Ralph H. Johnson Veterans Administration Medical Center, and Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA.
Behav Ther. 2012 Sep;43(3):560-9. doi: 10.1016/j.beth.2011.03.003. Epub 2011 May 24.
Combat-exposed military personnel from the wars in Iraq and Afghanistan report high rates of PTSD and associated psychiatric problems. A formidable body of research supports exposure therapy as a front-line intervention for PTSD; however, relative to studies of civilians, fewer investigations have evaluated the effectiveness of exposure therapy using military samples. Specifically, barriers to care (e.g., stigma associated with receiving mental health services ) may compromise utilization of evidence-based psychotherapy. As such, researchers have argued that veterans with PTSD may require an integrated and innovative approach to the delivery of exposure techniques. This paper presents the rationale for and preliminary data from an ongoing clinical trial that compares the home-based telehealth (HBT) application of a brief, behavioral treatment (Behavioral Activation and Therapeutic Exposure; BA-TE) for veterans with PTSD to the standard, in-person application of the same treatment. Forty OIF/OEF veterans with PTSD and MDD were consented, enrolled, and randomized to condition (BA-TE in-person, or BA-TE HBT) and symptoms of anxiety and depression were assessed at pre- and posttreatment. Participants in both conditions experienced reductions in depression, anxiety, and PTSD symptoms between pre- and posttreatment, suggesting that HBT application of an integrated PTSD treatment may be feasible and effective.
来自伊拉克和阿富汗战争的参战军人报告 PTSD 及相关精神问题的发生率很高。大量研究支持暴露疗法作为 PTSD 的一线干预措施；然而，与针对平民的研究相比，使用军事样本评估暴露疗法有效性的研究较少。具体而言，治疗障碍（例如，与接受心理健康服务相关的耻辱感）可能会影响基于证据的心理治疗的应用。因此，研究人员认为，患有 PTSD 的退伍军人可能需要一种综合和创新的方法来提供暴露技术。本文介绍了一项正在进行的临床试验的基本原理和初步数据，该试验比较了基于家庭的远程医疗 (HBT) 应用简短的行为治疗（行为激活和治疗暴露；BA-TE）与 PTSD 退伍军人的标准面对面应用相同治疗方法的效果。共有 40 名 OIF/OEF PTSD 和 MDD 退伍军人同意参与并被随机分配到条件（面对面 BA-TE 或 BA-TE HBT），并在治疗前和治疗后评估焦虑和抑郁症状。两种条件下的参与者在治疗前和治疗后都经历了抑郁、焦虑和 PTSD 症状的减轻，这表明综合 PTSD 治疗的 HBT 应用可能是可行和有效的。
