Hourani Laurel, Tueller Stephen, Kizakevich Paul, Lewis Gregory, Strange Laura, Weimer Belinda, Bryant Stephanie, Bishop Ellen, Hubal Robert, Spira James
RTI International, 3040 East Cornwallis Road, Research Triangle Park, Durham, NC 27709-2194.
National Center for PTSD, Department of Veterans Affairs, Pacific Island Division and the Department of Psychiatry, John Burns School of Medicine, University of Hawaii,3375 Koapaka Street, I-560, Honolulu, HI 96819.
Mil Med. 2016 Sep;181(9):1151-60. doi: 10.7205/MILMED-D-15-00192.
The objective of this pilot study was to design, develop, and evaluate a predeployment stress inoculation training (PRESIT) preventive intervention to enable deploying personnel to cope better with combat-related stressors and mitigate the negative effects of trauma exposure. The PRESIT program consisted of three predeployment training modules: (1) educational materials on combat and operational stress control, (2) coping skills training involving focused and relaxation breathing exercises with biofeedback, and (3) exposure to a video multimedia stressor environment to practice knowledge and skills learned in the first two modules. Heart rate variability assessed the degree to which a subset of participants learned the coping skills. With a cluster randomized design, data from 351 Marines randomized into PRESIT and control groups were collected at predeployment and from 259 of these who responded to surveys on return from deployment. Findings showed that the PRESIT group reduced their physiological arousal through increased respiratory sinus arrhythmia during and after breathing training relative to controls. Logistic regression, corrected for clustering at the platoon level, examined group effects on post-traumatic stress disorder (PTSD) as measured by the Post-traumatic Stress Checklist after controlling for relevant covariates. Results showed that PRESIT protected against PTSD among Marines without baseline mental health problems. Although limited by a small number of participants who screened positive for PTSD, this study supports the benefits of PRESIT as a potential preventive strategy in the U.S. military personnel.
这项初步研究的目的是设计、开发和评估一种部署前应激接种训练（PRESIT）预防性干预措施，以使部署人员能够更好地应对与战斗相关的压力源，并减轻创伤暴露的负面影响。PRESIT计划包括三个部署前训练模块：（1）关于战斗和作战压力控制的教育材料；（2）应对技能训练，包括有生物反馈的集中呼吸和放松呼吸练习；（3）接触视频多媒体压力源环境，以练习在前两个模块中学到的知识和技能。心率变异性评估了一部分参与者学习应对技能的程度。采用整群随机设计，在部署前收集了随机分为PRESIT组和对照组的351名海军陆战队员的数据，并在他们部署返回后对其中259名回复调查问卷的队员进行了调查。结果显示，与对照组相比，PRESIT组在呼吸训练期间及之后通过增加呼吸性窦性心律不齐降低了生理唤醒水平。在对排级聚类进行校正后，采用逻辑回归分析，在控制相关协变量后，检验了两组对创伤后应激障碍（PTSD）的影响，PTSD通过创伤后应激检查表进行测量。结果显示，PRESIT对没有基线心理健康问题的海军陆战队员预防PTSD有效。尽管这项研究受到PTSD筛查呈阳性的参与者数量较少的限制，但它支持了PRESIT作为美国军事人员潜在预防策略的益处。
