U.S. Department of Veterans Affairs (VA) Portland Health Care System, Portland, Oregon (Wagner, Kowalski); Department of Psychiatry, Oregon Health and Science University, Portland (Wagner); VA National Telemental Health Hub, Continental Region, Salt Lake City (Jakupcak); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Jakupcak); Department of Psychiatry, University of California, San Diego, La Jolla (Golshan). Dr. Bittinger, who was with the VA Puget Sound Health Care System, is now deceased.
Psychiatr Serv. 2019 Oct 1;70(10):867-873. doi: 10.1176/appi.ps.201800572. Epub 2019 Jul 24.
Although evidence-based, trauma-processing treatments exist for posttraumatic stress disorder (PTSD), many individuals do not seek out, complete, or fully respond to these treatments, pointing to the need for alternative treatments. In this study, the authors evaluated the effectiveness of behavioral activation therapy modified to address PTSD among veterans.
In a randomized trial, behavioral activation was compared with treatment as usual (referral to PTSD "standard care") among a sample of 80 veterans of the wars in Iraq and Afghanistan who were enrolled at the U.S. Department of Veterans Affairs (VA) Portland Health Care System and the VA Puget Sound Health Care System.
Levels of PTSD symptoms decreased for both groups across posttreatment and at 3-month follow-up as measured by clinical interview and self-report measures. The behavioral activation group had greater improvement on PTSD as evidenced by the self-report measure of symptom severity. Both groups also showed improvement on self-report measures of depression and overall functioning across time, with greater improvement on depression evidenced by the behavioral activation group. Ratings of treatment satisfaction were high for both groups.
Behavioral activation is a promising alternative treatment for PTSD.
尽管有循证的创伤后应激障碍（PTSD）处理治疗方法，但许多人并不寻求、完成或完全对这些治疗方法做出反应，这表明需要替代治疗方法。在这项研究中，作者评估了针对退伍军人 PTSD 而修改的行为激活疗法的有效性。
在一项随机试验中，行为激活疗法与作为常规治疗（转诊至 PTSD“标准护理”）进行了比较，共有 80 名参加美国退伍军人事务部（VA）波特兰医疗保健系统和 VA 普吉特湾医疗保健系统的伊拉克和阿富汗战争退伍军人入组。
通过临床访谈和自我报告措施测量，两组 PTSD 症状的严重程度在治疗后和 3 个月随访时均有所下降。行为激活组在 PTSD 方面的改善程度更大，这表现在症状严重程度的自我报告测量上。两组在抑郁和整体功能的自我报告测量上也随着时间的推移而有所改善，行为激活组在抑郁方面的改善程度更大。两组对治疗满意度的评价均较高。
行为激活是一种有前途的 PTSD 替代治疗方法。
