Atchley Rachel, Bedford Carter
Department of Precision Medicine, Brigham and Women's Hospital, Harvard Medical School , Boston, MA, USA.
Department of Psychology, Florida State University , Tallahassee, FL, USA.
J Trauma Dissociation. 2021 Jan-Feb;22(1):69-88. doi: 10.1080/15299732.2020.1760410. Epub 2020 May 13.
: Research on dissociative symptomatology in the context of Posttraumatic Stress Disorder (PTSD) has been gaining traction, with dissociation being studied as a set of complex symptoms following trauma exposure and as a specific subtype of PTSD. The aims of this review are to summarize the literature as it stands, examine the efficacy of existing interventions in treating dissociative symptomatology within the context of PTSD, and offer potential suggestions for future research. : A systematic approach was taken to locate empirical studies on PTSD that included dissociation as an outcome in the PubMed, Scopus, and PsycINFO databases. Recent experimental designs with adult subjects (18+ years) in the English language were included, yielding 103 potentially eligible studies. Thirty-three full-text articles were screened with 17 articles meeting criteria for inclusion in the systematic review. : Designs, populations, treatments, and inventories were extremely diverse. Most therapies did not target dissociation specifically, although the results of this review suggest that PTSD patients who experience dissociative symptoms could benefit from trauma-focused treatments, which often significantly reduced dissociative and trauma-related symptoms. : Future work should consider the evaluation of dissociation as a unique outcome to gain understanding about the nature of traumatic stress and to develop treatment options for its many presentations. The current literature displays limited generalizability to the treatment of individuals with high dissociation, which is a line of inquiry that should be explored. More RCTs are needed.
创伤后应激障碍(PTSD)背景下的分离症状学研究越来越受到关注,分离被视为创伤暴露后的一组复杂症状以及PTSD的一种特定亚型。本综述的目的是总结当前的文献,考察现有干预措施在治疗PTSD背景下的分离症状方面的疗效,并为未来研究提供潜在建议。
采用系统的方法在PubMed、Scopus和PsycINFO数据库中查找将分离作为结果的PTSD实证研究。纳入了近期以成年受试者(18岁及以上)为对象的英文实验设计,共得到103项可能符合条件的研究。对33篇全文进行筛选,其中17篇符合纳入系统综述的标准。
研究设计、研究对象、治疗方法和量表极为多样。大多数疗法并非专门针对分离症状,尽管本综述结果表明,经历分离症状的PTSD患者可能会从以创伤为重点的治疗中获益,这类治疗通常能显著减轻分离症状和与创伤相关的症状。
未来的研究应考虑将分离作为一个独特的结果进行评估,以了解创伤应激的本质,并为其多种表现形式开发治疗方案。目前的文献对高分离个体治疗的普遍适用性有限,这是一个值得探索的研究方向。需要更多的随机对照试验。
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