Department of Psychology, University of Konstanz and Center for Psychiatry Reichenau, Konstanz, Germany.
Psychother Psychosom. 2011;80(6):345-52. doi: 10.1159/000327253. Epub 2011 Aug 6.
The aim of the present randomized controlled trial was to compare the outcome of 2 active treatments for posttraumatic stress disorder (PTSD) as a consequence of war and torture: narrative exposure therapy (NET) and stress inoculation training (SIT).
Twenty-eight PTSD patients who had experienced war and torture, most of them asylum seekers, received 10 treatment sessions of either NET or SIT at the Outpatient Clinic for Refugees, University of Konstanz, Germany. Posttests were carried out 4 weeks after treatment, and follow-up tests were performed 6 months and 1 year after treatment. The main outcome measure was the PTSD severity score according to the Clinician-Administered PTSD Scale (CAPS) at each time point.
A significant reduction in PTSD severity was found for NET, but not for SIT. A symptom reduction in the NET group occurred between pretest and the 6-month follow-up examination, the effect size being d = 1.42 (for SIT: d = 0.12), and between pretest and the 1-year follow-up, the effect size being d = 1.59 (for SIT: d = 0.19). The rates and scores of major depression and other comorbid disorders did not decrease significantly over time in either of the 2 treatment groups.
The results indicate that exposure treatments like NET lead to a significant PTSD symptom reduction even in severely traumatized refugees and asylum seekers.
本随机对照试验的目的是比较两种创伤后应激障碍（PTSD）的治疗效果，这些患者都曾经历过战争和酷刑：叙事暴露疗法（NET）和应激接种训练（SIT）。
28 名 PTSD 患者接受了德国康斯坦茨大学难民门诊的 10 次 NET 或 SIT 治疗。治疗结束后 4 周进行了随访测试，治疗结束后 6 个月和 1 年分别进行了一次随访测试。主要观察指标是每个时间点根据临床医生管理 PTSD 量表（CAPS）的 PTSD 严重程度评分。
NET 组 PTSD 严重程度显著降低，但 SIT 组无明显变化。NET 组患者在治疗前和 6 个月随访检查之间出现症状缓解，效应量为 d = 1.42（SIT：d = 0.12），在治疗前和 1 年随访检查之间，效应量为 d = 1.59（SIT：d = 0.19）。在 NET 或 SIT 治疗组中，重度抑郁和其他合并症的发生率和评分并没有随时间明显降低。
结果表明，即使是在严重创伤的难民和寻求庇护者中，NET 等暴露疗法也能显著减轻 PTSD 症状。
