Psychosocial rehabilitation after war trauma with adaptive disclosure: Design and rationale of a comparative efficacy trial.
Psychosocial rehabilitation after war trauma with adaptive disclosure: Design and rationale of a comparative efficacy trial.
复制标题
战后创伤后心理康复与适应性披露：比较功效试验的设计和原理。
DOI：
10.1016/j.cct.2017.07.012
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发表时间：
2017
影响因子：
2.2
通讯作者：
Litz,BrettT
中科院分区：
文献类型：
--
作者：
Yeterian,JulieD;Berke,DanielleS;Litz,BrettT
背景战区暴露导致的创伤后应激障碍（PTSD）与慢性和致残的社会和职业问题有关。然而，在PTSD治疗中很少直接评估或针对功能障碍，而是专注于症状减轻。与创伤有关的功能下降的贡献者，包括内疚，羞耻，以及道德妥协或基于损失的战争经历所导致的愤怒，也没有得到足够的重视。本临床试验的目标是填补一个巨大的差距，在军事相关的创伤后应激障碍的治疗测试一个修改后的自适应披露（AD）治疗与战争相关的创伤后应激障碍源于道德伤害和创伤性损失，重点是改善心理社会功能AD。方法和designThis本文介绍了一个多站点的随机对照试验的原理和设计比较AD以目前为中心的治疗（PCT）。我们将招募186名患有PTSD的退伍军人，他们将在基线，治疗后以及治疗后3个月和6个月进行评估。主要结果是功能变化（即，功能/残疾和生活质量）。次要结果是心理健康变量（即，PTSD、抑郁、内疚、羞耻）。我们假设，与AD治疗的退伍军人将经历更大的改善，在所有的结果相比，与PCT治疗。DiscussionThis试验将通过测试第一个专门设计用于解决退伍军人与战争相关的PTSD的心理社会功能的治疗，以促进康复研究的知识。研究结果可能会提高退伍军人的心理健康护理质量，为退伍军人提供独特影响力的生态治疗。
BackgroundPosttraumatic stress disorder (PTSD) from warzone exposure is associated with chronic and disabling social and occupational problems. However, functional impairment is rarely assessed or targeted directly in PTSD treatments, which instead focus on symptom reduction. Trauma-related contributors to diminished functioning, including guilt, shame, and anger resulting from morally compromising or loss-based war experiences, are also underemphasized. The goal of this clinical trial is to fill a substantial gap in the treatment of military-related PTSD by testing a modified Adaptive Disclosure (AD) therapy for war-related PTSD stemming from moral injury and traumatic loss focused on improving psychosocial functioning AD.Method and designThis paper describes the rationale and design of a multi-site randomized controlled trial comparing AD to Present-Centered Therapy (PCT). We will recruit 186 veterans with PTSD, who will be assessed at baseline, post-treatment, and 3- and 6-months post-treatment. Primary outcomes are functional changes (i.e., functioning/disability and quality of life). Secondary outcomes are mental health variables (i.e., PTSD, depression, guilt, shame). We hypothesize that veterans treated with AD will experience greater improvements in all outcomes compared to those treated with PCT.DiscussionThis trial will advance knowledge in rehabilitation research by testing the first therapy specifically designed to address psychosocial functioning among veterans with war-related PTSD. The results may improve the quality of mental health care for veterans by offering an ecologically sound treatment for experiences that are uniquely impactful for war veterans.