Rosaura Polak A, Witteveen Anke B, Denys Damiaan, Olff Miranda
Department of Anxiety Disorders, Academic Medical Center (AMC), University of Amsterdam (UvA), Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands,
Appl Psychophysiol Biofeedback. 2015 Mar;40(1):25-31. doi: 10.1007/s10484-015-9268-y.
Although trauma-focused cognitive behavioral therapy (TF-CBT) with exposure is an effective treatment for posttraumatic stress disorder (PTSD), not all patients recover. Addition of breathing biofeedback to exposure in TF-CBT is suggested as a promising complementary technique to improve recovery of PTSD symptoms. Patients (n = 8) with chronic PTSD were randomized to regular TF-CBT or TF-CBT with complementary breathing biofeedback to exposure. PTSD symptoms were measured before, during and after TF-CBT with the Impact of Event Scale-Revised. The results show that breathing biofeedback is feasible and can easily be complemented to TF-CBT. Although PTSD symptoms significantly decreased from pre to post treatment in both conditions, there was a clear trend towards a significantly faster (p = .051) symptom reduction in biofeedback compared to regular TF-CBT. The most important limitation was the small sample size. The hastened clinical improvement in the biofeedback condition supports the idea that breathing biofeedback may be an effective complementary component to exposure in PTSD patients. The mechanism of action of breathing biofeedback may relate to competing working memory resources decreasing vividness and emotionality, similar to eye movement desensitization and reprocessing. Future research is needed to examine this.
尽管采用暴露疗法的创伤聚焦认知行为疗法（TF-CBT）是治疗创伤后应激障碍（PTSD）的有效方法，但并非所有患者都能康复。在TF-CBT的暴露疗法中加入呼吸生物反馈被认为是一种有前景的辅助技术，有助于改善PTSD症状的恢复。将8名慢性PTSD患者随机分为接受常规TF-CBT组或接受TF-CBT并辅以呼吸生物反馈暴露疗法组。在TF-CBT治疗前、治疗期间和治疗后，使用修订版事件影响量表测量PTSD症状。结果表明，呼吸生物反馈是可行的，并且可以很容易地与TF-CBT相结合。虽然两种治疗条件下PTSD症状从治疗前到治疗后均显著降低，但与常规TF-CBT相比，生物反馈组症状减轻明显更快（p = 0.051），有明显趋势。最重要的局限性是样本量小。生物反馈条件下临床改善加速支持了呼吸生物反馈可能是PTSD患者暴露疗法有效辅助成分的观点。呼吸生物反馈的作用机制可能与竞争工作记忆资源从而降低生动性和情绪性有关，类似于眼动脱敏再处理疗法。需要进一步的研究来对此进行检验。
