Mental Illness Research Education and Clinical Center for Post Deployment Mental Health, Durham VA Medical Center, Durham, NC, USA; Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA.
Mental Illness Research Education and Clinical Center for Post Deployment Mental Health, Durham VA Medical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA; Center for Health Services Research in Primary Care, Durham, NC, USA.
Psychiatry Res. 2014 Jan 30;215(1):154-8. doi: 10.1016/j.psychres.2013.10.038. Epub 2013 Nov 8.
The ethical conduct of research on posttraumatic stress disorder (PTSD) requires assessing the risks to study participants. Some previous findings suggest that patients with PTSD report higher distress compared to non-PTSD participants after trauma-focused research. However, the impact of study participation on participant risk, such as suicidal/homicidal ideation and increased desire to use drugs or alcohol, has not been adequately investigated. Furthermore, systematic evaluation of distress using pre- and post-study assessments, and the effects of study procedures involving exposure to aversive stimuli, are lacking. Individuals with a history of PTSD (n=68) and trauma-exposed non-PTSD controls (n=68) responded to five questions about risk and distress before and after participating in research procedures including a PTSD diagnostic interview and a behavioral task with aversive stimuli consisting of mild electrical shock. The desire to use alcohol or drugs increased modestly with study participation among the subgroup (n=48) of participants with current PTSD. Participation in these research procedures was not associated with increased distress or participant risk, nor did study participation interact with lifetime PTSD diagnosis. These results suggest some increase in distress with active PTSD but a participant risk profile that supports a favorable risk-benefit ratio for conducting research in individuals with PTSD.
创伤后应激障碍(PTSD)研究的伦理行为需要评估研究参与者的风险。一些先前的研究结果表明,与非 PTSD 参与者相比,PTSD 患者在创伤聚焦研究后报告的痛苦程度更高。然而,研究参与对参与者风险的影响,如自杀/杀人意念和增加使用毒品或酒精的欲望,尚未得到充分研究。此外,使用研究前后评估系统地评估痛苦,以及涉及暴露于厌恶刺激的研究程序的影响,也缺乏研究。有 PTSD 病史的个体(n=68)和创伤后非 PTSD 对照组(n=68)在参与包括 PTSD 诊断访谈和包含轻度电击的厌恶刺激行为任务在内的研究程序之前和之后,对五个关于风险和痛苦的问题做出了回应。在有当前 PTSD 的亚组(n=48)参与者中,随着研究参与,使用酒精或药物的欲望适度增加。这些研究程序的参与与增加的痛苦或参与者风险无关,也与终生 PTSD 诊断没有相互作用。这些结果表明,在有活跃 PTSD 的情况下,痛苦会略有增加,但参与者的风险状况支持对 PTSD 个体进行研究的有利风险效益比。