平民与成年军人中加速解决疗法（ART）治疗创伤后应激障碍（PTSD）症状和性创伤的比较

Comparison of Accelerated Resolution Therapy (ART) for Treatment of Symptoms of PTSD and Sexual Trauma Between Civilian and Military Adults.

作者信息

Kip Kevin E, Hernandez Diego F, Shuman Amy, Witt Ann, Diamond David M, Davis Sheryl, Kip Ryan, Abhayakumar Alisha, Wittenberg Trudy, Girling Sue Ann, Witt Steve, Rosenzweig Laney

机构信息

College of Nursing, University of South Florida, 12901 Bruce B. Downs Boulevard, MDN, Room 2010, Tampa, FL 33612.

Western New England University, 1215 Wilbraham Road, Springfield, MA 01119-284.

出版信息

Mil Med. 2015 Sep;180(9):964-71. doi: 10.7205/MILMED-D-14-00307.

DOI:10.7205/MILMED-D-14-00307

PMID:26327548

Abstract

OBJECTIVE

First-line psychotherapies for post-traumatic stress disorder (PTSD) were principally validated in civilian populations. We compared treatment of symptoms of psychological trauma between civilian and military adults by use of Accelerated Resolution Therapy (ART), an emerging, brief exposure-based therapy.

METHODS

We pooled individual patient data from two recently completed studies of ART. Treatment response for symptoms of PTSD was compared by civilian versus military status, stratified by gender and history of sexual trauma.

RESULTS

Mean age was 40.7 years in civilians (n = 62) vs. 42.2 years in military participants (n = 51). Mean PCL (PTSD) scores before/after treatment with ART were 53.2/30.2 among civilians compared with 56.0/40.5 among military participants (adjusted p = 0.25). Over follow-up (n = 91), there was an apparent greater reduction among civilians in Intrusive (p = 0.03) and Numbing symptoms (p = 0.01), but not in Arousal (p = 0.99) or Avoidance (p = 0.19) symptoms. Among females with sexual trauma, mean reductions on the PCL were substantial in civilian (-22.5 ± 16.7) and military (-21.2 ± 12.7) participants (p = 0.87).

CONCLUSIONS

In an average of <4 treatment sessions, treatment with ART results in meaningful reductions in symptoms of PTSD in civilian and military patients. The suggestion of stronger response among civilians may owe to differential clinical presentation and trauma exposure history among military personnel.

摘要

目的

创伤后应激障碍（PTSD）的一线心理治疗主要是在 civilian 人群中得到验证的。我们使用加速解决疗法（ART）比较了 civilian 和 military 成年人心理创伤症状的治疗情况，加速解决疗法是一种新兴的、基于简短暴露的疗法。

方法

我们汇总了两项最近完成的 ART 研究的个体患者数据。按 civilian 与 military 身份比较 PTSD 症状的治疗反应，并按性别和性创伤史进行分层。

结果

civilians（n = 62）的平均年龄为 40.7 岁，而 military 参与者（n = 51）的平均年龄为 42.2 岁。ART 治疗前后 civilian 的平均 PCL（PTSD）评分为 53.2/30.2，而 military 参与者为 56.0/40.5（调整后 p = 0.25）。在随访期间（n = 91），civilians 在侵入性症状（p = 0.03）和麻木症状（p = 0.01）方面的减少似乎更大，但在唤醒症状（p = 0.99）或回避症状（p = 0.19）方面并非如此。在有性创伤的女性中， civilian（-22.5±16.7）和 military（-21.2±12.7）参与者的 PCL 平均降低幅度很大（p = 0.87）。