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创伤后应激障碍认知加工治疗过程中创伤叙事及感知回忆能力的变化

Change in Trauma Narratives and Perceived Recall Ability over a Course of Cognitive Processing Therapy for PTSD.

作者信息

Mott Juliette M, Galovski Tara E, Walsh Ryan M, Elwood Lisa S

机构信息

Veterans Affairs National Center for Posttraumatic Stress Disorder-Executive Division, White River Junction, Vermont, USA.

University of Missouri-St. Louis, Center for Trauma Recovery, St. Louis, Missouri, USA.

出版信息

Traumatology (Tallahass Fla). 2015 Mar 1;21(1):47-54. doi: 10.1037/trm0000012.

Abstract

This study sought to evaluate changes in written trauma narratives completed during a course of Cognitive Processing Therapy (CPT). Participants were 22 female survivors of interpersonal assault who represented a subset of participants from two larger CPT treatment trials. Participants completed two written trauma narratives over the course of treatment. We predicted that narratives would increase in length and peritraumatic detail, and that participants would perceive an increase in their recall ability for important aspects of the trauma. Although narrative length and amount of peritraumatic detail did not change significantly from first to final narrative, participants evidenced changes in the content of the peritraumatic details. Patients commonly omitted assaultive acts from one of their narratives. There was a greater degree of fluctuation within the reporting of sexual assaults, as compared to physical assaults, with 55% of participants reporting a forced sexual act in one narrative, but not the other. Participants did not report significant changes in perceived recall ability for the traumatic event after completing the narratives, but did report improvements in perceived recall from pre to posttreatment. Overall, findings indicate that clients included different details (but not more details) in their final narrative, and that perceived increases in recall ability may not be a typical experience for clients as they complete written narratives in the context of trauma treatment.

摘要

本研究旨在评估在认知加工疗法(CPT)疗程中所完成的创伤书面叙述的变化情况。参与者为22名人际攻击的女性幸存者,她们是两项更大规模CPT治疗试验的参与者子集。参与者在治疗过程中完成了两篇创伤书面叙述。我们预测叙述的长度和创伤周围细节将会增加,并且参与者会感觉到他们对创伤重要方面的回忆能力有所提高。尽管从第一篇叙述到最后一篇叙述,叙述长度和创伤周围细节的数量没有显著变化,但参与者在创伤周围细节的内容上表现出了变化。患者通常会在其中一篇叙述中省略攻击行为。与身体攻击相比,性攻击报告中的波动程度更大,55%的参与者在一篇叙述中报告了强迫性行为,而在另一篇中则没有。参与者在完成叙述后,并未报告对创伤事件的回忆能力有显著变化,但确实报告了从治疗前到治疗后回忆能力有所改善。总体而言,研究结果表明,客户在最终叙述中包含了不同的细节(但不是更多细节),并且在创伤治疗背景下完成书面叙述时,回忆能力的感知增强可能并非客户的典型体验。

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