Department of Psychology, University of Miami, FL 33146, USA.
J Consult Clin Psychol. 2013 Apr;81(2):284-98. doi: 10.1037/a0030814. Epub 2012 Dec 17.
Trauma histories and symptoms of PTSD occur at very high rates in people with HIV and are associated with poor disease management and accelerated disease progression. The authors of this study examined the efficacy of a brief written trauma disclosure intervention on posttraumatic stress, depression, HIV-related physical symptoms, and biological markers of HIV disease progression.
HIV-infected men and women were randomized to four 30-min expressive writing sessions in either a treatment (trauma writing) or an attention control (daily events writing) condition. The disclosure intervention augmented the traditional emotional disclosure paradigm with probes to increase processing by focusing on trauma appraisals, self-worth, and problem solving. Outcomes were assessed at baseline, 1-, 6-, and 12-month follow-up.
Hierarchical linear modeling (N = 244, intent-to-treat analyses) revealed no significant treatment effects for the group as a whole. Gender by treatment group interactions were significant such that women in the trauma-writing group had significantly reduced posttraumatic stress disorder (PTSD) symptoms (p = .017), depression (p = .009), and HIV-related symptoms (p = .022) compared with their controls. In contrast, men in the trauma-treatment condition did not improve more than controls on any outcome variables. Unexpectedly, men in the daily-event-writing control group had significantly greater reductions in depression then men in the trauma-writing group. Treatment effects were magnified in women when the analysis was restricted to those with elevated PTSD symptoms at baseline.
A brief (4-session) guided written emotional disclosure intervention resulted in significant and meaningful reductions in PTSD, depression, and physical symptoms for women with HIV, but not for men.
艾滋病毒感染者中创伤史和创伤后应激障碍症状的发生率非常高，且与疾病管理不善和疾病进展加速有关。本研究的作者研究了简短的书面创伤披露干预对创伤后应激、抑郁、与艾滋病毒相关的身体症状和艾滋病毒疾病进展的生物学标志物的疗效。
艾滋病毒感染者被随机分配到治疗组（创伤写作）或对照组（日常事件写作）的四个 30 分钟表达性写作疗程中。披露干预在传统的情感披露范式中增加了探测，通过关注创伤评估、自我价值和解决问题来增加处理过程。在基线、1 个月、6 个月和 12 个月的随访时评估结果。
分层线性建模（N = 244，意向治疗分析）显示，整个组没有显著的治疗效果。性别与治疗组的相互作用具有统计学意义，即创伤写作组的女性创伤后应激障碍（PTSD）症状（p =.017）、抑郁（p =.009）和与艾滋病毒相关的症状（p =.022）显著降低，与对照组相比。相比之下，创伤治疗组的男性在任何结果变量上都没有比对照组改善得更多。出乎意料的是，日常事件写作对照组的男性抑郁症状的减轻程度明显大于创伤写作组的男性。当分析仅限于基线时 PTSD 症状升高的女性时，治疗效果更加显著。
一项简短的（4 次疗程）指导性书面情感披露干预对 HIV 女性患者的 PTSD、抑郁和身体症状产生了显著而有意义的降低，但对男性患者没有影响。
