Group-Delivered Cognitive/Exposure Therapy for PTSD in Women Veterans: A Randomized Controlled Trial
Group-Delivered Cognitive/Exposure Therapy for PTSD in Women Veterans: A Randomized Controlled Trial
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DOI：
10.1037/tra0000111
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发表时间：
2016-05-01
影响因子：
6.3
通讯作者：
Keane, Terence M.
中科院分区：
文献类型：
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作者：
Castillo, Diane T.;Chee, Christine L.;Keane, Terence M.
目的：创伤后应激障碍（PTSD）治疗的群体交付有几个优点，但群体研究是不可比的个人试验。本研究通过改进方法学扩展了组文献，研究了3模块（认知、暴露、技能）组治疗PTSD的疗效，建立了一种提供组暴露治疗的格式，并比较了组内3个治疗模块。方法：将86名持久自由行动（OEF）/伊拉克自由行动（OIF）女性退伍军人随机分为16周，3人组治疗（Tx）或等待名单（WL）条件。主要（临床医生管理的创伤后应激障碍量表[CAPS]）和次要（医疗结局研究简表-36 [SF-36]、生活质量量表[QOLI]和创伤后应激障碍清单[PCL]）结局指标在基线、治疗后/治疗后以及治疗后3个月和6个月进行测量（每个治疗模块还在治疗前/治疗后进行PCL）。结果如下：Tx组参与者的PTSD症状显著改善（p <0.001，ES = 1.72;分析组单位：n = 14），精神和身体生活功能（SF-36; p <0.001）和生活质量（QOLI; p <0.001）也有改善。WL在SF-36（精神; p = .04）和QOLI（p = .02）方面显著改善。Tx组的临床改善（CAPS）反映了77%的治疗反应（下降>= 10分）和PTSD诊断的丢失（
Objective: Group delivery of posttraumatic stress disorder (PTSD) treatment has several advantages, however group research is not comparable to individual trials. This study extends the group literature by improving methodology in examining the efficacy of a 3-module (cognitive, exposure, skills) group treatment for PTSD, establishes a format for the delivery of group exposure therapy, and compares 3 treatment modules within the group. Method: Eighty-six Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) women veterans were randomized to a 16-week, 3-member group treatment (Tx) or a waitlist (WL) condition. The primary (Clinician Administered PTSD Scale [CAPS]) and secondary (Medical Outcomes Study Short Form-36 [SF-36], Quality of Life Inventory [QOLI], and PTSD Checklist [PCL]) outcome measures were administered at baseline, post Tx/WL, and at 3- and 6-months post Tx (PCL additionally at pre/post for each treatment module). Results: PTSD symptoms significantly improved in Tx arm participants (p < .001, ES = 1.72; unit of analysis group: n = 14), as did mental and physical life functioning (SF-36; p < .001), and quality of life (QOLI; p < .001). The WL significantly improved on the SF-36 (mental; p = .04) and QOLI (p = .02). Clinical improvement (CAPS) in the Tx arm reflected a treatment response (>= 10-point decrease) in 77% and loss of PTSD diagnosis (