National Psychotrauma Center for Children and Youth, University Medical Center Utrecht, Utrecht, The Netherlands.
Psychotrauma Center for Children and Youth, GGZ Rivierduinen Leiden, Leiden, The Netherlands.
Eur J Psychotraumatol. 2014 Jun 3;5. doi: 10.3402/ejpt.v5.22969. eCollection 2014.
Efficacy studies on treatment in adolescent victims of single rape are lacking, even though sexual victimization is most likely to occur during adolescence and despite the fact that adolescents are at risk to develop subsequent posttraumatic stress disorder.
The aim of this prospective observational study was to evaluate the short- and long-term outcomes of a nine-session cognitive behavior group therapy (STEPS), including a parallel six-session parents' group on rape-related symptomatology in female adolescents (13-18 years). STEPS includes psychoeducation, exposure in sensu as well as in vivo, cognitive restructuring, and relapse prevention.
Fifty-five female adolescents with mental health problems due to single rape, but without prior sexual trauma, received STEPS while their parents participated in a support group. Subjects were assessed on posttraumatic stress (PTS) and comorbid symptoms using self-report questionnaires prior to and directly after treatment, and at 6 and 12 months follow-up.
Repeated measures analysis showed a significant and large decrease in symptoms of PTS, anxiety, depression, anger, dissociation, sexual concerns, and behavior problems directly after treatment, which maintained at 12 months follow-up. Time since trauma did not influence the results. Dropout during STEPS was 1.8%.
The results potentially suggest that the positive treatment outcomes at short- and long-term may be caused by STEPS. The encouraging findings need confirmation in future controlled studies on the effectiveness of STEPS because it may be possible that the treatment works especially well for more chronic symptoms, while the less chronic part of the sample showed considerable improvement on its own.
针对单一强奸事件中青少年受害者的治疗效果研究较为缺乏，尽管性侵犯最有可能发生在青少年时期，而且青少年有发展创伤后应激障碍的风险。
本前瞻性观察研究旨在评估 9 节认知行为团体治疗（STEP）的短期和长期效果，包括针对与强奸相关症状的平行 6 节父母团体治疗，对 13-18 岁的女性青少年进行治疗。STEP 包括心理教育、感觉暴露和现场暴露、认知重构和复发预防。
55 名因单一强奸而出现心理健康问题但无先前性创伤的女性青少年接受了 STEP 治疗，同时他们的父母参加了支持小组。在治疗前、治疗后直接和 6 个月及 12 个月随访时，通过自我报告问卷评估创伤后应激障碍（PTS）和共病症状。
重复测量分析显示，PTS、焦虑、抑郁、愤怒、解离、性问题和行为问题的症状在治疗后直接显著且大幅下降，在 12 个月随访时仍保持。创伤后时间并没有影响结果。STEP 治疗中的脱落率为 1.8%。
这些结果可能表明短期和长期的积极治疗效果可能是 STEP 治疗的结果。令人鼓舞的发现需要在未来关于 STEPS 有效性的对照研究中得到证实，因为这种治疗方法可能对更慢性的症状效果特别好，而样本中较少的慢性部分本身就有了相当大的改善。
