Lacefield Katharine, Samph Stephanie Pavlos, Orbon Stephanie, Otis John
Department of Psychology, Washington DC VA Medical Center.
Department of Psychology, VA San Diego Healthcare System.
Psychol Trauma. 2020 Oct;12(7):725-729. doi: 10.1037/tra0000635. Epub 2020 Aug 6.
Posttraumatic stress disorder (PTSD) and fibromyalgia syndrome (FMS) are two commonly co-occurring conditions among women veterans. Each contributes to functional impairment that is compounded in those with both diagnoses. This emphasizes the need for integrated evidence-based treatments aimed at reducing symptoms of both. This pilot study examined feasibility and preliminary effectiveness of an integrated treatment combining elements of cognitive behavioral therapy for chronic pain and cognitive processing therapy in a small sample of women veterans with PTSD and FMS.
Participants completed 12 sessions of an integrated treatment for PTSD and FMS, and symptoms of PTSD, FMS, and depression were evaluated using the PTSD Checklist-Civilian (PCL-C), Fibromyalgia Impact Questionnaire-Revised (FIQR), and Patient Health Questionnaire-9 (PHQ-9), respectively. Data were analyzed by identification of trends in scores due to small sample size.
Five of 11 eligible veterans completed all 12 sessions of the treatment. The mean pretreatment score on the FIQR was 82.81, and the mean pretreatment PCL-C score was 72.5. At posttreatment, the mean FIQR score decreased to 68.9 and the PCL-C score decreased to 60.8. The average reduction on PHQ-9 scores was 11 points, and all participants reported high satisfaction with treatment.
Preliminary results suggest that integrated treatment of PTSD and FMS symptoms may help to improve chronic pain, PTSD, and depressive symptoms in women veterans with PTSD, in light of several identified limitations. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
创伤后应激障碍(PTSD)和纤维肌痛综合征(FMS)是女性退伍军人中两种常见的共病情况。每种情况都会导致功能损害,而在同时患有这两种疾病的患者中,这种损害会更加严重。这凸显了需要采用基于证据的综合治疗方法来减轻这两种疾病的症状。这项试点研究在一小群患有PTSD和FMS的女性退伍军人样本中,检验了一种结合慢性疼痛认知行为疗法和认知加工疗法要素的综合治疗方法的可行性和初步有效性。
参与者完成了12节针对PTSD和FMS的综合治疗课程,并分别使用创伤后应激障碍检查表-平民版(PCL-C)、纤维肌痛影响问卷修订版(FIQR)和患者健康问卷-9(PHQ-9)对PTSD、FMS和抑郁症状进行了评估。由于样本量较小,通过识别分数趋势来分析数据。
11名符合条件的退伍军人中有5人完成了全部12节治疗课程。FIQR的平均治疗前分数为82.81,PCL-C的平均治疗前分数为72.5。治疗后,FIQR的平均分数降至68.9,PCL-C的分数降至60.8。PHQ-9分数的平均降低值为11分,所有参与者对治疗的满意度都很高。
初步结果表明,鉴于已确定的一些局限性,对患有PTSD的女性退伍军人进行PTSD和FMS症状的综合治疗可能有助于改善慢性疼痛、PTSD和抑郁症状。(PsycInfo数据库记录(c)2020美国心理学会,保留所有权利)