在对讲阿拉伯语的创伤后应激障碍患者进行简短的网络暴露和认知重组治疗期间,创伤评价发生了变化。

IF 4.2 2区 医学 Q1 PSYCHIATRY European Journal of Psychotraumatology Pub Date : 2024-01-01 Epub Date: 2024-03-21 DOI:10.1080/20008066.2024.2324631
Jana Stein, Rayan El-Haj-Mohamad, Nadine Stammel, Max Vöhringer, Birgit Wagner, Yuriy Nesterko, Maria Böttche, Christine Knaevelsrud
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引用次数: 0

摘要

背景:适应不良的创伤评价在创伤后应激障碍(PTSD)的发展和维持中起着重要作用。虽然已有研究证明暴露疗法和认知疗法对创伤后应激障碍症状有效,但此类疗法对特定创伤评价的影响仍不甚了解:本研究调查了暴露疗法和基于互联网的认知重组疗法对阿拉伯语创伤后应激障碍参与者特定创伤评价的影响:334 名参与者接受了暴露疗法(167 人)或认知重组疗法(167 人)。在治疗前后对创伤后应激障碍症状严重程度(PCL-5)和特定创伤评价(TAQ)进行评估。采用多组变化模型分析了两种治疗方法内部和之间特定创伤评价的变化。创伤后应激障碍症状严重程度的变化与创伤评价的变化之间的关联采用皮尔逊积矩相关法进行评估。对于两种治疗方法,使用韦尔奇检验比较了有可靠改善和无可靠改善的参与者在特定创伤评价方面的变化。对 100 个多重估算数据集进行了分析:两种治疗方法都使羞愧、自责、恐惧、愤怒和疏远感发生了显著变化(所有 ps 均小于 .001)。只有认知重组疗法在背叛方面有显著变化(P < .001)。没有证据表明不同治疗方法在任何特定创伤评价方面存在差异。创伤后应激障碍症状严重程度的变化与创伤评价的变化有显著相关性(均 ps < .001)。在两种治疗方法中,创伤后应激障碍症状严重程度得到可靠改善的参与者与没有得到可靠改善的参与者相比,其特定创伤评价在治疗前和治疗后的变化明显更大。同样,只有认知重组疗法在背叛方面的差异显著:研究结果表明,两种治疗方法都能有效减少阿拉伯语创伤后应激障碍患者的创伤评价。创伤评价的改变似乎与创伤后应激障碍症状的改变有关:试验注册:德国临床试验注册标识符:DRKS00010245.
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Changes in trauma appraisal during brief internet-based exposure and cognitive restructuring treatment for Arabic-speaking people with PTSD.

Background: Maladaptive trauma appraisal plays an important role in the development and maintenance of posttraumatic stress disorder (PTSD). While studies have demonstrated the effectiveness of exposure and cognitive treatments for PTSD symptomatology, the effect of such treatments on specific trauma appraisals is still not well understood.Objective: The study investigated the effect of an exposure and a cognitive restructuring internet-based treatment on specific trauma appraisals in Arabic-speaking participants with PTSD.Method: 334 participants received either an exposure (n = 167) or a cognitive restructuring (n = 167) internet-based treatment. PTSD symptom severity (PCL-5) and specific trauma appraisals (TAQ) were assessed at pre- and post-treatment. Changes in specific trauma appraisals within and between the two treatments were analyzed using multi-group change modelling. Associations between changes in PTSD symptom severity and changes in trauma appraisals were evaluated using Pearson product-moment correlation. For both treatments, participants with versus without reliable improvement were compared regarding changes in specific trauma appraisals using Welch tests. Analyses were performed on 100 multiple imputed datasets.Results: Both treatments yielded significant changes in shame, self-blame, fear, anger, and alienation (all ps < .001). Changes in betrayal were only significant in the cognitive restructuring treatment (p < .001). There was no evidence of differences between treatments for any specific trauma appraisal. Changes in PTSD symptom severity were significantly associated with changes in trauma appraisals (all ps < .001). In both treatments, participants who experienced reliable improvement in PTSD symptom severity showed significantly larger pre- to post-treatment changes in specific trauma appraisals compared to those without reliable improvement. Again, differences in betrayal were only significant in the cognitive restructuring treatment.Conclusions: The findings indicate that both treatments are effective in reducing trauma appraisals in Arabic-speaking people with PTSD. Changes in trauma appraisal seem to be associated with changes in PTSD symptomatology.Trial registration: German Clinical Trials Register identifier: DRKS00010245.

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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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