Müller-Engelmann Meike, Wünsch Susanne, Volk Marina, Steil Regina
Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University FrankfurtFrankfurt, Germany.
Trauma-und Opferzentrum Frankfurt e.V.Frankfurt, Germany.
Front Psychol. 2017 Sep 5;8:1407. doi: 10.3389/fpsyg.2017.01407. eCollection 2017.
There is promising evidence that mindfulness-based interventions are effective in reducing the symptoms of posttraumatic stress disorder (PTSD). However, until now, studies have often lacked a full clinical PTSD assessment, and interventions are often administered in addition to other interventions. This study examined the feasibility of mindfulness-based stress reduction (MBSR) as a standalone intervention in patients with PTSD who have experienced mixed traumatic events. Fourteen patients participated in 8 weeks of MBSR. The patients were assessed prior to treatment, post-treatment and at a 1-month follow-up through self-ratings (e.g., the Davidson Trauma Scale) and the Clinician-Administered PTSD Scale to determine the effects of the intervention. Furthermore, after the intervention, the patients participated in qualitative interviews regarding their experiences with MBSR and their ideas for future improvements. Nine patients finished the program, and these patients considered the exercises to be applicable and helpful. In the Clinician-Administered PTSD Scale, we found large effects regarding the reduction of PTSD symptoms among completers (Cohen's = 1.2). In the Davidson Trauma Scale, the effect sizes were somewhat lower (Cohen's = 0.6) but nevertheless confirmed the efficacy of MBSR in reducing PTSD symptoms. In the qualitative interviews, the patients reported an augmentation of wellbeing and improvement regarding the handling of difficult situations and more distance from the traumatic event. Despite the large effects, the high dropout rates and the results of the post-treatment interviews suggest that the intervention should be better adapted to the needs of PTSD patients, e.g., by giving more information regarding the exercises and by including shorter exercises to manage acute distress.
有确凿证据表明，基于正念的干预措施在减轻创伤后应激障碍（PTSD）症状方面是有效的。然而，到目前为止，研究往往缺乏全面的临床PTSD评估，而且干预措施通常是在其他干预措施之外实施的。本研究探讨了以正念减压疗法（MBSR）作为经历过混合创伤事件的PTSD患者的独立干预措施的可行性。14名患者参加了为期8周的MBSR。在治疗前、治疗后和1个月随访时，通过自我评分（如戴维森创伤量表）和临床医生管理的PTSD量表对患者进行评估，以确定干预效果。此外，干预结束后，患者参加了关于他们对MBSR的体验以及对未来改进的想法的定性访谈。9名患者完成了该项目，这些患者认为这些练习适用且有帮助。在临床医生管理的PTSD量表中，我们发现完成者在减轻PTSD症状方面有显著效果（科恩d值 = 1.2）。在戴维森创伤量表中，效应量略低（科恩d值 = 0.6），但仍证实了MBSR在减轻PTSD症状方面的疗效。在定性访谈中，患者报告幸福感增强，在处理困难情况方面有所改善，与创伤事件的距离更远。尽管效果显著，但高退出率和治疗后访谈结果表明，该干预措施应更好地适应PTSD患者的需求，例如，通过提供更多关于练习的信息以及纳入更短的练习来应对急性痛苦。
