Behavioural Science Institute, Radboud University Nijmegen, Montessorilaan 3, Room A07.03, 6525 HR Nijmegen, The Netherlands.
J Behav Ther Exp Psychiatry. 2013 Sep;44(3):312-5. doi: 10.1016/j.jbtep.2013.01.003. Epub 2013 Jan 30.
Distressing intrusions are a hallmark of posttraumatic stress disorder (PTSD). Dysfunctional appraisal of these symptoms may exacerbate the disorder, and conversely may lead to further intrusive memories. This raises the intriguing possibility that learning to 'reappraise' potential symptoms more functionally may protect against such symptoms. Woud, Holmes, Postma, Dalgleish, and Mackintosh (2012) found that 'reappraisal training' when delivered after an analogue stressful event reduced later intrusive memories and other posttraumatic symptoms. The present study aimed to investigate whether reappraisal training administered before a stressful event is also beneficial.
Participants first received positive or negative reappraisal training (CBM-App training) using a series of scripted vignettes. Subsequently, participants were exposed to a film with traumatic content. Effects of the CBM-App training procedure were assessed via three distinct outcome measures, namely: (a) post-training appraisals of novel ambiguous vignettes, (b) change scores on the Post Traumatic Cognitions Inventory (PTCI), and (c) intrusive symptom diary.
CBM-App training successfully induced training-congruent appraisal styles. Moreover, those trained positively reported less distress arising from their intrusive memories of the trauma film during the subsequent week than those trained negatively. However, the induced appraisal bias only partly affected PTCI scores.
Participants used their own negative event as a reference for the PTCI assessments. The events may have differed regarding their emotional impact. There was no control group.
CBM-App training has also some beneficial effects when applied before a stressful event and may serve as a cognitive prophylaxis against trauma-related symptomatology.
痛苦的闯入是创伤后应激障碍（PTSD）的一个标志。对这些症状的功能失调的评估可能会使疾病恶化，反之，也可能导致进一步的侵入性记忆。这就提出了一个有趣的可能性，即学习更“重新评估”潜在症状的功能可能会预防此类症状。Woud、Holmes、Postma、Dalgleish 和 Mackintosh（2012）发现，在模拟应激事件后进行“重新评估训练”可以减少以后的侵入性记忆和其他创伤后症状。本研究旨在调查在应激事件之前进行重新评估训练是否也有益。
参与者首先使用一系列脚本片段接受积极或消极的重新评估训练（CBM-App 训练）。随后，参与者观看了一段有创伤内容的电影。通过三个不同的结果衡量标准评估 CBM-App 训练程序的效果，即：（a）对新的模棱两可的小插图进行训练后的评估，（b）创伤后认知清单（PTCI）的变化分数，和（c）侵入性症状日记。
CBM-App 训练成功地诱导了与训练一致的评估风格。此外，与接受消极训练的人相比，接受积极训练的人在随后的一周内报告的创伤电影引起的侵入性记忆所带来的痛苦要少。然而，诱导的评估偏差仅部分影响了 PTCI 分数。
参与者将自己的负面事件作为 PTCI 评估的参考。这些事件在情绪影响方面可能有所不同。没有对照组。
CBM-App 训练在应用于应激事件之前也有一些有益的效果，并且可以作为预防与创伤相关的症状的认知预防措施。
