Department of Psychiatry, Wolverhampton City Primary Care Trust, Wolverhampton, UK.
Neuropsychiatr Dis Treat. 2011;7:167-81. doi: 10.2147/NDT.S10389. Epub 2011 Apr 4.
Post-traumatic stress disorder (PTSD) is a psychiatric sequel to a stressful event or situation of an exceptionally threatening or catastrophic nature. Cognitive behavioral therapy (CBT) has been used in the management of PTSD for many years. This paper reviews the effectiveness of CBT for the treatment of PTSD following various types of trauma, its potential to prevent PTSD, methods used in CBT, and reflects on the mechanisms of action of CBT in PTSD.
Electronic databases, including PubMed, were searched for articles on CBT and PTSD. Manual searches were conducted for cross-references in the relevant journal sites.
The current literature reveals robust evidence that CBT is a safe and effective intervention for both acute and chronic PTSD following a range of traumatic experiences in adults, children, and adolescents. However, nonresponse to CBT by PTSD can be as high as 50%, contributed to by various factors, including comorbidity and the nature of the study population. CBT has been validated and used across many cultures, and has been used successfully by community therapists following brief training in individual and group settings. There has been effective use of Internet-based CBT in PTSD. CBT has been found to have a preventive role in some studies, but evidence for definitive recommendations is inadequate. The effect of CBT has been mediated mostly by the change in maladaptive cognitive distortions associated with PTSD. Many studies also report physiological, functional neuroimaging, and electroencephalographic changes correlating with response to CBT.
There is scope for further research on implementation of CBT following major disasters, its preventive potential following various traumas, and the neuropsychological mechanisms of action.
创伤后应激障碍（PTSD）是一种对压力事件或具有极大威胁性或灾难性性质的情况的精神后遗症。认知行为疗法（CBT）多年来一直被用于 PTSD 的治疗管理。本文综述了 CBT 对各种类型创伤后 PTSD 的治疗效果、预防 PTSD 的潜力、CBT 中使用的方法，并反思了 CBT 在 PTSD 中的作用机制。
通过电子数据库（包括 PubMed）搜索有关 CBT 和 PTSD 的文章，并在相关期刊网站上进行手动检索以获取交叉引用。
目前的文献表明，CBT 是一种安全有效的干预措施，适用于成人、儿童和青少年在经历各种创伤性经历后出现的急性和慢性 PTSD。然而，CBT 对 PTSD 的非反应率可能高达 50%，这归因于多种因素，包括共病和研究人群的性质。CBT 已在许多文化中得到验证和使用，并在经过简短的个体和团体培训后，由社区治疗师成功应用。基于互联网的 CBT 在 PTSD 中也得到了有效应用。一些研究发现 CBT 具有预防作用，但缺乏明确推荐的证据。CBT 的效果主要通过改变与 PTSD 相关的适应不良认知扭曲来介导。许多研究还报告了与 CBT 反应相关的生理、功能神经影像学和脑电图变化。
需要进一步研究 CBT 在重大灾害后的实施、其在各种创伤后的预防潜力以及神经心理作用机制。
