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创伤后成长在创伤后应激障碍认知行为联合疗法随机对照试验中的作用

The Role of Posttraumatic Growth in a Randomized Controlled Trial of Cognitive-Behavioral Conjoint Therapy for PTSD.

作者信息

Wagner Anne C, Torbit Lindsey, Jenzer Tiffany, Landy Meredith S H, Pukay-Martin Nicole D, Macdonald Alexandra, Fredman Steffany J, Monson Candice M

机构信息

Department of Psychology, Ryerson University, Toronto, Ontario, Canada.

Department of Psychology, The University at Buffalo, State University of New York, Buffalo, New York, USA.

出版信息

J Trauma Stress. 2016 Aug;29(4):379-83. doi: 10.1002/jts.22122. Epub 2016 Jul 19.

Abstract

Posttraumatic growth (PTG) is defined as a positive psychological change that can emerge following a traumatic life event. Although documented in noninterventional studies of traumatized individuals, there are scant data on the potential for therapy to induce or improve PTG. Thus, the primary goal of this study was to examine changes in PTG in a controlled trial of cognitive-behavioral conjoint therapy for posttraumatic stress disorder versus waitlist (CBCT for PTSD; Monson & Fredman, 2012). We also examined whether pretreatment relationship satisfaction and PTSD symptomatology moderated change in PTG. There were 40 couples (75% with a female partner with PTSD) who were randomized to either immediate CBCT for PTSD or a 3-month waitlist (WL). Compared to WL, individuals who received treatment immediately demonstrated a significant increase in PTG. There was a moderate effect size between-group difference (Hedge's g = 0.45). There was a nonsignificant relationship with a moderate effect size (Hedge's g = 0.65) for the positive effect of pretreatment relationship satisfaction on the trajectory of PTG, but no effect of pretreatment PTSD symptoms. Results suggested that CBCT for PTSD facilitated PTG, even with a limited focus on PTG in this conjoint intervention. Future research should target PTG as a treatment goal and further examine the role of close others in facilitating development of PTG.

摘要

创伤后成长(PTG)被定义为在经历创伤性生活事件后可能出现的积极心理变化。尽管在对受创伤个体的非干预性研究中有相关记录,但关于治疗诱导或改善PTG可能性的数据却很少。因此,本研究的主要目标是在一项针对创伤后应激障碍的认知行为联合治疗与等待名单对照试验(创伤后应激障碍的认知行为联合治疗;蒙森和弗雷德曼,2012年)中,检验PTG的变化情况。我们还研究了治疗前的关系满意度和创伤后应激障碍症状是否会调节PTG的变化。共有40对夫妇(75%的女性伴侣患有创伤后应激障碍)被随机分为立即接受创伤后应激障碍的认知行为联合治疗组或3个月的等待名单组(WL)。与等待名单组相比,立即接受治疗的个体在PTG方面有显著增加。组间差异的效应量中等(赫奇斯g值 = 0.45)。治疗前关系满意度对PTG轨迹的积极影响存在中等效应量(赫奇斯g值 = 0.65)的非显著关系,但治疗前创伤后应激障碍症状没有影响。结果表明,创伤后应激障碍的认知行为联合治疗促进了PTG,即使在这种联合干预中对PTG的关注有限。未来的研究应以PTG作为治疗目标,并进一步研究亲密他人在促进PTG发展中的作用。

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