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认知行为疗法对智利地震和海啸后创伤后应激症状中灾后困扰的疗效。

Effectiveness of cognitive-behavioural therapy for post-disaster distress in post-traumatic stress symptoms after Chilean earthquake and tsunami.

作者信息

Leiva-Bianchi Marcelo, Cornejo Felipe, Fresno Andrés, Rojas Carolina, Serrano Camila

机构信息

Faculty of Psychology, University of Talca, Talca, Chile.

Faculty of Psychology, University of Talca, Talca, Chile.

出版信息

Gac Sanit. 2018 May-Jun;32(3):291-296. doi: 10.1016/j.gaceta.2017.07.018. Epub 2017 Oct 5.

Abstract

OBJECTIVE

This is the first time that the effectiveness of cognitive-behavioural therapy for post-disaster stress (CBT-PD) in symptoms of posttraumatic stress disorder (PTSD) has been tested outside the United States of America.

DESIGN

Quasi-experiment with three groups. In the quasi-control group, complete CBT-PD was applied even though its members did not have PTSD; in quasi-experimental conditions, participants received complete treatment because they had this diagnosis; and in the third group, participants with PTSD received an abbreviated treatment (double sessions) due to organisational requirements.

LOCATION

Primary health care workers in Constitución (Chile), city exposed to earthquake and tsunami; public department workers in Talca (city exposed only to earthquake) and teachers from a school (Constitución).

PARTICIPANTS

A total of 13 of the 91 people diagnosed with PTSD participated. In addition, 16 people without diagnosis voluntarily participated. The treatment was completed by 29 participants. There were no dropouts. Only 1 of the 9 participants in the quasi-experimental group did not respond to treatment.

INTERVENTIONS

CBT-PD is a group therapy (10-12 sessions) that includes psychoeducation, breathing retraining, behavioural activation and cognitive restructuring. CBT-PD (complete and abbreviated) was applied between September and December 2010.

MEASUREMENTS

Short Posttraumatic Stress Disorder Rating Interview (SPRINT-E) was used to measure PTSD symptoms before and after treatment.

RESULTS

The group that received the complete treatment and was diagnosed with PTSD showed a significant decrease in the total symptoms to below dangerous levels (IGA: 31.556; p<0.01; 95%CI: 0.21-2.01]; η=0.709).

DISCUSSION

The effectiveness and benefits of incorporating CBT-PD in the health network after events like disasters were discussed.

摘要

目的

这是首次在美国以外的地区测试认知行为疗法对灾后应激(CBT-PD)在创伤后应激障碍(PTSD)症状方面的有效性。

设计

三组准实验。在准对照组中,即使其成员没有创伤后应激障碍,也应用完整的CBT-PD;在准实验条件下,参与者因患有该诊断而接受完整治疗;在第三组中,由于组织要求,患有创伤后应激障碍的参与者接受了简化治疗(双倍疗程)。

地点

康塞普西翁(智利)的初级卫生保健工作者,该市遭受了地震和海啸;塔尔卡的公共部门工作人员(仅遭受地震的城市)以及一所学校(康塞普西翁)的教师。

参与者

91名被诊断患有创伤后应激障碍的人中共有13人参与。此外,16名未被诊断的人自愿参与。29名参与者完成了治疗。没有退出者。准实验组的9名参与者中只有1人对治疗无反应。

干预措施

CBT-PD是一种团体治疗(10 - 12次疗程),包括心理教育、呼吸再训练、行为激活和认知重构。CBT-PD(完整和简化版)于2010年9月至12月应用。

测量方法

使用简短创伤后应激障碍评定访谈(SPRINT-E)在治疗前后测量创伤后应激障碍症状。

结果

接受完整治疗且被诊断患有创伤后应激障碍的组在总症状方面显著下降至危险水平以下(IGA:31.556;p < 0.01;95%CI:0.21 - 2.01];η = 0.709)。

讨论

讨论了在灾难等事件后将CBT-PD纳入卫生网络的有效性和益处。

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