Cognitive therapy for post-traumatic stress disorder: development and evaluation
Cognitive therapy for post-traumatic stress disorder: development and evaluation
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DOI：
10.1016/j.brat.2004.03.006
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发表时间：
2005-04-01
影响因子：
4.1
通讯作者：
Fennell, M
中科院分区：
文献类型：
--
作者：
Ehlers, A;Clark, DM;Fennell, M
本文介绍了认知治疗（CT）程序的创伤后应激障碍（PTSD），是基于最近的认知模型（Behav。Res. Therapy 38（2000）319）。在一个连续的病例系列中，20例经CT治疗的PTSD患者的PTSD、抑郁和焦虑症状均得到了非常显著的改善。随后的随机对照试验比较了CT（N = 14）和3个月的等待名单条件（WL，N = 14）。CT导致PTSD症状、残疾、抑郁和焦虑大幅减少，而等待名单组没有改善。在这两项研究中，治疗增益在6个月随访时保持良好。CT是高度可接受的，总体脱落率仅为3%。从治疗前到治疗后PTSD症状变化程度的意向治疗效应量为2.70-2.82（自我报告）和2.07（评估者评定）。CT与WL治疗后评分的对照效应量分别为2.25（自我报告）和2.18（评估者评定）。正如认知模型所预测的，良好的治疗结果与创伤后认知功能障碍的更大变化有关。患者的特征，如合并症，创伤类型，既往创伤史，或创伤事件发生后的时间不能预测治疗反应，然而，低教育程度和低社会经济地位与更好的结果有关。(c)2004爱思唯尔有限公司保留所有权利。
The paper describes the development of a cognitive therapy (CT) program for post-traumatic stress disorder (PTSD) that is based on a recent cognitive model (Behav. Res. Therapy 38 (2000) 319). In a consecutive case series, 20 PTSD patients treated with CT showed highly significant improvement in symptoms of PTSD, depression and anxiety. A subsequent randomized controlled trial compared CT (N = 14) and a 3-month waitlist condition (WL, N = 14). CT led to large reductions in PTSD symptoms, disability, depression and anxiety, whereas the waitlist group did not improve. In both studies, treatment gains were well maintained at 6-month follow-up. CT was highly acceptable, with an overall dropout rate of only 3%. The intent-to-treat effect sizes for the degree of change in PTSD symptoms from pre to post-treatment were 2.70-2.82 (self-report), and 2.07 (assessor-rated). The controlled effect sizes for CT versus WL post-treatment scores were 2.25 (self-report) and 2.18 (assessor-rated). As predicted by the cognitive model, good treatment outcome was related to greater changes in dysfunctional post-traumatic cognitions. Patient characteristics such as comorbidity, type of trauma, history of previous trauma, or time since the traumatic event did not predict treatment response, however, low educational attainment and low socioeconomic status were related to better outcome. (c) 2004 Elsevier Ltd. All rights reserved.