Can families help veterans get more from PTSD treatment? A randomized clinical trial examining Prolonged Exposure with and without family involvement.
Can families help veterans get more from PTSD treatment? A randomized clinical trial examining Prolonged Exposure with and without family involvement.
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家庭能帮助退伍军人从PTSD治疗中获得更多吗？一项随机临床试验，检查有和没有家庭参与的长期暴露。
DOI：
10.1186/s13063-022-06183-2
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发表时间：
2022-03-30
期刊：
影响因子：
2.5
通讯作者：
Polusny MA
中科院分区：
文献类型：
--
作者：
Meis LA;Glynn SM;Spoont MR;Kehle-Forbes SM;Nelson D;Isenhart CE;Eftekhari A;Ackland PE;Linden EB;Orazem RJ;Cutting A;Hagel Campbell EM;Astin MC;Porter KE;Smith E;Chuick CD;Lamp KE;Vuper TC;Oakley TA;Khan LB;Keckeisen SK;Polusny MA
多达五分之一的退伍军人患有创伤后应激障碍，并对个人、家庭和整个社会造成一系列负面的、长期的后果。以创伤为重点的治疗，如长时间暴露，对许多人有临床意义的症状缓解。坚持这些治疗（即，参加会议和遵守家庭作业）对确保康复至关重要，但对患者来说可能具有挑战性。让家庭参与退伍军人的治疗可以证明是一种有效的策略，可以促进治疗依从性，同时也可以解决长期以来呼吁更好地将家庭纳入创伤后应激障碍治疗的问题。本文描述了一项实用的随机对照试验的方法，该试验旨在评估家庭纳入延长暴露是否可以提高治疗依从性。156名有明显创伤后应激障碍临床症状的退伍军人将在三个不同的退伍军人管理局设施中随机接受标准的长期暴露或通过家庭参与（家庭支持的长期暴露）加强的长期暴露。我们的主要结果是会议出勤率和家庭作业依从性。次要结局包括创伤后应激障碍症状严重程度、抑郁、生活质量和关系功能。该研究包括一项同步过程评估，以确定家庭参与长期暴露的潜在实施促进因素和障碍。虽然家庭参与创伤后应激障碍治疗的重要性是没有争议的，但关于如何将家庭融入体育或任何其他以创伤为重点的创伤后应激障碍治疗的最佳实践，没有证据基础支持。这项研究是解决这一差距的重要一步，为以创伤为中心的治疗中保留和家庭参与的文献做出了贡献。ClinicalTrials.govNCT03256227。2017年8月21日注册。
Posttraumatic stress disorder occurs in as many as one in five combat veterans and is associated with a host of negative, long-term consequences to the individual, their families, and society at large. Trauma-focused treatments, such as Prolonged Exposure, result in clinically significant symptom relief for many. Adherence to these treatments (i.e., session attendance and homework compliance) is vital to ensuring recovery but can be challenging for patients. Engaging families in veterans’ treatment could prove to be an effective strategy for promoting treatment adherence while also addressing long-standing calls for better family inclusion in treatment for posttraumatic stress disorder. This paper describes the methods of a pragmatic randomized controlled trial designed to evaluate if family inclusion in Prolonged Exposure can improve treatment adherence. One hundred fifty-six veterans, with clinically significant symptoms of posttraumatic stress disorder, will be randomized to receive either standard Prolonged Exposure or Prolonged Exposure enhanced through family inclusion (Family-Supported Prolonged Exposure) across three different VA facilities. Our primary outcomes are session attendance and homework compliance. Secondary outcomes include posttraumatic stress disorder symptom severity, depression, quality of life, and relationship functioning. The study includes a concurrent process evaluation to identify potential implementation facilitators and barriers to family involvement in Prolonged Exposure within VA. While the importance of family involvement in posttraumatic stress disorder treatment is non-controversial, there is no evidence base supporting best practices on how to integrate families into PE or any other individually focused trauma-focused treatments for posttraumatic stress disorder. This study is an important step in addressing this gap, contributing to the literature for both retention and family involvement in trauma-focused treatments. ClinicalTrials.govNCT03256227. Registered on August 21, 2017.
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影响因子：
12.7
作者：
Glasgow, RE;Vogt, TM;Boles, SM
通讯作者：
Boles, SM
影响因子：
5
作者：
COHEN, S;KAMARCK, T;MERMELSTEIN, R
通讯作者：
MERMELSTEIN, R
DOI：
10.1016/0749-5978(91)90020-t
发表时间：
1991-12-01
影响因子：
4.6
作者：
AJZEN, I
通讯作者：
AJZEN, I
影响因子：
10.3
作者：
Fredman, Steffany J.;Vorstenbosch, Valerie;Monson, Candice M.
通讯作者：
Monson, Candice M.
影响因子：
2.2
作者：
EPSTEIN, NB;BALDWIN, LM;BISHOP, DS
通讯作者：
BISHOP, DS