Angelo Frank N, Miller Helen E, Zoellner Lori A, Feeny Norah C
University of Washington, Seattle, WA 98195-1525, USA.
Behav Ther. 2008 Mar;39(1):13-21. doi: 10.1016/j.beth.2007.02.002. Epub 2007 Oct 18.
A significant proportion of individuals suffering from posttraumatic stress disorder do not seek or receive effective treatment. Understanding the reasons why an individual chooses to seek treatment or prefers one treatment to another is a critical step to improve treatment seeking. To begin to understand these reasons, we conducted a qualitative analysis of the reasons women gave for choosing a cognitive-behavioral treatment, prolonged exposure (PE), or a pharmacological treatment, sertraline (SER). A community sample of women with trauma histories were asked to view standardized rationales, to choose among PE, SER, or no treatment, and to give 5 reasons for their choice. Women indicated that they were more likely to prefer the psychotherapy to the medication. Across reasons given, the most commonly cited reason for treatment preference highlighted why or how the treatment worked (e.g., I need to talk about it); and this reason emerged as the strongest predictor of preference for PE. Understanding this role of perceived treatment mechanism may aid clinicians and public health policy officials to identify and address help-seeking barriers regarding treatment.
很大一部分患有创伤后应激障碍的人没有寻求或接受有效的治疗。了解个体选择寻求治疗或更喜欢一种治疗而非另一种治疗的原因，是改善治疗寻求行为的关键一步。为了开始理解这些原因，我们对女性选择认知行为疗法、延长暴露疗法（PE）或药物疗法舍曲林（SER）的原因进行了定性分析。我们让一组有创伤史的社区女性样本查看标准化的治疗原理，在PE、SER或不治疗之间进行选择，并给出她们选择的5个理由。女性表示，相较于药物治疗，她们更倾向于心理治疗。在给出的所有理由中，最常被提及的治疗偏好原因突出了治疗起作用的原因或方式（例如，我需要谈论这件事）；而这个原因成为了对PE偏好的最强预测因素。理解感知到的治疗机制的这一作用，可能有助于临床医生和公共卫生政策官员识别并解决与治疗相关的寻求帮助障碍。
