Prolonged exposure therapy for combat-related posttraumatic stress disorder: an examination of treatment effectiveness for veterans of the wars in Afghanistan and Iraq.
Prolonged exposure therapy for combat-related posttraumatic stress disorder: an examination of treatment effectiveness for veterans of the wars in Afghanistan and Iraq.
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DOI：
10.1016/j.janxdis.2010.11.002
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发表时间：
2011-04
影响因子：
10.3
通讯作者：
Acierno R
中科院分区：
文献类型：
--
作者：
Tuerk PW;Yoder M;Grubaugh A;Myrick H;Hamner M;Acierno R
退伍军人健康管理局（VHA）发起了一项大规模的倡议，以促进长期暴露（PE）治疗，这是一种基于证据的PTSD治疗方法。虽然现有的随机对照试验（RCT）明确支持PE在平民和一些军事人群中的疗效，但需要更好地了解在规范的精神卫生保健环境中接受PE的当前战争退伍军人的治疗过程。目前的研究调查了65名在城市VA医疗中心接受治疗的退伍军人。所有退伍军人通过结构化访谈被诊断为PTSD，并接受PE治疗。在治疗前和治疗后以及治疗期间每两次收集PTSD和抑郁的测量结果。使用依赖平均值t检验来估计治疗前和治疗后的d型效应大小。此外，分层线性模型（HLM）用于研究随时间推移的治疗效果、患者特征与结局之间的关系，并提供R2型效应量的估计值。结果表明，PE在常规VA精神卫生保健的背景下，可以作为实施时，在仔细进行随机对照试验的有效性。
The Veteran's Health Administration (VHA) has launched a large-scale initiative to promote prolonged exposure (PE) therapy, an evidence-based treatment for PTSD. While existing randomized controlled trials (RCTs) unambiguously support the efficacy of PE in civilian and some military populations, there is a need to better understand the course of treatment for combat Veterans of the current wars receiving PE in normative mental healthcare settings. The current study investigates 65 Veterans receiving care at an urban VA medical center. All Veterans were diagnosed with PTSD via a structured interview and treated with PE. Measures of PTSD and depression were collected pre- and post-treatment and every two sessions during treatment. Dependent means t-tests were used to estimate pre- and post-treatment d-type effect sizes. Additionally, hierarchical linear models (HLM) were used to investigate treatment effects over time, relationships between patient characteristics and outcomes, and to provide estimates of R2-type effect sizes. Results indicate that PE in regular VA mental healthcare contexts can be as effective as when implemented in carefully conducted RCTs.