Kredlow M Alexandra, Szuhany Kristin L, Lo Stephen, Xie Haiyi, Gottlieb Jennifer D, Rosenberg Stanley D, Mueser Kim T
Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, United States.
Geisel School of Medicine at Dartmouth, Hanover, NH 03755, United States.
Psychiatry Res. 2017 Mar;249:86-93. doi: 10.1016/j.psychres.2016.12.045. Epub 2017 Jan 4.
Secondary analyses were performed on data from two randomized controlled trials of a cognitive behavioral therapy (CBT) program for posttraumatic stress disorder (PTSD) in individuals with severe mental illness (SMI) to examine the feasibility, tolerability, and effectiveness for individuals with borderline personality disorder (BPD). In Study 1, 27 participants received CBT or treatment as usual. In Study 2, 55 participants received CBT or a Brief treatment. Feasibility and tolerability of CBT, PTSD symptoms, and other mental health and functional outcomes were examined, with assessments at baseline, post-treatment, and two follow-up time points. CBT was feasible and tolerable in this population. Study 1 participants in CBT improved significantly more in PTSD symptoms, depression, and self-reported physical health. Study 2 participants in both CBT and Brief improved significantly in PTSD symptoms, posttraumatic cognitions, depression, and overall functioning, with those in CBT acquiring significantly more PTSD knowledge, and having marginally significantly greater improvement in PTSD symptoms. CBT for PTSD was feasible and tolerated in individuals with SMI, BPD, and PTSD, and associated with improvements in PTSD symptoms and related outcomes. Prospective research is needed to evaluate CBT in individuals with BPD, including comparing it with staged interventions for this population.
对两项随机对照试验的数据进行了二次分析，这两项试验针对患有严重精神疾病（SMI）的创伤后应激障碍（PTSD）患者开展了一项认知行为疗法（CBT）项目，以检验该疗法对边缘性人格障碍（BPD）患者的可行性、耐受性和有效性。在研究1中，27名参与者接受了CBT或常规治疗。在研究2中，55名参与者接受了CBT或简短治疗。研究人员对CBT的可行性和耐受性、PTSD症状以及其他心理健康和功能结局进行了检查，并在基线、治疗后以及两个随访时间点进行了评估。CBT在该人群中是可行且可耐受的。研究1中接受CBT的参与者在PTSD症状、抑郁和自我报告的身体健康方面改善更为显著。研究2中接受CBT和简短治疗的参与者在PTSD症状、创伤后认知、抑郁和整体功能方面均有显著改善，其中接受CBT的参与者获得了显著更多的PTSD知识，且在PTSD症状方面的改善略为显著。针对患有SMI、BPD和PTSD的个体，CBT治疗PTSD是可行且可耐受的，并且与PTSD症状及相关结局的改善相关。需要开展前瞻性研究来评估针对BPD患者的CBT，包括将其与针对该人群的分阶段干预措施进行比较。
