ArtEZ University of the Artsm, Enschede, The Netherlands.
Tactus, Addiction Care Twente, Enschede, The Netherlands.
J Music Ther. 2020 Jul 18;57(3):353-378. doi: 10.1093/jmt/thaa007.
Patients diagnosed with both substance use disorder (SUD) and posttraumatic stress disorder (PTSD) often experience hypervigilance, increased fear, and difficulties regulating emotions. This dual diagnosis increases treatment complexity. Recently, a short-term music therapy intervention for arousal and attention regulation (the SMAART intervention) was designed based on neurobiological findings. Twelve patients with SUD and PTSD (50% females) in outpatient treatment participated in six weekly one-hour sessions of the SMAART intervention. Six patients completed the study. PTSD symptom severity was evaluated with the Posttraumatic Stress Disorder Symptom Scale Interview for DSM-5 (PSSI-5) pre- and post-intervention, and sustained attention was evaluated with the Bourdon-Wiersma (BW) test. A significant difference in measurements for the PSSI-5 overall symptom severity was found pre- and post-intervention. Furthermore, participants showed significant improvement on subscales of hyperarousal, mood and cognition, and attention. The BW test completion time decreased significantly. Two participants dropped out before the end of the intervention due to craving. Concerning future research, it is recommended to define the role of the music more explicitly and to change the design to a randomized controlled trial. A risk for future larger studies is a high dropout rate (50%). Several limitations of the study are discussed.
患有物质使用障碍(SUD)和创伤后应激障碍(PTSD)的患者通常会出现警觉过度、恐惧增加和情绪调节困难。这种双重诊断增加了治疗的复杂性。最近,根据神经生物学发现,设计了一种用于唤醒和注意力调节的短期音乐治疗干预(SMAART 干预)。12 名门诊治疗的 SUD 和 PTSD 患者(50%为女性)参加了 6 周每周 1 小时的 SMAART 干预。6 名患者完成了研究。使用 DSM-5 创伤后应激障碍症状量表访谈(PSSI-5)在干预前后评估 PTSD 症状严重程度,使用 Bourdon-Wiersma(BW)测试评估持续注意力。发现 PSSI-5 总体症状严重程度的测量值在干预前后存在显著差异。此外,参与者在过度警觉、情绪和认知以及注意力等子量表上的表现均有显著改善。BW 测试完成时间显著缩短。由于渴望,有 2 名参与者在干预结束前退出。关于未来的研究,建议更明确地定义音乐的作用,并将设计改为随机对照试验。未来更大规模研究的风险是高辍学率(50%)。讨论了该研究的一些局限性。