Early psychological interventions for adult survivors of trauma: A review
Early psychological interventions for adult survivors of trauma: A review
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DOI：
10.1016/s0006-3223(02)01812-7
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发表时间：
2003-05-01
影响因子：
10.6
通讯作者：
Clark, DM
中科院分区：
文献类型：
--
作者：
Ehlers, A;Clark, DM
创伤事件后的心理干预最近才在随机对照试验中进行评估。最近的系统性综述得出结论，单次个人心理汇报对减轻痛苦或随后的创伤后应激障碍（PTSD）症状无效。本文综述了创伤后早期认知行为治疗（CBT）的试验。认知行为疗法在预防PTSD症状慢性化方面比支持性咨询更有效;然而，在大多数现有的研究中，与不干预相比，支持性咨询是否促进或延迟恢复仍不清楚。在创伤的第一个月进行简短的CBT计划并不上级重复评估;然而，在创伤后1-4个月进行长达16次的CBT课程上级自助，重复评估和无干预。CBT和汇报或自助之间的疗效差异的可能原因进行了讨论。这些包括通过创伤记忆工作的方式以及干预措施对患者解释其PTSD症状的影响。可能的方法来确定谁是在创伤后需要专业心理干预的人，谁是不太可能恢复自己进行了讨论。一些想法提供帮助创伤幸存者的替代方式，并为未来的研究方法的建议。Biol Psychiatry 2003;53：817-826（C）2003 Society of Biological Psychiatry.
Psychological interventions after traumatic events have only recently been evaluated in randomized, controlled trials. Recent systematic reviews concluded that single sessions of individual psychological debriefing are not effective in reducing distress or subsequent posttraumatic stress disorder (PTSD) symptoms. The present article reviews trials of early cognitive behavior therapy (CBT) after trauma. Cognitive behavioral therapy was more effective than supportive counseling in preventing chronicity of PTSD symptoms; however, in most available studies it remained unclear whether supportive counseling facilitated or retarded recovery, compared with no intervention. A brief CBT program given in the first month of trauma was not superior to repeated assessment; however, a course of CBT of up to 16 sessions given at 1-4 months after trauma was superior to self-help, repeated assessment, and no intervention. Possible reasons for the difference in efficacy between CBT and debriefing or self-help are discussed. These include the way of working through traumatic memories and the impact of the interventions on patients' interpretations of their PTSD symptoms. Possible ways of identifying people who are in need of specialist psychological intervention after trauma and who are unlikely to recover on their own are discussed. Some ideas for alternative ways of offering help to trauma survivors are presented, and methodologic suggestions for future research are given. Biol Psychiatry 2003;53: 817-826 (C) 2003 Society of Biological Psychiatry.