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“它将如何帮助我?”创伤后应激障碍中舍曲林与延长暴露疗法治疗偏好背后的原因

"How will it help me?" Reasons underlying treatment preferences between sertraline and prolonged exposure in posttraumatic stress disorder.

作者信息

Chen Jessica A, Keller Stephanie M, Zoellner Lori A, Feeny Norah C

机构信息

University of Washington, Seattle, WA 98195, USA.

出版信息

J Nerv Ment Dis. 2013 Aug;201(8):691-7. doi: 10.1097/NMD.0b013e31829c50a9.

Abstract

Individuals with posttraumatic stress disorder (PTSD) often wait years before seeking treatment. Improving treatment initiation and adherence requires a better understanding of patient beliefs that lead to treatment preferences. Using a treatment-seeking sample (N = 200) with chronic PTSD, qualitative reasons underlying treatment preferences for either prolonged exposure (PE) or sertraline (SER) were examined. Reasons for treatment preference primarily focused on how the treatment was perceived to reduce PTSD symptoms rather than practical ones. The patients were more positive about PE than SER. Individual differences did not reliably predict underlying preference reasons, suggesting that what makes a treatment desirable is not strongly determined by current functioning, treatment, or trauma history. Taken together, this information is critical for treatment providers, arguing for enhancing psychoeducation about how treatment works and acknowledging preexisting biases against pharmacotherapy for PTSD that should be addressed. This knowledge has the potential to optimize and better personalize PTSD patient care.

摘要

患有创伤后应激障碍(PTSD)的个体往往要等待数年才会寻求治疗。改善治疗的启动和依从性需要更好地理解导致患者产生治疗偏好的信念。通过对200名患有慢性创伤后应激障碍的寻求治疗者进行抽样,研究了他们对延长暴露疗法(PE)或舍曲林(SER)的治疗偏好背后的定性原因。治疗偏好的原因主要集中在对治疗如何减轻创伤后应激障碍症状的认知上,而非实际因素。患者对延长暴露疗法的评价比对舍曲林更为积极。个体差异并不能可靠地预测潜在的偏好原因,这表明使一种治疗变得可取的因素并非由当前的功能、治疗或创伤史强烈决定。总之,这些信息对治疗提供者至关重要,主张加强关于治疗作用机制的心理教育,并认识到针对创伤后应激障碍药物治疗存在的预先存在的偏见,这些偏见需要得到解决。这些知识有可能优化并更好地实现创伤后应激障碍患者护理的个性化。

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