Varkovitzky Ruth L, Sherrill Andrew M, Reger Greg M
1 VA Puget Sound Health Care System-American Lake Division, Tacoma, WA, USA.
2 University of Washington School of Medicine, Seattle, WA, USA.
Behav Modif. 2018 Mar;42(2):210-230. doi: 10.1177/0145445517724539. Epub 2017 Aug 27.
Effective treatment options are needed for veterans who do not participate in trauma-focused psychotherapy. Research has yet to examine the effectiveness of transdiagnostic psychotherapy in veterans with posttraumatic stress disorder (PTSD) and co-occurring psychological disorders. This pilot study examined the effectiveness of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) delivered in a 16-week group format. We examined treatment outcomes in male and female veterans ( n = 52) in an outpatient specialty PTSD clinic at a large Veterans Affairs (VA) medical center. We hypothesized significant decreases in emotion regulation difficulty (Difficulties in Emotion Regulation Scale), PTSD symptom severity (PTSD Checklist for DSM-5), and depressive symptom severity (Patient Health Questionnaire-9). In addition, we hypothesized that reductions in emotion regulation difficulty across treatment would negatively predict PTSD and depressive symptoms at posttreatment. PTSD symptoms, depressive symptoms, and emotion regulation difficulty all evidenced significant improvements at the end of treatment relative to baseline ( ps < .001). In addition, reductions in emotion regulation across treatment were associated with lower PTSD and depressive symptoms at posttreatment ( ps < .001). This pilot study provides preliminary evidence supporting use of UP among veterans with PTSD and co-occurring disorders. Well-designed clinical trials evaluating efficacy of UP among veterans are needed.
对于未参与以创伤为重点的心理治疗的退伍军人而言，需要有效的治疗方案。目前尚未有研究探讨跨诊断心理治疗在患有创伤后应激障碍（PTSD）及并发心理障碍的退伍军人中的有效性。这项初步研究考察了以16周小组形式开展的情绪障碍跨诊断治疗统一方案（UP）的有效性。我们在一家大型退伍军人事务（VA）医疗中心的门诊专科PTSD诊所，对男性和女性退伍军人（n = 52）的治疗结果进行了考察。我们假设情绪调节困难（情绪调节困难量表）、PTSD症状严重程度（DSM-5的PTSD检查表）和抑郁症状严重程度（患者健康问卷-9）会显著降低。此外，我们假设整个治疗过程中情绪调节困难的减少会对治疗后PTSD和抑郁症状产生负向预测作用。与基线相比，治疗结束时PTSD症状、抑郁症状和情绪调节困难均有显著改善（p值均小于0.001）。此外，整个治疗过程中情绪调节的减少与治疗后较低的PTSD和抑郁症状相关（p值均小于0.001）。这项初步研究提供了初步证据支持在患有PTSD及并发疾病的退伍军人中使用UP。需要开展精心设计的临床试验来评估UP在退伍军人中的疗效。
