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创伤后应激障碍退伍军人的阶梯式团体治疗:疗效及性别对结果的影响

STAIR Group Treatment for Veterans with PTSD: Efficacy and Impact of Gender on Outcome.

作者信息

Jackson Christie, Weiss Brandon J, Cloitre Marylene

机构信息

New York Harbor Healthcare System - Manhattan Campus, 423 East 23rd Street, New York, NY.

National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, 795 Willow Rd., Menlo Park, CA.

出版信息

Mil Med. 2019 Jan 1;184(1-2):e143-e147. doi: 10.1093/milmed/usy164.

Abstract

INTRODUCTION

Group Skills Training in Affective and Interpersonal Regulation (STAIR) is an evidence-based, manualized treatment for individuals with post-traumatic stress symptoms, that focuses on improving functioning through mood management (e.g., emotion regulation) and relationship skills development. To date, no study has evaluated the potential benefit of group STAIR among Veterans. Feasibility of delivering STAIR in a mixed-gender group format and the potential impact of gender on outcome were examined.

MATERIALS AND METHODS

Participants (n = 39) were Veterans enrolled in a post-traumatic stress disorder (PTSD) Clinic at a large VA Medical Center. Veterans participated in one of four mixed-gender STAIR groups and completed self-report questionnaires of PTSD symptoms and general psychological distress at pre-treatment and post-treatment. Institutional review board approval was obtained for this study.

RESULTS

There was significant pre-treatment to post-treatment improvements in PTSD symptoms as measured by the Post-traumatic Stress Checklist (PCL) (Cohen's d = 0.91), as well as in general psychological distress as measured by the Brief Symptom Inventory (BSI) (Cohen's d = 0.90). Change in PTSD symptoms from pre-treatment to post-treatment did not differ across gender. However, the interaction between gender and time on change in (BSI) was significant, where change in general psychological distress significantly decreased from pre-treatment to post-treatment for male Veterans but not for female Veterans.

CONCLUSION

The results from this study demonstrate the feasibility and initial effectiveness of STAIR delivered in a mixed-gender group format for Veterans with PTSD. It should be noted, however, that male Veterans benefited more from this approach than female Veterans. The findings suggest the value of investigating Veterans' attitudes and beliefs about the benefits and drawbacks of mixed-gender group therapy for trauma-related difficulties.

摘要

引言

情感与人际调节团体技能训练(STAIR)是一种针对有创伤后应激症状个体的循证、手册化治疗方法,其重点在于通过情绪管理(如情绪调节)和人际关系技能发展来改善功能。迄今为止,尚无研究评估团体STAIR对退伍军人的潜在益处。本研究考察了以混合性别团体形式开展STAIR的可行性以及性别对治疗结果的潜在影响。

材料与方法

参与者(n = 39)为一家大型退伍军人事务部医疗中心创伤后应激障碍(PTSD)诊所收治的退伍军人。退伍军人参加了四个混合性别STAIR团体中的一个,并在治疗前和治疗后完成了PTSD症状及一般心理困扰的自我报告问卷。本研究获得了机构审查委员会的批准。

结果

根据创伤后应激检查表(PCL)测量,PTSD症状从治疗前到治疗后有显著改善(科恩d值 = 0.91),根据简明症状量表(BSI)测量,一般心理困扰也有显著改善(科恩d值 = 0.90)。PTSD症状从治疗前到治疗后的变化在不同性别间无差异。然而,性别与时间对(BSI)变化的交互作用显著,男性退伍军人的一般心理困扰从治疗前到治疗后显著降低,而女性退伍军人则不然。

结论

本研究结果证明了以混合性别团体形式为患有PTSD的退伍军人提供STAIR的可行性和初步有效性。然而,应注意到男性退伍军人比女性退伍军人从这种方法中获益更多。研究结果表明,调查退伍军人对混合性别团体治疗创伤相关困难的利弊的态度和信念具有重要价值。

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