Alliger-Horn Christina, Zimmermann Peter Lutz, Schmucker Mervyn
Bundeswehrkrankenhaus Berlin, Abt. VIB Psychotraumazentrum, Scharnhorststr. 13, 10115 Berlin, Germany.
Klinik am Waldschlösschen, Zentrum für Psychotherapie, 01067 Dresden, Germany.
J Clin Med. 2016 Oct 20;5(10):90. doi: 10.3390/jcm5100090.
The consideration of specific trauma-associated emotions poses a challenge for the differential treatment planning in trauma therapy. Soldiers experiencing deployment-related posttraumatic stress disorder often struggle with emotions of guilt and shame as a central component of their PTSD.
The purpose of this study was to examine the extent to which soldiers' PTSD symptoms and their trauma-related guilt and shame may be affected as a function of their ability to develop compassionate imagery between their CURRENT SELF (today) and their TRAUMATIZED SELF (back then).
The sample comprised 24 male German soldiers diagnosed with PTSD who were examined on the Posttraumatic Diagnostic Scale (PDS) and two additional measures: the Emotional Distress Inventory (EIBE) and the Quality of Interaction between the CURRENT SELF and the TRAUMATIZED SELF (QUI-HD: Qualität der Interaktion zwischen HEUTIGEN ICH und DAMALIGEN ICH) at pre- and post-treatment and again at follow-up. The treatment used was imagery rescripting and reprocessing therapy (IRRT).
Eighteen of the 24 soldiers showed significant improvement in their PTSD symptoms at post-treatment and at follow-up (on their reliable change index). A significant change in trauma-associated guilt and shame emerged when compassionate imagery was developed towards one's TRAUMATIZED SELF. The degree and intensity of the guilt and shame felt at the beginning of treatment and the degree of compassionate imagery developed toward the TRAUMATIZED SELF were predictors for change on the PDS scores.
For soldiers suffering from specific war-related trauma involving PTSD, the use of self-nurturing, compassionate imagery that fosters reconciling with the traumatized part of the self can effectively diminish trauma-related symptoms, especially when guilt and shame are central emotions.
考虑与创伤相关的特定情绪对创伤治疗中的差异化治疗规划构成了挑战。经历与部署相关的创伤后应激障碍的士兵常常与内疚和羞耻情绪作斗争，这些情绪是他们创伤后应激障碍的核心组成部分。
本研究的目的是检验士兵的创伤后应激障碍症状以及他们与创伤相关的内疚和羞耻感在何种程度上可能受到他们在当前自我（现在）和受创伤自我（当时）之间产生同情意象的能力的影响。
样本包括24名被诊断患有创伤后应激障碍的德国男性士兵，他们在治疗前和治疗后以及随访时接受了创伤后诊断量表（PDS）以及另外两项测量：情绪困扰量表（EIBE）和当前自我与受创伤自我之间的互动质量（QUI-HD：HEUTIGEN ICH与DAMALIGEN ICH之间的互动质量）。所采用的治疗方法是意象重写与再处理疗法（IRRT）。
24名士兵中有18名在治疗后和随访时（根据其可靠变化指数）的创伤后应激障碍症状有显著改善。当对自己的受创伤自我产生同情意象时，与创伤相关的内疚和羞耻感出现了显著变化。治疗开始时所感受到的内疚和羞耻的程度以及对受创伤自我产生的同情意象的程度是PDS得分变化的预测因素。
对于患有涉及创伤后应激障碍的特定战争相关创伤的士兵，使用自我滋养、富有同情心的意象来促进与自我受创伤部分的和解，可以有效减轻与创伤相关的症状，尤其是当内疚和羞耻是核心情绪时。
