Examination of a Safety Aid Reduction Protocol for Treatment Resistant PTSD among Veterans

近年来，军人中创伤后应激障碍(PTSD)的发病率激增。在……里面 作为回应，退伍军人事务部(VA)已在全国范围内发起培训倡议，以传播 两种有强有力经验支持的创伤后应激障碍治疗方法：长时间暴露(PE)疗法和认知处理 治疗(CPT)。尽管PE和CPT的有效性得到了很好的证明，但只有少数退伍军人患有 创伤后应激障碍启动了这些以创伤为重点的治疗。一种处理非创伤焦点的创伤后应激障碍的方法 流行的做法是利用经验支持的治疗方法，重点是减少安全援助。安全辅助设备有 不适应的认知和/或行为策略，旨在预防、避免或减轻焦虑。最初 介绍了一种解释病理性焦虑如何在反复暴露于恐惧的情况下仍然存在的方法 已经发现，刺激、安全辅助在各种焦虑的病因和维持中起着关键作用 以及包括创伤后应激障碍在内的相关疾病。重要的是，另一项研究表明，安全辅助设备 能够通过认知行为干预来改变。尽管前景看好，但这些试验并没有包括 患有创伤后应激障碍的患者。在此背景下，提出临床科学研究和开发的目的 (CSR&D)职业发展奖-2(CDA-2)是为了适应和延长现有的安全援助削减 用于患有创伤后应激障碍的退伍军人的治疗方案。这种治疗方案被称为安全辅助减少 治疗创伤后应激障碍(START-PTSD)，然后将评估可接受性和可行性，然后测试 与等待名单对照的疗效比较。参与者将包括被诊断为创伤后应激障碍的个人 拒绝参加创伤后应激障碍的循证心理治疗(EBPS)，即PE或CPT。

Rates of posttraumatic stress disorder (PTSD) among military personnel have surged in recent years. In response, the Department of Veterans Affairs (VA) has launched nationwide training initiatives to disseminate two PTSD treatments with strong empirical support: prolonged exposure (PE) therapy and cognitive processing therapy (CPT). Despite the well-documented effectiveness of PE and CPT, only a minority of Veterans with PTSD initiate these trauma-focused treatments. One approach to addressing PTSD in a non-trauma focused fashion is to utilize empirically supported treatments focused on safety aid reduction. Safety aids are maladaptive cognitive and/or behavioral strategies designed to prevent, avoid, or alleviate anxiety. Initially introduced as a way to explain how pathological anxiety can persist despite repeated exposure to feared stimuli, safety aids have been found to play a critical role in the etiology and maintenance of various anxiety and related conditions including PTSD. Importantly, a separate line of research suggests that safety aids are amenable to change through cognitive behavioral interventions. While promising, these trials did not include patients with PTSD. In this context, the purpose of the proposed Clinical Science Research and Development (CSR&D) Career Development Award-2 (CDA-2) is to adapt and extend an existing safety aid reduction treatment protocol for use among Veterans with PTSD. This treatment protocol, termed Safety Aid Reduction Treatment for PTSD (START-PTSD), will then be evaluated for acceptability and feasibility, prior to testing the efficacy compared to a wait-list control. Participants will include individuals with a diagnosis of PTSD who decline to participate in evidence-based psychotherapies (EBPs) for PTSD, namely PE or CPT.