A Randomized Clinical Trial of Group Cognitive Processing Therapy Compared With Group Present-Centered Therapy for PTSD Among Active Duty Military Personnel
A Randomized Clinical Trial of Group Cognitive Processing Therapy Compared With Group Present-Centered Therapy for PTSD Among Active Duty Military Personnel
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DOI：
10.1037/ccp0000016
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发表时间：
2015-12-01
影响因子：
5.9
通讯作者：
Peterson, Alan L.
中科院分区：
文献类型：
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作者：
Resick, Patricia A.;Wachen, Jennifer Schuster;Peterson, Alan L.
目的：为了确定团体治疗是否可以改善创伤后应激障碍（PTSD）的症状，这项随机临床试验比较了现役军人的团体认知处理疗法（仅认知版本；CPT-C）与团体当前中心疗法（PCT）的疗效。方法：患者在德克萨斯州胡德堡参加为期 6 周的每周两次每次 90 分钟的小组活动。在基线、治疗前每周以及治疗后 2 周、6 个月和 12 个月进行独立评估。共有 108 名军人（100 名男性，8 名女性）被随机分组。纳入标准包括军事部署后的创伤后应激障碍和药物稳定性。排除标准包括自杀/杀人意图或其他需要立即治疗的严重精神障碍。无论治疗是否完成，均进行后续评估。主要结果指标是 PTSD 检查表（压力源特定版本；PCL-S）和贝克抑郁量表 II。创伤后应激症状访谈 (PSS-1) 是次要措施。结果：两种治疗均导致 PTSD 严重程度大幅降低，但 CPT-C 改善更大。 CPT-C 还减少了抑郁症，并且在随访期间仍然取得了进展。在 PCT 中，抑郁症仅在基线和第 1 节之前有所改善。两种治疗均很少出现不良事件。结论：CPT-C 和 PCT 的耐受性良好，并且在小组形式中减轻了 PTSD 症状，但只有 CPT-C 改善了抑郁症。这项研究具有公共政策意义，因为有大量现役军人需要 PTSD 治疗，并表明 PTSD 的团体治疗方式可以带来显着的改善，并且耐受性良好。在治疗师有限的环境中，团体治疗可能是一种重要的形式。
Objective: To determine whether group therapy improves symptoms of posttraumatic stress disorder (PTSD), this randomized clinical trial compared efficacy of group cognitive processing therapy (cognitive only version; CPT-C) with group present-centered therapy (PCT) for active duty military personnel. Method: Patients attended 90-min groups twice weekly for 6 weeks at Fort Hood, Texas. Independent assessments were administered at baseline, weekly before sessions, and 2 weeks, 6 months, and 12 months posttreatment. A total of 108 service members (100 men, 8 women) were randomized. Inclusion criteria included PTSD following military deployment and medication stability. Exclusion criteria included suicidal/homicidal intent or other severe mental disorders requiring immediate treatment. Follow-up assessments were administered regardless of treatment completion. Primary outcome measures were the PTSD Checklist (Stressor Specific Version; PCL-S) and Beck Depression Inventory-II. The Posttraumatic Stress Symptom Interview (PSS-1) was a secondary measure. Results: Both treatments resulted in large reductions in PTSD severity, but improvement was greater in CPT-C. CPT-C also reduced depression, with gains remaining during follow-up. In PCT, depression only improved between baseline and before Session 1. There were few adverse events associated with either treatment. Conclusions: Both CPT-C and PCT were tolerated well and reduced PTSD symptoms in group format, but only CPT-C improved depression. This study has public policy implications because of the number of active military needing PTSD treatment, and demonstrates that group format of treatment of PTSD results in significant improvement and is well tolerated. Group therapy may an important format in settings in which therapists are limited.