Department of Psychology, Boston University, Boston, MA, USA.
J Consult Clin Psychol. 2013 Jun;81(3):375-82. doi: 10.1037/a0031523. Epub 2013 Jan 21.
In the present study, we examined the relationship between posttraumatic and depressive symptoms during prolonged exposure (PE) treatment with and without cognitive restructuring (CR) for the treatment of posttraumatic stress disorder (PTSD).
Female assault survivors (N = 153) with PTSD were randomized to either PE alone or PE with added CR (PE/CR). During treatment, bi-weekly self-report measures of posttraumatic and depressive symptoms were administered.
Multilevel mediational analyses indicated that during PE, changes in posttraumatic symptoms accounted for 80.3% of changes in depressive symptoms, whereas changes in depressive symptoms accounted for 45.0% of changes in posttraumatic symptoms. During PE/CR, changes in posttraumatic symptoms accounted for 59.6% of changes in depressive symptoms, and changes in depressive symptoms accounted for 50.7% of changes in posttraumatic symptoms.
This pattern of results suggests that PE primarily affects posttraumatic symptoms, which in turn affect depressive symptoms. In contrast, PE/CR results in a more reciprocal relationship between posttraumatic and depressive symptoms.
在本研究中，我们考察了创伤后和抑郁症状与延长暴露（PE）治疗的关系，以及认知重构（CR）是否对创伤后应激障碍（PTSD）的治疗有影响。
153 名女性创伤后幸存者（PTSD）被随机分为单独进行 PE 治疗或进行 PE 加 CR（PE/CR）治疗。在治疗过程中，每周进行两次 PTSD 和抑郁症状的自我报告评估。
多层次中介分析表明，在 PE 期间，创伤后症状的变化解释了抑郁症状变化的 80.3%，而抑郁症状的变化解释了创伤后症状变化的 45.0%。在 PE/CR 期间，创伤后症状的变化解释了抑郁症状变化的 59.6%，而抑郁症状的变化解释了创伤后症状变化的 50.7%。
这些结果表明，PE 主要影响创伤后症状，而这些症状反过来又影响抑郁症状。相比之下，PE/CR 导致了创伤后和抑郁症状之间更具互惠性的关系。
