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认知疗法与眼动脱敏再处理疗法对减轻灾难丧亲者心理病理学症状的效果:一项随机对照试验的研究方案

Cognitive therapy and eye movement desensitization and reprocessing for reducing psychopathology among disaster-bereaved individuals: study protocol for a randomized controlled trial.

作者信息

Lenferink Lonneke I M, Piersma Eline, de Keijser Jos, Smid Geert E, Boelen Paul A

机构信息

Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands.

Department of Clinical Psychology, Faculty of Social Sciences, Utrecht University, Utrecht, The Netherlands.

出版信息

Eur J Psychotraumatol. 2017 Oct 18;8(1):1388710. doi: 10.1080/20008198.2017.1388710. eCollection 2017.

Abstract

: Confrontation with a traumatic (e.g. disaster-related) loss is a risk factor for the development of psychopathology, including symptoms of prolonged grief (PG), posttraumatic stress (PTS), and depression. Although interventions have been developed for reducing post-loss psychopathology, more research into the effectiveness of treatment is needed to improve care for bereaved persons. Cognitive therapy (CT) and eye movement desensitization and reprocessing (EMDR) have been shown to be effective in trauma-exposed populations. We hypothesize that CT and EMDR are also effective in reducing symptoms among people exposed to traumatic loss. : In this article we describe the rationale of a randomized controlled trial (RCT) to examine (1) treatment effects of CT and EMDR for reducing PG, PTS, and depression among traumatically bereaved people, and (2) the associations between improvements in PG, PTS, and depression symptoms on the one hand and tentative mechanisms of change, including a sense of unrealness, negative cognitions, avoidance behaviour, and intrusive memories, on the other hand. : A two-armed (intervention versus waiting list controls) RCT will be conducted. Participants will be asked to fill in questionnaires prior to treatment, during treatment, and one, 12, and 24 weeks post-treatment. Potential participants are people who have lost one or multiple significant other(s) in the Ukrainian plane disaster in 2014 with clinically significant levels of self-rated PG, PTS, and/or depression. Multiple regression, including analysis of covariance, and multilevel regression analyses will be used. : There is a need for treatment for psychopathology following traumatic loss. Strengths of this study are the development of a treatment that targets grief and trauma-related complaints and the examination of potential mechanisms of change in CT and EMDR. Bereaved people, clinicians, and researchers could benefit from the results of this study.

摘要

面对创伤性(如与灾难相关的)丧失是精神病理学发展的一个风险因素,包括持续性悲伤(PG)、创伤后应激(PTS)和抑郁症状。尽管已经开发出了减少丧失后精神病理学的干预措施,但仍需要更多关于治疗效果的研究来改善对丧亲者的护理。认知疗法(CT)和眼动脱敏再处理疗法(EMDR)已被证明对遭受创伤的人群有效。我们假设CT和EMDR对减少遭受创伤性丧失的人群的症状也有效。在本文中,我们描述了一项随机对照试验(RCT)的基本原理,以检验:(1)CT和EMDR对减少遭受创伤性丧亲者的PG、PTS和抑郁的治疗效果;(2)一方面PG、PTS和抑郁症状的改善与另一方面包括不真实感、消极认知、回避行为和侵入性记忆等暂定变化机制之间的关联。将进行一项双臂(干预组与等待名单对照组)RCT。参与者将被要求在治疗前、治疗期间以及治疗后1周、12周和24周填写问卷。潜在参与者是在2014年乌克兰飞机灾难中失去一个或多个重要他人且自我评定的PG、PTS和/或抑郁达到临床显著水平的人。将使用多重回归,包括协方差分析和多水平回归分析。创伤性丧失后精神病理学的治疗是有必要的。本研究的优势在于开发了一种针对悲伤和创伤相关主诉的治疗方法,并检验了CT和EMDR中潜在的变化机制。丧亲者、临床医生和研究人员都可以从本研究的结果中受益。

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