Maguen Shira, Burkman Kristine, Madden Erin, Dinh Julie, Bosch Jeane, Keyser Jessica, Schmitz Martha, Neylan Thomas C
San Francisco VA Medical Center.
University of California, San Francisco.
J Clin Psychol. 2017 Sep;73(9):997-1012. doi: 10.1002/jclp.22471. Epub 2017 Mar 10.
The purpose of this pilot study was to test the effectiveness of Impact of Killing (IOK), a novel, cognitive-behavioral treatment (CBT) aimed at reducing mental health symptoms and functional impairment.
Participants were 33 combat Veterans with a posttraumatic stress disorder (PTSD) diagnosis who had completed trauma-focused psychotherapy and reported distress regarding killing or feeling responsible for the deaths of others in war. Veterans were randomized to either IOK treatment or a 6-week waitlist condition, after which Veterans could receive IOK. IOK is a 6- to 8-session, weekly, individual, CBT, lasting 60-90 minutes, and focused on key themes, including physiology of killing responses, moral injury, self-forgiveness, spirituality, making amends, and improved functioning.
We found that compared to controls (N = 16), the IOK group (N = 17) experienced a significant improvement in PTSD symptoms, general psychiatric symptoms, and quality of life functional measures. Veterans who received IOK reported that the treatment was acceptable and feasible.
These results provide preliminary evidence that Veterans can benefit from a treatment focused on the impact of killing after initial trauma therapy.
本初步研究旨在测试“杀戮影响疗法”（IOK）的有效性，这是一种旨在减轻心理健康症状和功能障碍的新型认知行为疗法（CBT）。
参与者为33名被诊断患有创伤后应激障碍（PTSD）的退伍军人，他们已完成针对创伤的心理治疗，并报告在战争中对杀戮或对他人死亡感到负有责任而感到痛苦。退伍军人被随机分为接受IOK治疗组或为期6周的等待名单组，之后等待名单组的退伍军人也可接受IOK治疗。IOK是一种为期6至8节、每周一次的个体CBT，每次持续60至90分钟，重点关注关键主题，包括杀戮反应的生理机制、道德伤害、自我宽恕、精神层面、弥补过错以及功能改善。
我们发现，与对照组（N = 16）相比，IOK组（N = 17）在PTSD症状、一般精神症状和生活质量功能指标方面有显著改善。接受IOK治疗的退伍军人报告称该治疗是可接受且可行的。
这些结果提供了初步证据，表明退伍军人在初始创伤治疗后可从专注于杀戮影响的治疗中获益。
