Pitman R K, Altman B, Greenwald E, Longpre R E, Macklin M L, Poiré R E, Steketee G S
Veterans Affairs Medical Center, Manchester, NH 03103.
J Clin Psychiatry. 1991 Jan;52(1):17-20.
The authors use six case vignettes to illustrate underrecognized complications occurring during flooding therapy for posttraumatic stress disorder (PTSD), including exacerbation of depression, relapse of alcoholism, and precipitation of panic disorder. A common denominator to the majority of these cases appears to be the mobilization of negative posttrauma appraisal, accompanied by shame, guilt, and anger. The authors suggest that flooding may not be helpful for these negative emotions in the manner that it is for anxiety. Suggestions for preventing and treating complications of flooding therapy for PTSD include employing more cognitive forms of therapy in cases at risk; supporting abstinence from alcohol and other substances; providing adjunctive pharmacologic treatment as indicated, e.g., tricyclics for depression or panic; and providing long-term follow-up.
作者使用六个病例 vignettes 来说明创伤后应激障碍（PTSD）洪水疗法期间发生的未被充分认识的并发症，包括抑郁症加重、酒精中毒复发和惊恐障碍的诱发。这些病例大多数的一个共同特征似乎是创伤后负面评价的动员，伴有羞耻、内疚和愤怒。作者认为，洪水疗法对这些负面情绪可能不像对焦虑情绪那样有帮助。预防和治疗 PTSD 洪水疗法并发症的建议包括：对有风险的病例采用更多认知形式的疗法；支持戒酒和其他物质；根据需要提供辅助药物治疗，例如用于治疗抑郁症或惊恐症的三环类药物；以及提供长期随访。
