImRs in reducing such symptoms.

Method

Participants (N = 49; 65.3% female; M_age = 35.86) were clients at an Australian transdiagnostic clinic for voice hearers. A one-arm open trial design was used with three pre-treatment baselines and a mid-treatment, post-treatment and 3-month follow up assessments of PTSD symptoms (Posttraumatic Diagnostic Scale for DSM-5), voices (Hamilton Program for Schizophrenia Voices Questionnaire) and emotional symptoms (Depression Anxiety and Stress Scales-21). Five single-item measures were administered weekly to explore the trajectories of change in trauma intrusions, voice-related distress, voice frequency and positive and negative voice valance.

Results

ImRs was associated with very large reductions in PTSD symptoms and voices (both emotional and physical characteristics of voices) and emotional symptoms at post-treatment and follow-up (η²_p = 0.24–0.44). There were medium-large to large reductions in weekly symptoms of intrusions, voice-related distress, voice frequency and negative voices (η²_p = 0.12–0.16) and a non-significant increase in positive voices (η²_p = 0.05).

Conclusions

This study provides further evidence that ImRs is an effective treatment for voices and PTSD symptoms in voice hearers with a range of diagnoses. Randomised controlled trials are needed to compare the efficacy of ImRs to CBT protocols.

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对受创伤影响的听障人士进行意象重写的有效性：公开试验

目的听到声音（幻听）的人通常会出现创伤后应激障碍（PTSD）症状。认知行为疗法（CBT）在治疗幻听者的声音和创伤后应激障碍（PTSD）症状方面的结果并不一致。初步证据表明，意象重写疗法（ImRs）可显著减轻幻听和创伤后应激障碍症状。本研究使用更大的样本重复了过去的研究，以检验意象重述在减轻此类症状方面的效果。方法参与者（N = 49；65.3% 为女性；Mage = 35.86）是澳大利亚一家嗓音听觉障碍患者跨诊断诊所的客户。采用单臂开放式试验设计，以治疗前、治疗中、治疗后和 3 个月随访为三个基线，分别评估创伤后应激障碍症状（DSM-5 创伤后诊断量表）、幻听（汉密尔顿精神分裂症幻听问卷）和情绪症状（抑郁、焦虑和压力量表-21）。每周进行五次单项测量，以探索创伤侵入、声音相关痛苦、声音频率以及积极和消极声音价值的变化轨迹。结果 ImRs 与创伤后应激障碍症状和声音（声音的情绪和物理特征）以及治疗后和随访时的情绪症状的大幅减少有关（η2p = 0.24-0.44）。每周侵扰症状、与声音有关的痛苦、声音频率和消极声音（η2p = 0.12-0.16）均有中度至大幅减少，而积极声音（η2p = 0.05）则无显著增加。结论本研究进一步证明，ImRs 可以有效治疗各种诊断的幻听者的幻听和创伤后应激障碍症状。需要进行随机对照试验，以比较 ImRs 与 CBT 方案的疗效。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.