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难民和寻求庇护者创伤后应激障碍的心理干预措施:系统评价和荟萃分析。

Psychological interventions for post-traumatic stress disorder in refugees and asylum seekers: A systematic review and meta-analysis.

机构信息

South Wales Doctoral Programme in Clinical Psychology, Cardiff University, Cardiff, UK.

Psychology and Psychological Therapies Directorate, Cardiff and Vale University Health Board, Cardiff, UK.

出版信息

Clin Psychol Rev. 2018 Jul;63:66-79. doi: 10.1016/j.cpr.2018.06.006. Epub 2018 Jun 15.

Abstract

There is a high prevalence of post-traumatic stress disorder (PTSD) in refugee and asylum seeker populations which can pose distinct challenges for mental health professionals. This review included 16 randomised controlled trials (RCTs) with 1111 participants investigating the effect of psychological interventions on PTSD in these populations. We searched PsychInfo, ProQuest (including selected databases ASSIA, IBSS, PILOTS), Web of Science, the Cochrane Central Database of Controlled Studies (CENTRAL) and Cochrane Database for Systematic Reviews (CDSR) to identify peer-reviewed, primary research articles up to May 2018. We used rigorous methods to assess the quality of included trials and evidence using Cochrane, SURE and GRADE systems. 525 trials were reviewed, 16 were included with 15 contributed to meta-analyses. Despite the challenges of conducting research in this field we found evidence for trauma-focused psychological interventions for PTSD in this population. Following sub-group analyses, we found evidence to support the use of EMDR and Narrative Exposure Therapy for PTSD symptoms. We considered these findings in relation to the broader PTSD treatment literature and related literature from survivors of large scale conflict. These findings suggest that trauma focused psychological therapies can be effective in improving symptoms for refugees and asylum seekers with PTSD.

摘要

创伤后应激障碍(PTSD)在难民和寻求庇护者群体中发病率很高,这给心理健康专业人员带来了明显的挑战。本综述包括 16 项随机对照试验(RCT),共有 1111 名参与者,旨在研究心理干预对这些人群中 PTSD 的影响。我们在 2018 年 5 月前在 PsychInfo、ProQuest(包括选定的数据库 ASSIA、IBSS、PILOTS)、Web of Science、Cochrane 对照试验中央数据库(CENTRAL)和 Cochrane 系统评价数据库(CDSR)中搜索了同行评审的、主要的研究文章。我们使用 Cochrane、SURE 和 GRADE 系统,采用严格的方法评估纳入试验的质量和证据。我们审查了 525 项试验,其中 16 项被纳入,其中 15 项有助于荟萃分析。尽管在该领域开展研究存在挑战,但我们发现针对该人群 PTSD 的创伤聚焦心理干预有证据支持。经过亚组分析,我们发现有证据支持 EMDR 和叙事暴露疗法对 PTSD 症状的作用。我们结合更广泛的 PTSD 治疗文献和大规模冲突幸存者的相关文献来考虑这些发现。这些发现表明,创伤聚焦心理疗法可以有效改善患有 PTSD 的难民和寻求庇护者的症状。

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