Multi-site Feasibility of Compassion Meditation for Veterans with PTSD

项目摘要/摘要 创伤后应激障碍(PTSD)是退伍军人常见的健康问题。虽然 经验支持的方法广泛可用，参与率低，部分/无响应 很普通。人们对补充和替代干预措施的作用非常感兴趣 创伤后应激障碍，但几乎没有研究可以指导有关护理的决定。慈悲冥想(CM)，一种 旨在培养与他人联系的冥想练习，显示出治疗 退伍军人的创伤后应激障碍。在健康人群中，CM培养积极的情绪和社会联系，两者都 众所周知，在面对极端压力时，它们可以增强应对能力和韧性。基于这一理论 理论基础，我们最近完成了一项针对患有创伤后应激障碍的退伍军人的CM的两阶段概念验证试验。第一 阶段采用定性和定量程序反复改进现有的CM方案，CBCT® (基于认知的同情心训练)，针对患有创伤后应激障碍的退伍军人。第二阶段利用了一名飞行员 建立退伍军人CM随机试验的可行性和可接受性的随机对照试验 并检查潜在的临床影响。在前景看好的基础上，拟议的项目将 评估中药治疗创伤后应激障碍未来多点疗效试验的可行性。 尽管我们之前的工作是令人鼓舞的第一步，但关键问题仍然存在。首先，我们的数据来自 位于南加州的单一站点。CM的可接受性可能存在地区差异，因此 我们计划研究招募和挽留居住在其他地区的退伍军人的可行性，以及 确认该方法对更多样化的样本的可接受性。其次，我们之前的试验依赖于 单身治疗师，他积极参与了发展进程。重要的是要证明 其他人可以接受培训，以忠实地交付方法，并对我们的结果具有一定的信心 归因于协议而不是个人。最后，为了最终理解 这些干预措施导致症状改变的方式，我们将继续完善我们的评估战略， 包括增加行为方法论，以增强从自我报告措施中收集到的信息。如果 该项目的成功将为CM的疗效试验奠定必要的基础，最终可能 为患有创伤后应激障碍的退伍军人提供额外的循证治疗选择。

PROJECT SUMMARY/ABSTRACT Posttraumatic stress disorder (PTSD) is a common health concern among Veterans. Although empirically-supported approaches are widely available, engagement rates are low and partial/non response is common. There has been considerable interest in the role of complementary and alternative interventions for PTSD, but little research is available to guide decisions about care. Compassion meditation (CM), a contemplative practice that is intended to foster connectedness with others, shows promise for the treatment of PTSD in Veterans. In healthy populations, CM fosters positive emotion and social connectedness, both of which are known to enhance coping and resilience in the face of extreme stress. Based on this theoretical rationale, we recently completed a two-phase proof of concept trial of CM for Veterans with PTSD. The first phase employed qualitative and quantitative procedures to iteratively refine an existing CM protocol, CBCT® (Cognitively-Based Compassion Training), for Veterans with PTSD. The second phase utilized a pilot randomized controlled trial to establish the feasibility and acceptability of a randomized trial of CM for Veterans with PTSD and to examine potential clinical impact. On the basis of promising results, the proposed project will evaluate the feasibility of a future multi-site efficacy trial of CM for PTSD. Although our prior work is an encouraging first step, key questions remain. First, our data come from a single site in Southern California. It is possible that there are regional differences in the acceptability of CM, so we plan to examine the feasibility of recruiting and retaining Veterans residing in another area as well as confirming the acceptability of the approach to a more diverse sample. Second, our previous trial relied on a single therapist, who was actively engaged in the development process. It is important to demonstrate that others can be trained to deliver the approach with fidelity and to have some confidence that our results are attributable to the protocol rather than to an individual. Finally, in the interest of ultimately understanding the way in which these interventions lead to symptom change, we will continue to refine our assessment strategy, including adding behavioral methodologies to augment what can be gleaned from self-report measures. If successful, this project will lay the necessary groundwork for an efficacy trial of CM, which ultimately could provide an additional evidence-based treatment option for Veterans with PTSD.