Michael E. DeBakey Veterans Affairs Medical Center, United States; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, United States; Center for Innovations in Quality, Effectiveness and Safety, United States; VA South Central Mental Illness Research, Education, and Clinical Center, United States.
Michael E. DeBakey Veterans Affairs Medical Center, United States; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, United States.
J Anxiety Disord. 2015 Jun;33:1-7. doi: 10.1016/j.janxdis.2015.04.002. Epub 2015 Apr 21.
This pilot study examines the feasibility, acceptability, and potential effectiveness of delivering an intensive weekend group treatment for panic disorder (PD) to Veterans returning from deployments to Iraq and Afghanistan with co-occurring posttraumatic stress disorder (PTSD). The treatment program lasted 6h each day and was delivered by two experienced therapists. Patients received core components of panic treatment, including psychoeducation, cognitive restructuring, and interoceptive exposure. The interoceptive exposure exercises directly targeted anxiety sensitivity, a psychological construct also implicated in the maintenance of PTSD. Eighty-nine percent of patients who expressed interest in the treatment attended a baseline evaluation, and 63% of those who were study eligible initiated treatment. Treatment retention was high, with all 10 patients who initiated treatment completing the program. Veterans reported finding the treatment and delivery format highly acceptable and reported high levels of satisfaction. Panic symptoms improved significantly following the treatment and were maintained at a 7-month follow-up, with 71.4% of the sample reporting being panic free. Co-occurring PTSD symptoms also improved along with symptoms of anxiety and depression. Preliminary findings suggest that brief and intensive group treatments for PD/PTSD are a promising method of delivering cognitive behavioral therapy that may rapidly improve symptoms. This innovative treatment delivery format also may be a cost-effective way of increasing treatment engagement through increased access to quality care.
这项初步研究考察了为从伊拉克和阿富汗部署归来的同时患有创伤后应激障碍(PTSD)的退伍军人提供密集周末团体治疗惊恐障碍(PD)的可行性、可接受性和潜在效果。该治疗方案每天持续 6 小时,由两名经验丰富的治疗师提供。患者接受惊恐治疗的核心内容,包括心理教育、认知重构和内脏暴露。内脏暴露练习直接针对焦虑敏感性,这也是维持 PTSD 的一个心理结构。对治疗表示感兴趣的患者中,有 89%参加了基线评估,其中 63%符合研究条件的患者开始接受治疗。治疗保留率很高,所有开始治疗的 10 名患者都完成了治疗。退伍军人报告说,他们发现治疗和交付格式非常可接受,并报告了高度的满意度。治疗后惊恐症状显著改善,并在 7 个月的随访中保持稳定,71.4%的样本报告无惊恐发作。同时存在的 PTSD 症状以及焦虑和抑郁症状也得到改善。初步结果表明,PD/PTSD 的短期密集团体治疗是一种很有前途的提供认知行为疗法的方法,可能会迅速改善症状。这种创新的治疗提供模式也可能是通过增加获得优质护理来提高治疗参与度的一种具有成本效益的方式。