Pilot Testing an Aerobic Exercise Intervention for Veterans with PTSD

针对患有创伤后应激障碍 (PTSD) 的退伍军人进行有氧运动干预试点测试

• 批准号: 8633692
• 负责人: M. Tracie Shea
• 金额: --
• 依托单位: PROVIDENCE VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-11-01 至 2015-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8633692
• 关键词: Address; Aerobic Exercise; Aftercare; Alcohol consumption; Anxiety; Arousal; Cardiovascular Diseases; Chronic; Data; Diagnosis; Drug usage; Economic Burden; Effectiveness; Emotional; Exercise; Family; Feedback; Functional disorder; Future; Goals; Health; Health education; Hospitals; Intervention; Lead; Literature; Mental Health; Mental disorders; Methodology; Military Personnel; Morbidity - disease rate; Nature; Occupational; Outcome; Participant; Physical activity; Population; Post-Traumatic Stress Disorders; Preparation; Prevalence; Procedures; Psychopathology; Public Health; Quality of life; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Relative (related person); Research; Resources; Risk; Risk Factors; Severities; Sleep; Social Work; Symptoms; Testing; Time; Trauma; Treatment outcome; United States Department of Veterans Affairs; Veterans; Work; base; chronic pain; combat; cost; cost effective; depressive symptoms; design; disability; effective intervention; efficacy testing; experience; fitness; flexibility; follow-up; improved; novel; programs; public health relevance; social; social stigma; treatment effect; treatment program

DESCRIPTION (provided by applicant): Posttraumatic Stress Disorder (PTSD), a highly prevalent, chronic psychiatric disorder, often co-occurs with other psychiatric disorders, is associated with occupational and social dysfunction, and can lead to chronic disability. PTSD is also a risk factor for a number of health-related concerns including chronic pain and cardiovascular disease and is associated with significant economic burden. Veterans are at increased risk for PTSD with prevalence rates up to 3 times those who are non-Veterans. Existing PTSD treatments have been found to be less effective for Veterans with PTSD, in fact, combat-related trauma has been associated with the lowest treatment effect sizes in studies of PTSD treatments. Veterans with PTSD often experience difficulty engaging in traditional CBT exposure based approaches, which can trigger the uncomfortable emotional arousal they want to avoid. Further, the repeated nature of trauma exposure resulting from multiple and longer deployments, mental health stigma within military culture, and administration time, resources, and costs for mass populations such as the military, all contribute to decreased implementation and possibly efficacy of existing PTSD treatments. Therefore, novel and adjunctive interventions for the treatment of PTSD are sorely needed for Veterans with PTSD. The aim of the proposed research is to examine the potential of exercise as an adjunctive intervention for PTSD in Veterans. There is a growing body of literature that supports the efficacy of exercise interventions in treating clinically diagnosed populations with various psychiatric disorders, and increasing physical activity has the potential to be cost-effective, flexible, and accessible. Veterans may find engaging in exercise as a more acceptable, less stigmatizing approach to managing PTSD symptoms. We propose to conduct a small, randomized clinical trial with 50 Veterans in treatment for PTSD randomized to receive either an adjunctive aerobic exercise (AE) intervention or a contact control health education comparison (HEC) intervention. The pilot RCT will allow us to 1) determine the feasibility of recruitment and randomization, 2) determine the acceptability of the AE and HEC conditions, and 3) to provide preliminary evidence of the effects of AE. This project will thus lay the groundwork for a subsequent randomized controlled trial with adequate statistical power to test the efficacy of AE in reducing PTSD symptoms, decreasing anxiety and depressive symptoms, and increasing quality of life and cardiorespiratory fitness in Veterans with PTSD. The longer term significance of this project lies in the potential for adapting the AE intervention for use in VA hospitals nationwide. The larger aim of this program of research is to disseminate an effective, aerobic exercise intervention that can be readily integrated into PTSD treatment programs across treatment settings within Veterans Administration (VA) hospitals. Future dissemination of this approach could result in high public health significance in decreasing the overall severity of PTSD symptomatology in Veterans, thereby reducing PTSD-related morbidity.

描述(由申请人提供)： 创伤后应激障碍(PTSD)是一种非常普遍的慢性精神障碍，通常与其他精神障碍并存，与职业和社会功能障碍有关，并可导致慢性残疾。创伤后应激障碍也是一些与健康有关的问题的风险因素，包括慢性疼痛和心血管疾病，并与巨大的经济负担有关。退伍军人患创伤后应激障碍的风险增加，患病率高达非退伍军人的3倍。现有的创伤后应激障碍治疗被发现对患有创伤后应激障碍的退伍军人不太有效，事实上，在创伤后应激障碍治疗的研究中，与战斗相关的创伤与最低的治疗效果有关。患有创伤后应激障碍的退伍军人经常在基于CBT暴露的传统方法中遇到困难，这可能会引发他们想要避免的不舒服的情绪唤醒。此外，多次和更长时间的部署造成的创伤暴露的反复性质，军事文化中的精神健康污名，以及军队等大众人口的管理时间、资源和费用，都导致现有创伤后应激障碍治疗的执行率和可能的有效性下降。因此，对于患有创伤后应激障碍的退伍军人，迫切需要新的辅助干预措施来治疗创伤后应激障碍。这项拟议研究的目的是检验运动作为退伍军人创伤后应激障碍的辅助干预的潜力。越来越多的文献支持运动干预在治疗临床诊断为各种精神障碍的人群中的有效性，而增加体力活动具有成本效益、灵活性和可获得性的潜力。退伍军人可能会发现，参加锻炼是一种更容易接受、更少羞辱的方式来管理创伤后应激障碍症状。我们建议对50名接受创伤后应激障碍治疗的退伍军人进行一项小型随机临床试验，随机接受辅助有氧运动(AE)干预或接触控制健康教育对照(HEC)干预。试验性随机对照试验将使我们能够1)确定招募和随机化的可行性，2)确定AE和HEC条件的可接受性，3)提供AE影响的初步证据。因此，该项目将为随后的具有足够统计能力的随机对照试验奠定基础，以测试AE在减轻创伤后应激障碍症状、降低焦虑和抑郁症状、提高患有创伤后应激障碍退伍军人的生活质量和心肺功能方面的有效性。该项目的较长期意义在于有可能将AE干预措施用于 全国范围内的退伍军人医院。这项研究计划的更大目标是传播一种有效的有氧运动干预，这种干预可以很容易地整合到退伍军人管理局(VA)医院内的各个治疗环境中的PTSD治疗计划中。未来这种方法的推广可能会在降低退伍军人创伤后应激障碍症状的总体严重性方面产生很高的公共卫生意义，从而减少与创伤后应激障碍相关的发病率。