Başoglu Metin, Salcioglu Ebru, Livanou Maria
Section of Trauma Studies, Division of Psychological Medicine, Institute of Psychiatry, King's College London, University of London, UK.
Psychol Med. 2007 Feb;37(2):203-13. doi: 10.1017/S0033291706009123.
Brief interventions are needed in dealing with traumatic stress problems in large survivor populations after devastating earthquakes. The present study examined the effectiveness of a single session of exposure to simulated tremors in an earthquake simulator and self-exposure instructions in reducing post-traumatic stress disorder (PTSD).
Participants were consecutively recruited from among survivors screened during field surveys in the disaster region in Turkey. Thirty-one earthquake survivors with PTSD were assigned either to a single session of behavioural treatment (n=16) or to repeated assessments (RA; n=15). Assessments in the treatment group were at 4, 8, 12, 24 weeks and 1-2 years post-treatment. The RA cases were assessed at baseline and 4 and 8 weeks after trial entry, after which they received the same treatment and were followed up at 4, 12, 24 weeks and 1-2 years.
Between-group treatment effects at week 8 were significant on measures of fear, PTSD and self- and assessor-rated global improvement. Improvement rates were 40% at week 4, 72% at week 12, 80% at week 24, and 80% at 1-2-years' follow-up, with large effect sizes on fear and PTSD measures. Post-session reduction in fear of earthquakes and increased sense of control over fear at follow-up related to improvement in PTSD.
The study provided further evidence of the effectiveness of a single session of behavioural treatment in reducing fear and PTSD in earthquake survivors. Future research needs to examine the usefulness of earthquake simulators in increasing psychological preparedness for earthquakes.
在毁灭性地震后,需要对大量幸存者群体中的创伤应激问题进行简短干预。本研究考察了在地震模拟器中单次暴露于模拟震颤及自我暴露指导在减轻创伤后应激障碍(PTSD)方面的有效性。
参与者是从土耳其灾区实地调查中筛选出的幸存者中连续招募的。31名患有PTSD的地震幸存者被分配到单次行为治疗组(n = 16)或重复评估组(RA;n = 15)。治疗组在治疗后4周、8周、12周、24周以及1 - 2年进行评估。RA组在基线时以及试验开始后4周和8周进行评估,之后接受相同治疗,并在4周、12周、24周以及1 - 2年进行随访。
在第8周时,两组间在恐惧、PTSD以及自我和评估者评定的总体改善指标上的治疗效果显著。第4周时改善率为40%,第12周时为72%,第24周时为80%,1 - 2年随访时为80%,在恐惧和PTSD指标上效应量较大。治疗后对地震恐惧的减轻以及随访时对恐惧控制感的增强与PTSD的改善相关。
该研究进一步证明了单次行为治疗在减轻地震幸存者恐惧和PTSD方面的有效性。未来研究需要考察地震模拟器在增强对地震的心理准备方面的有用性。