Amstadter Ananda B, Broman-Fulks Joshua, Zinzow Heidi, Ruggiero Kenneth J, Cercone Jen
Medical University of South Carolina National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, P.O. Box 250852, Charleston, SC 29425, USA.
Clin Psychol Rev. 2009 Jul;29(5):410-20. doi: 10.1016/j.cpr.2009.04.001. Epub 2009 Apr 7.
Exposure to potentially traumatic events is a common occurrence. Most individuals exposed to such an event are resilient or recover rapidly, although some individuals develop psychological problems that warrant treatment. However, a small percentage of individuals seek traditional treatment, thereby calling for novel approaches or methodologies of treatment. The present paper provides a comprehensive and critical review of the extant literature on computerized and internet-based interventions (IBIs) for traumatic stress-related conditions (i.e., panic disorder, posttraumatic stress disorder/complicated grief, depression, comorbid anxiety and depression, alcohol abuse, smoking cessation). Generally, computerized or IBIs for depression and anxiety are yielding effect sizes that are comparable to traditional psychosocial treatment. Interventions aimed at alcohol and smoking cessation generally have lower effect sizes than do IBIs for anxiety and depression. Most interventions reviewed in this paper included common components (e.g., were developed through a cognitive behavioral framework and included psychoeducation, cognitive restructuring, goal setting, exposure). Therefore, it is possible that these shared features may in part account for symptom reduction. Little is known regarding mechanisms of change. Future directions for novel web-based approaches to treatment are provided.
暴露于潜在创伤性事件是常有的事。大多数暴露于此类事件的个体具有复原力或能迅速恢复,尽管有些个体出现了需要治疗的心理问题。然而,一小部分个体寻求传统治疗,因此需要新颖的治疗方法或手段。本文对现有的关于针对创伤应激相关病症(即惊恐障碍、创伤后应激障碍/复杂性哀伤、抑郁症、共病焦虑症和抑郁症、酒精滥用、戒烟)的计算机化和基于互联网的干预措施(IBIs)的文献进行了全面且批判性的综述。一般来说,针对抑郁症和焦虑症的计算机化或基于互联网的干预措施所产生的效应量与传统心理社会治疗相当。针对酒精滥用和戒烟的干预措施的效应量通常低于针对焦虑症和抑郁症的基于互联网的干预措施。本文综述的大多数干预措施都包含共同要素(例如,通过认知行为框架开发,包括心理教育、认知重构、目标设定、暴露)。因此,这些共同特征可能在一定程度上解释了症状的减轻。关于改变机制知之甚少。本文还提供了基于网络的新颖治疗方法的未来发展方向。