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使用视空间干扰干预减少创伤后应激障碍(PTSD)住院患者的侵入性记忆。

Reducing intrusive memories of trauma using a visuospatial interference intervention with inpatients with posttraumatic stress disorder (PTSD).

机构信息

Department of Psychosomatic Medicine and Psychotherapy.

Department of Clinical Neuroscience, Karolinska Institutet.

出版信息

J Consult Clin Psychol. 2018 Dec;86(12):1076-1090. doi: 10.1037/ccp0000340.

Abstract

OBJECTIVE

The core clinical feature of posttraumatic stress disorder (PTSD) is recurrent intrusive memories of trauma. This study aimed to test a novel and simple intervention, inspired by the concepts of concurrent task interference and memory reconsolidation, to reduce the occurrence of intrusive memories among inpatients with complex PTSD.

METHOD

In this open-label single case series 20 patients with longstanding complex PTSD in inpatient treatment monitored the occurrence of intrusive trauma memories (intrusions) over the course of their admission (5 to 10 weeks). Patients received study-specific intervention sessions (including a memory reminder for a specific intrusion then 25 min Tetris gameplay) on a weekly basis. A within-subjects multiple baseline AB design was used, in that the length of baseline ("A," preintervention, monitoring only) and postintervention ("B") phases varied within-subjects across individual intrusions. Further, some intrusions were never targeted by the intervention. The study was registered prior to analysis, ISRCTN34320836.

RESULTS

Frequency of targeted intrusions reduced by on average 64% from baseline to the postintervention phase. Conversely, never-targeted intrusions reduced in frequency by on average 11% over a comparable time-period. Of the 20 patients, 16 met our criteria for showing "response" to the intervention.

CONCLUSIONS

Results provide initial evidence that this brief behavioral procedure might reduce the occurrence of intrusive traumatic memories in longstanding and complex PTSD, here delivered in an inpatient setting. The potential of this simple, focused intervention opens up new possibilities for tackling a core clinical symptom of PTSD, warranting further research. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

摘要

目的

创伤后应激障碍(PTSD)的核心临床特征是创伤后反复出现的侵入性记忆。本研究旨在测试一种新的简单干预措施,该措施受并发任务干扰和记忆再巩固概念的启发,以减少长期住院治疗的复杂 PTSD 患者侵入性记忆的发生。

方法

在这项开放标签的单病例系列研究中,20 名长期患有复杂 PTSD 的住院患者在住院期间监测侵入性创伤记忆(侵入)的发生情况(5 至 10 周)。患者每周接受一次特定于研究的干预,包括对特定侵入记忆的记忆提醒,然后是 25 分钟的俄罗斯方块游戏。使用了个体内多个基线 AB 设计,即在个体内,每个侵入的基线(“A”,干预前,仅监测)和干预后(“B”)阶段的长度不同。此外,一些侵入从未成为干预的目标。在分析之前,该研究已在 ISRCTN34320836 上进行了注册。

结果

与基线相比,目标侵入的频率平均降低了 64%。相反,在可比时间内,从未针对干预的侵入的频率平均降低了 11%。在 20 名患者中,有 16 名符合我们的标准,表明对干预有“反应”。

结论

结果初步证明,这种简短的行为程序可能会减少长期和复杂 PTSD 中侵入性创伤记忆的发生,在这里在住院环境中进行。这种简单,针对性强的干预措施的潜力为解决 PTSD 的核心临床症状开辟了新的可能性,值得进一步研究。

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