Dissemination and Training Division of the National Center for PTSD, NC-PTSD/334, VAPAHCS, 795 Willow Road, Menlo Park, CA 94025, USA.
J Trauma Stress. 2011 Dec;24(6):615-27. doi: 10.1002/jts.20697. Epub 2011 Dec 6.
This study provides a summary of the results of an expert opinion survey initiated by the International Society for Traumatic Stress Studies Complex Trauma Task Force regarding best practices for the treatment of complex posttraumatic stress disorder (PTSD). Ratings from a mail-in survey from 25 complex PTSD experts and 25 classic PTSD experts regarding the most appropriate treatment approaches and interventions for complex PTSD were examined for areas of consensus and disagreement. Experts agreed on several aspects of treatment, with 84% endorsing a phase-based or sequenced therapy as the most appropriate treatment approach with interventions tailored to specific symptom sets. First-line interventions matched to specific symptoms included emotion regulation strategies, narration of trauma memory, cognitive restructuring, anxiety and stress management, and interpersonal skills. Meditation and mindfulness interventions were frequently identified as an effective second-line approach for emotional, attentional, and behavioral (e.g., aggression) disturbances. Agreement was not obtained on either the expected course of improvement or on duration of treatment. The survey results provide a strong rationale for conducting research focusing on the relative merits of traditional trauma-focused therapies and sequenced multicomponent approaches applied to different patient populations with a range of symptom profiles. Sustained symptom monitoring during the course of treatment and during extended follow-up would advance knowledge about both the speed and durability of treatment effects.
本研究总结了国际创伤后应激障碍研究协会复杂创伤工作组发起的一项专家意见调查的结果，该调查涉及创伤后应激障碍（PTSD）的最佳治疗方法。对 25 名复杂 PTSD 专家和 25 名经典 PTSD 专家通过邮件调查的评分进行了研究，以了解最适合复杂 PTSD 的治疗方法和干预措施，评估了达成共识和存在分歧的领域。专家们对治疗的几个方面达成了一致意见，84%的人赞成采用基于阶段或序列的治疗作为最合适的治疗方法，干预措施针对特定的症状集进行定制。与特定症状相匹配的一线干预措施包括情绪调节策略、创伤记忆叙述、认知重构、焦虑和压力管理以及人际交往技巧。冥想和正念干预措施经常被确定为情绪、注意力和行为（例如，攻击性）障碍的有效二线治疗方法。对于预期的改善过程或治疗持续时间，调查结果并没有达成一致意见。调查结果为开展研究提供了强有力的依据，研究重点是传统以创伤为重点的治疗方法和针对不同患者群体应用的多成分序列方法的相对优势，这些患者群体具有不同的症状特征。在治疗过程中和延长的随访期间持续进行症状监测，将有助于了解治疗效果的速度和持久性。
