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针对患有创伤后应激障碍(PTSD)和轻度智力残疾的家庭开展的强化创伤聚焦治疗项目的可行性及潜在效果。

Feasibility and potential effectiveness of an intensive trauma-focused treatment programme for families with PTSD and mild intellectual disability.

作者信息

Mevissen Liesbeth, Ooms-Evers Marjolein, Serra Marike, de Jongh Ad, Didden Robert

机构信息

Trajectum, Zwolle, The Netherlands.

Ambiq, Hoogeveen, The Netherlands.

出版信息

Eur J Psychotraumatol. 2020 Jul 14;11(1):1777809. doi: 10.1080/20008198.2020.1777809.

Abstract

BACKGROUND

Persons with mild intellectual disabilities or borderline intellectual functioning (MID-BIF; IQ 50-85) have a higher risk of being exposed to traumatic events and developing posttraumatic stress disorder (PTSD). EMDR therapy has shown to be applicable, safe and potentially effective for the treatment of PTSD in individuals with MID-BIF. However, in traumatized multi-problem families with MID-BIF and (impending) out of home placement of children, standard PTSD treatment in an outpatient setting may not be appropriate.

OBJECTIVE

To evaluate the feasibility and potential effectiveness of KINGS-ID, a six-week clinical trauma-focused treatment programme consisting of intensive EMDR therapy with parents and children, and parental skills training followed by two weeks of parent support at home.

METHOD

Six families (nine parents of whom six had MID-BIF) and 10 children (all having MID-BIF) participated in the KINGS-ID programme. Seven parents and seven children had PTSD. Data were collected within a single case study design. For each family member data were collected during baseline (three measurements), treatment (seven weekly measurements), posttreatment (three measurements) and at follow-up (three measurements).

RESULTS

None of the family members dropped out. Within the first two treatment weeks all but one child and one parent no longer met PTSD symptom criteria. In both children and parents, trauma-related symptoms and daily life impairment significantly decreased following treatment and in parents a significant decrease in symptoms of general psychopathology and parental stress was found. Results were maintained at six-month follow-up.

CONCLUSIONS

The findings of the current study are promising given that the treatment programme seems to offer new perspectives for traumatized multi-problem families with MID-BIF.

摘要

背景

轻度智力残疾或边缘智力功能障碍(MID - BIF;智商50 - 85)的人群遭受创伤性事件并患上创伤后应激障碍(PTSD)的风险更高。眼动脱敏再处理(EMDR)疗法已被证明适用于患有MID - BIF的个体治疗PTSD,且安全且可能有效。然而,在有MID - BIF且(即将)面临儿童离家安置问题的受创伤多问题家庭中,门诊环境下的标准PTSD治疗可能并不合适。

目的

评估KINGS - ID的可行性和潜在有效性,这是一个为期六周、以临床创伤为重点的治疗项目,包括与父母和孩子一起进行强化EMDR治疗、父母技能培训,随后在家中进行两周的父母支持。

方法

六个家庭(九名父母,其中六名患有MID - BIF)和十名儿童(均患有MID - BIF)参与了KINGS - ID项目。七名父母和七名儿童患有PTSD。数据收集采用单病例研究设计。对于每个家庭成员,在基线期(三次测量)、治疗期(每周测量七次)、治疗后(三次测量)和随访期(三次测量)收集数据。

结果

没有家庭成员退出。在治疗的前两周内,除一名儿童和一名父母外,其他所有人都不再符合PTSD症状标准。在儿童和父母中,治疗后与创伤相关的症状和日常生活功能损害均显著降低,并且在父母中,发现一般精神病理学症状和父母压力也显著降低。六个月随访时结果得以维持。

结论

鉴于该治疗项目似乎为患有MID - BIF的受创伤多问题家庭提供了新的视角,本研究结果很有前景。

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Child protection services and parents with intellectual and developmental disabilities.儿童保护服务与智力和发育障碍的父母。
J Appl Res Intellect Disabil. 2017 May;30(3):521-532. doi: 10.1111/jar.12323. Epub 2016 Dec 21.

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