Woidneck Michelle R, Morrison Kate L, Twohig Michael P
Utah State University, Logan, USA
Utah State University, Logan, USA.
Behav Modif. 2014 Jul;38(4):451-76. doi: 10.1177/0145445513510527. Epub 2013 Nov 20.
The number of individuals who meet diagnostic criteria for posttraumatic stress disorder (PTSD) is a small percentage of those exposed to trauma; many youth who do not meet criteria for PTSD continue to experience problematic posttraumatic stress (PTS) symptomology. Acceptance and commitment therapy (ACT) has shown preliminary effectiveness in the treatment of adult PTSD, but its effectiveness in treating PTS in youth is unknown. Using a multiple-baseline design, this study investigated the effectiveness of 10 weeks of ACT to treat PTS in youth. Four adolescents from a community sample and three adolescents from a residential sample participated. The Clinician Administered PTSD Scale for Children and Adolescents (CAPS-CA), Child PTSD Symptom Scale (CPSS), and Comprehensive Quality of Life Scale were completed at pretreatment, posttreatment, and 3-month follow-up. Individuals reported baseline data for 7 to 66 days. Symptom and process measures were completed at each session. Results revealed a decrease in PTS symptomology across both samples with mean reductions in self-reported PTS symptomology at posttreatment of 69% and 81% for the community and residential samples, respectively, and an overall 68% and 84% respective reduction at follow-up. Reductions in clinician rated measures of PTSD were observed for all participants with mean reductions of 57% and 61% in the community and residential samples at posttreatment, and 71% and 60% at follow-up, respectively. Results provide preliminary support for ACT as a treatment for adolescent PTS. Empirical and clinical implications as well as limitations and future directions are discussed.
符合创伤后应激障碍（PTSD）诊断标准的个体数量在遭受创伤的人群中占比很小；许多未达到PTSD标准的青少年仍持续经历创伤后应激（PTS）症状。接纳与承诺疗法（ACT）已在成人PTSD治疗中显示出初步疗效，但其对青少年PTS的治疗效果尚不清楚。本研究采用多基线设计，调查了为期10周的ACT治疗青少年PTS的有效性。来自社区样本的4名青少年和来自寄宿样本的3名青少年参与了研究。在治疗前、治疗后和3个月随访时完成了儿童青少年临床医生施测的PTSD量表（CAPS-CA）、儿童PTSD症状量表（CPSS）和综合生活质量量表。个体报告了7至66天的基线数据。每次治疗时均完成症状和过程测量。结果显示，两个样本中的PTS症状均有所减轻，社区样本和寄宿样本在治疗后自我报告的PTS症状平均分别减少了69%和81%，随访时总体分别减少了68%和84%。所有参与者的临床医生评定的PTSD测量值均有所降低，社区样本和寄宿样本在治疗后平均分别降低了57%和61%，随访时分别降低了71%和60%。结果为ACT作为青少年PTS的一种治疗方法提供了初步支持。讨论了实证和临床意义以及局限性和未来方向。
