The temporal sequence of change in PTSD symptoms and hypothesized mediators in Cognitive Processing Therapy and Written Exposure Therapy for PTSD.
The temporal sequence of change in PTSD symptoms and hypothesized mediators in Cognitive Processing Therapy and Written Exposure Therapy for PTSD.
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PTSD症状变化的时间顺序和PTSD认知加工疗法和书面暴露疗法中假设的介质。
DOI：
10.1016/j.brat.2021.103918
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发表时间：
2021-09
影响因子：
4.1
通讯作者：
Sloan DM
中科院分区：
文献类型：
--
作者：
Lee DJ;Marx BP;Thompson-Hollands J;Gallagher MW;Resick PA;Sloan DM
我们研究了在接受认知加工疗法（CPT）或书面暴露疗法（WET）的个体中，负面创伤相关信念的消失或变化是否发生在创伤后应激症状变化之前或同时，使用允许正确识别时间序列的统计方法。社区参与者与PTSD（N = 126）均匀随机分配到12个会议的CPT或5个会议的WET。我们评估了第一次治疗后6周、12周、24周、36周和60周内唤醒和效价的变化以及创伤相关信念的变化。在接受WET的参与者中，会议后情绪效价的会议间变化在时间上先于PTSD症状减轻，但不能预测随后的症状减轻。虽然消极的创伤相关的信念改变与PTSD症状减轻在这两种情况下平行和相关，这种变化并没有暂时先症状减轻。我们的研究结果是不一致的，从以前的研究，并建议这些结构可能更适当的特点是相关的，而不是介质，症状减轻。这些结果突出了识别假设介质和症状之间的时间顺序变化的价值，并强调我们仍然有很多要了解的循证治疗如何减少PTSD症状。
We examined whether extinction or changes negative trauma-related beliefs occur either prior to or concurrently with changes in posttraumatic stress symptoms among individuals who received either Cognitive Processing Therapy (CPT) or Written Exposure Therapy (WET) using statistical methods that permit proper discernment of temporal sequence. Community participants with PTSD (N = 126) were evenly randomized to 12 sessions of CPT or 5 sessions of WET. We assessed within- and between-session changes in arousal and valence and changes in trauma-related beliefs 6-, 12-, 24-, 36- and 60-weeks following the first treatment session. Between-session change in post-session emotional valence temporally preceded PTSD symptom reduction among participants who received WET but did not predict subsequent symptom reduction. Although negative trauma-related beliefs changed in parallel with and correlated with PTSD symptom reduction in both conditions, this change did not temporally precede symptom reduction. Our results are inconsistent with those from prior studies and suggest these constructs may more appropriately be characterized as correlates, rather than mediators, of symptom reduction. These results highlight the value of discernment of the temporal sequence of change between hypothesized mediators and symptoms and underscore that we still have much to learn about how evidence-based treatments reduce PTSD symptoms.
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影响因子：
4.1
作者：
Ehlers, A;Clark, DM;Fennell, M
通讯作者：
Fennell, M
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