Initial Evaluation of an Integrated Treatment for Comorbid PTSD and Smoking Using a Nonconcurrent, Multiple-Baseline Design
Initial Evaluation of an Integrated Treatment for Comorbid PTSD and Smoking Using a Nonconcurrent, Multiple-Baseline Design
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DOI：
10.1016/j.beth.2013.04.003
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发表时间：
2013-09-01
期刊：
影响因子：
3.7
通讯作者：
Zvolensky, Michael J.
中科院分区：
文献类型：
--
作者：
Feldner, Matthew T.;Smith, Rose C.;Zvolensky, Michael J.
本研究探讨了一种综合治疗共病创伤后应激障碍（PTSD）和吸烟题为“无烟克服PTSD：综合治疗”（STOP IT计划）。采用非同期多基线设计，对6名社区招募的患有PTSD的成年吸烟者进行研究，以调查患者对治疗的接受程度及其对PTSD和吸烟的初步疗效。潜在的顺序影响的基于安全和影响管理组件也进行了检查。包括临床医生管理的PTSD量表的金标准评估策略（Blake埃塔尔，1995）和自我报告的吸烟状态的生化验证被用来测量治疗的主要目标。结果表明STOP TT方案耐受性良好。创伤后应激障碍的结果有临床意义的改善，但只是暂时减少吸烟。参与者治疗后相对较低的吸烟水平在随访评估中有所增加，尽管没有达到基线水平。治疗组分顺序似乎不影响治疗结局，但那些在影响管理培训条件之前被分配到以确定为重点的写作的患者似乎更有可能在开始暴露前停止治疗。这些初步数据支持STOP TT项目的安全性、可接受性和潜在疗效。STOP TT计划的未来研究应包括测试增加以吸烟为重点的干预剂量的增量疗效，以及采用金标准进行治疗结局研究的随机对照试验。
The present study examined an integrated treatment for comorbid posttraumatic stress disorder (PTSD) and smoking entitled "Smoke-Free to Overcome PTSD: An Integrated Treatment" (STOP IT program). A nonconcurrent multiple-baseline design was used with six community-recruited adult smokers with PTSD to investigate both patient acceptance of the treatment and its initial efficacy on both PTSD and smoking. Potential order effects of exposure-based and affect management components were also examined. A gold-standard assessment strategy that included the Clinician Administered PTSD Scale (Blake etal., 1995) and biochemical verification of self-reported smoking status was employed to measure primary targets of treatment. Results suggested that the STOP TT program was well tolerated. There were clinically significant improvements in PTSD outcomes, but only temporary reductions in smoking. Participants' relatively low posttreatment smoking levels increased by the follow-up assessment, although not to baseline levels. Treatment component order did not appear to affect treatment outcomes, but those who were assigned to the exposure-focused writing prior to affect management training condition appeared more likely to discontinue treatment before beginning exposure. These preliminary data support the safety, acceptability, and potential efficacy of the STOP TT program. Future investigation of the STOP TT program should include testing the incremental efficacy of increasing the dose of smoking-focused intervention, as well as randomized controlled tests of the treatment that employ gold standards for treatment outcome research.