Bryant Richard A, Moulds Michelle L, Guthrie Rachel M, Dang Suzanne T, Mastrodomenico Julie, Nixon Reginald D V, Felmingham Kim L, Hopwood Sally, Creamer Mark
School of Psychology, University of New South Wales, Sydney, New South Wales, Australia.
J Consult Clin Psychol. 2008 Aug;76(4):695-703. doi: 10.1037/a0012616.
Previous studies have reported that adding cognitive restructuring (CR) to exposure therapy does not enhance treatment gains in posttraumatic stress disorder (PTSD). This study investigated the extent to which CR would augment treatment response when provided with exposure therapy. The authors randomly allocated 118 civilian trauma survivors with PTSD to receive 8 individually administered sessions of either (a) imaginal exposure (IE), (b) in vivo exposure (IVE), (c) IE combined with IVE (IE/IVE), or (d) IE/IVE combined with CR (IE/IVE/CR). There were fewer patients with PTSD in the IE/IVE/CR (31%) condition than the IE (75%), IVE (69%), and IE/IVE (63%) conditions at a 6-month follow-up assessment. The IE/IVE/CR condition resulted in larger effect sizes than each of the other conditions in terms of PTSD and depressive symptoms. These findings suggest that optimal treatment outcome may be achieved by combining CR with exposure therapy in treating PTSD patients.
先前的研究报告称，在暴露疗法中加入认知重建（CR）并不能提高创伤后应激障碍（PTSD）的治疗效果。本研究调查了在进行暴露疗法时，CR增强治疗反应的程度。作者将118名患有PTSD的平民创伤幸存者随机分配，接受8次单独进行的治疗，治疗方式分别为：（a）想象暴露（IE），（b）实景暴露（IVE），（c）IE联合IVE（IE/IVE），或（d）IE/IVE联合CR（IE/IVE/CR）。在6个月的随访评估中，IE/IVE/CR组（31%）患有PTSD的患者少于IE组（75%）、IVE组（69%）和IE/IVE组（63%）。就PTSD和抑郁症状而言，IE/IVE/CR组的效应量比其他各组都大。这些发现表明，在治疗PTSD患者时，将CR与暴露疗法相结合可能会取得最佳治疗效果。
