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针对创伤后应激障碍的基于互联网的聚焦创伤认知行为疗法:有无暴露成分的随机对照试验。

Internet-based trauma-focused cognitive behavioural therapy for PTSD with and without exposure components: a randomised controlled trial.

作者信息

Spence Jay, Titov Nickolai, Johnston Luke, Jones Michael P, Dear Blake F, Solley Karen

机构信息

Macquarie University, Sydney, NSW, Australia.

NHMRC Public Health Fellow, Macquarie University, Sydney, NSW, Australia.

出版信息

J Affect Disord. 2014 Jun;162:73-80. doi: 10.1016/j.jad.2014.03.009. Epub 2014 Mar 25.

Abstract

BACKGROUND

Internet-delivered trauma-focused cognitive behavioural therapy is efficacious for PTSD; however, no studies have investigated the roles of individual treatment components or the safety of online treatments.

AIMS

To compare the efficacy and safety of an online treatment for PTSD comprised of psychoeducation, stress management, cognitive restructuring and exposure components with the equivalent protocol without the exposure components, using a randomised controlled trial design.

METHODS

Sixty-six individuals were randomised to a non-exposure condition and 59 to the full protocol with exposure components. Treatment duration was 8 weeks and pre-, post-treatment and three-month follow-up outcomes were analysed using a mixed linear modelling approach.

RESULTS

Both groups achieved improvements in symptoms with no differences between groups on any primary or secondary outcome measures, diagnostic remission rates or adverse events.

LIMITATIONS

The study included several secondary measures that have not been previously validated and treatments were not time matched in terms of number of lessons.

CONCLUSIONS

These findings indicate that trauma-focused cognitive behavioural therapy for PTSD with or without exposure components can be safe and efficacious.

摘要

背景

通过互联网提供的以创伤为重点的认知行为疗法对创伤后应激障碍有效;然而,尚无研究调查各个治疗组成部分的作用或在线治疗的安全性。

目的

采用随机对照试验设计,比较由心理教育、压力管理、认知重构和暴露组成部分构成的创伤后应激障碍在线治疗方案与不含暴露组成部分的等效方案的疗效和安全性。

方法

66人被随机分配至非暴露组,59人被随机分配至包含暴露组成部分的完整方案组。治疗为期8周,采用混合线性建模方法分析治疗前、治疗后及三个月随访结果。

结果

两组症状均有改善,在任何主要或次要结局指标、诊断缓解率或不良事件方面,两组之间均无差异。

局限性

该研究纳入了一些之前未经验证的次要指标,且治疗课程数量在时间上不匹配。

结论

这些发现表明,有或没有暴露组成部分的针对创伤后应激障碍的以创伤为重点的认知行为疗法都是安全有效的。

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