Sleep-directed hypnosis as a complement to CPT in treating PTSD

描述（由申请人提供）：该提案旨在测试睡眠指导催眠作为现有经验支持的心理社会干预的补充的有效性，认知加工疗法（CPT）在患有创伤后应激障碍的人际暴力女性幸存者中的样本。此外，该提案旨在确定治疗中导致症状改善、更大功能领域改善和健康相关问题的作用机制。为此，将进行多方法、多模式评估，包括精神病学、心理学和心理生理学领域的每日和间歇监测。具体而言，将40例受试者随机分配至催眠+ CPT（hypCPT）条件或症状监测（监测3周，以控制时间推移和症状监测的任何潜在影响）加CPT活性对照组（CPTac）。本研究的参与者将接受一系列访谈和自我报告措施，包括1。临床医生管理PTSD量表，2.）DSM-IV轴I障碍的结构化临床访谈，3。标准化创伤访谈，4。）创伤后应激障碍诊断量表，5）贝克抑郁量表- II，6。Pennebaker边缘系统Landuigness量表，7。）SF-36健康调查，8。生活质量量表，9。社会适应量表、匹兹堡睡眠质量指数和失眠严重程度指数。此外，生理指标将用于评估睡眠障碍和过度觉醒之间的关系以及生理反应性随时间的变化。还将进行精神警觉任务，以测试睡眠剥夺（即通过反应时间测量的“嗜睡”）的存在以及随时间的相关变化。受试者将通过使用每日日记监测症状和每日压力源，并在治疗前、治疗后和三个月随访点进行正式评估。进行拟议的研究将有重要的意义，对补救睡眠障碍（最常报告的症状PTSD和最难治疗的一个）利用一种新的方法，催眠，在创伤人群中。同时，这一建议旨在阐明催眠的作用机制，这是一种研究不足的补充治疗元素，在创伤文献中几乎没有经验支持。

DESCRIPTION (provided by applicant): This proposal seeks to test the efficacy of sleep-directed hypnosis as a complement to an existing empirically supported psychosocial intervention, Cognitive Processing Therapy (CPT) in sample of female survivors of interpersonal violence suffering from PTSD. Further, this proposal seeks to identify mechanisms of action in the therapy that lead to symptom modification, improvement in larger domains of functioning, and health-related concerns. Towards this end, a multi-method, multimodal assessment will be administered including daily and intermittent monitoring across psychiatric, psychological, and psychophysiological domains. Specifically, forty subjects will be randomly assigned to either a hypnosis + CPT (hypCPT) condition or to a symptom monitoring (3 weeks of monitoring to control for the passage of time and any potential effects of symptom monitoring) plus CPTactive control group (CPTac). Participants in this study will be administered a battery of interviews and self-report measures including the 1.) Clinician Administered PTSD Scale, 2.) Structured Clinical Interview for DSM-IV Axis I Disorders, 3.) Standardized Trauma Interview, 4.) PTSD Diagnostic Scale, 5) Beck Depression Inventory - II, 6.) Pennebaker Inventory of Limbic Landuigness, 7.) The SF-36 Health Survey, 8.) Quality of Life Inventory, 9.) Social Adjustment Scale, 10) Pittsburgh Sleep Quality Index, and the 11) Insomnia Severity Index. In addition, physiological indices will be used to assess the relationship between sleep impairment and hyperarousal as well as changes over time in physiological reactivity. A Psychomotor Vigilance Task will also be administered to test for the presence of sleep deprivation (i.e. "sleepiness" as measured by reaction time) as well as related changes over time. Subjects will monitor symptoms and daily stressors through the use of daily diaries as well as undergo formal assessments at pre-treatment, post- treatment and three month follow-up points. Conducting the proposed study will have important implications on remediating sleep impairment (the most often reported symptom of PTSD and one of the most refractory to treatment) utilizing a novel approach, the addition of hypnosis, within a traumatized population. Concurrently this proposal aims to illuminate the mechanisms of action in hypnosis, an understudied complementary treatment element with virtually no empirical support in the trauma literature.