重新整合创伤记忆对复杂创伤后应激障碍的疗效--印度一家健康中心的试点准实验研究

Gunjan Y Trivedi , Neha Pandya , Parishi Thakore , Hemalatha Ramani , Riri G Trivedi , Soundappan Kathirvel
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摘要

根据 ICD-11 指南,复杂创伤后应激障碍(CPTSD)与创伤后应激障碍有几个独特的特征。长期或频繁接触极具威胁性或恐怖性的事件或系列事件会增加成人罹患 CPTSD 的风险。对于创伤后应激障碍,创伤记忆再巩固(RTM)已成为一种有效的干预措施。关于如何治疗 CPTSD 的研究还很有限。因此,RTM 对 CPTSD 的有效性尚未确定。在印度,关于创伤后应激障碍的研究很少(主要集中在自然灾害和暴力方面),关于 CPTSD 的研究也很少,关于 RTM 的有效性的研究也很少。不幸的是,印度有 4 亿年轻人,精神健康问题的发病率高且识别能力有限,因此在这一领域存在很大差距。这项准实验性试点研究旨在评估 RTM 对印度一家健康中心 CPTSD 患者的干预效果。向健康中心求助的参与者(>18 岁,n = 107)由两名训练有素的治疗师(包括一名心理学家)使用国际创伤问卷对 CPTSD 现象问题进行评估。其他评估包括重度抑郁量表和广泛性焦虑症-7。根据创伤指数框架,进行 RTM 干预。一个月(或五个疗程)后,80 人的 CPTSD 状态变为 "无"(无诊断),2 人的 CPTSD 状态变为 "创伤后应激障碍"。这一结果在三个月后(n = 30)得以持续。配对 t 检验证实,与基线相比,一个月后 CPTSD 得分总体下降,与一个月后相比,三个月后 CPTSD 得分甚至下降,这在统计学上具有显著性(p <.01)。研究结果证实了 RTM 干预对 CPTSD 患者的有效性。研究的局限性(准实验设计、城市、讲英语的印度人)可在今后的工作中加以解决。
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The effectiveness of Reconsolidation of Traumatic Memories for Complex PTSD – A pilot quasi-experimental study from a wellness centre in India
Complex Post-Traumatic Stress Disorder (CPTSD), based on ICD-11 guidelines, is differentiated from PTSD by several unique characteristics. Prolonged or frequent exposure to an event or series of events of extremely threatening or horrific nature increases the risk for CPTSD in adults. For PTSD, Reconsolidation of Traumatic Memories (RTM) has emerged as an effective intervention. There are limited studies on how to address CPTSD. Hence, RTM's effectiveness for CPTSD has not yet been established. In India, there are very few studies on PTSD (focusing mainly on natural disasters and violence), none on CPTSD and none on the effectiveness of RTM. Unfortunately, India, with >400 million young individuals and with high prevalence and limited identification of mental health issues, has a major gap in this area. This quasi-experimental pilot study aimed to assess the effectiveness of the RTM intervention for individuals with CPTSD at a wellness centre in India.
The participants (>18 years, n = 107) who reached out to a wellness center for help were assessed by two trained therapists (including a psychologist) based on the presenting problems for CPTSD using the International Trauma Questionnaire. Additional assessments included Major Depression Inventory and Generalized Anxiety Disorder-7. Based on the index-trauma framework, RTM intervention was delivered. Post-measurements were done (a) after one month or at least after five sessions and (b) after three months.
After one month (or five sessions), the CPTSD status changed to “none” (no diagnosis) for 80 and “PTSD” for 2 individuals. The results were sustained post-three months (n = 30). The paired t-test confirmed the overall reduction in CPTSD score after one month compared to baseline and even after three months compared to after one month, based on statistical significance (p < .01). The findings confirmed the effectiveness of RTM intervention for individuals with CPTSD. The study's limitations (quasi-experimental design, urban, English-speaking Indians) could be addressed in future work.
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