Müller-Engelmann Meike, Steil Regina
Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Varrentrappstr. 40-42, D-60486 Frankfurt/Main, Germany.
J Behav Ther Exp Psychiatry. 2017 Mar;54:44-50. doi: 10.1016/j.jbtep.2016.06.004. Epub 2016 Jun 17.
Cognitive restructuring and imagery modification for PTSD (CRIM-PTSD) is a new short intervention. It consists of the cognitive restructuring of core trauma-related dysfunctional beliefs about the self and the use of imagery to encourage more functional beliefs. A randomized controlled trial showed that CRIM was effective for reducing posttraumatic stress disorder (PTSD) in survivors of childhood sexual abuse (CSA) when it focused on the feeling of being contaminated. For this study, CRIM was adapted to treat PTSD symptoms more generally and after various types of trauma by addressing the patients' negative self-concept.
Ten patients with PTSD received two assessment sessions, two treatment sessions, and a booster session. The Clinician-Administered PTSD Scale (CAPS) was administered prior to and four weeks after treatment. Self-ratings, e.g., the Posttraumatic Diagnostic Scale (PDS) and the Posttraumatic Cognitions Inventory (PTCI), were administered at baseline, immediately posttreatment, and four weeks after treatment.
The participants showed significant improvements in both clinician-rated (d = 2.55; p < 0.01) and self-reported PTSD symptoms (d = 1.47; p < 0.01). One month after treatment, 9 patients no longer fully met the diagnostic criteria for PTSD.
The results are limited by the small sample size and the lack of a control group.
This pilot study suggests that addressing the negative self-concept of PTSD patients using a combination of cognitive techniques and imagery modification can effectively reduce PTSD symptoms. Further research is needed to assess the treatment's effects and stability in a randomized controlled trial.
创伤后应激障碍的认知重构与意象修正（CRIM-PTSD）是一种新型的短期干预方法。它包括对与创伤相关的关于自我的核心功能失调信念进行认知重构，并运用意象来促进形成更具适应性的信念。一项随机对照试验表明，当CRIM聚焦于被污染感时，它对减轻童年性虐待（CSA）幸存者的创伤后应激障碍（PTSD）有效。在本研究中，通过解决患者的消极自我概念，CRIM被调整为更广泛地治疗各种类型创伤后的PTSD症状。
10名PTSD患者接受了两次评估 sessions、两次治疗 sessions 和一次强化 sessions。在治疗前和治疗后四周使用临床医生管理的PTSD量表（CAPS）进行评估。在基线、治疗后立即以及治疗后四周进行自我评定，例如创伤后诊断量表（PDS）和创伤后认知量表（PTCI）。
参与者在临床医生评定的（d = 2.55；p < 0.01）和自我报告的PTSD症状（d = 1.47；p < 0.01）方面均有显著改善。治疗后一个月，9名患者不再完全符合PTSD的诊断标准。
结果受样本量小和缺乏对照组的限制。
这项初步研究表明，结合认知技术和意象修正来解决PTSD患者的消极自我概念可以有效减轻PTSD症状。需要进一步的研究来评估该治疗方法在随机对照试验中的效果和稳定性。
