van Minnen Agnes, van Dalen Birgit, Voorendonk Eline M, Wagenmans Anouk, de Jongh Ad
Behavioural Science Institute (BSI), Radboud University Nijmegen, Nijmegen, The Netherlands.
Research Department, Research Department PSYTREC, Bilthoven, The Netherlands.
Eur J Psychotraumatol. 2020 Aug 11;11(1):1794729. doi: 10.1080/20008198.2020.1794729.
It is often assumed that individuals with posttraumatic stress disorder (PTSD) who overreport their symptoms should be excluded from trauma-focused treatments.
To investigate the effects of a brief, intensive trauma-focused treatment programme for individuals with PTSD who are overreporting symptoms.
Individuals ( = 205) with PTSD participated in an intensive trauma-focused treatment programme consisting of EMDR and prolonged exposure (PE) therapy, physical activity and psycho-education. Assessments took place at pre- and post-treatment (Structured Inventory of Malingered Symptomatology; SIMS, Clinician Administered PTSD Scale for DSM-5; CAPS-5).
Using a high SIMS cut-off of 24 or above, 14.1% ( = 29) had elevated SIMS scores (i.e. 'overreporters'). The group of overreporters showed significant decreases in PTSD-symptoms, and these treatment results did not differ significantly from other patients. Although some patients (35.5%) remained overreporters at post-treatment, SIMS scores decreased significantly during treatment.
The results suggest that an intensive trauma-focused treatment not only is a feasible and safe treatment for PTSD in general, but also for individuals who overreport their symptoms.
人们通常认为，那些过度报告自身症状的创伤后应激障碍（PTSD）患者应被排除在以创伤为重点的治疗之外。
探讨针对过度报告症状的PTSD患者开展简短、强化的以创伤为重点的治疗方案的效果。
205名PTSD患者参加了一个强化的以创伤为重点的治疗方案，该方案包括眼动脱敏再处理（EMDR）和延长暴露（PE）疗法、体育活动和心理教育。在治疗前和治疗后进行评估（伪装症状结构化量表；SIMS，临床医生用DSM-5创伤后应激障碍量表；CAPS-5）。
使用24分及以上的高SIMS临界值，14.1%（29名）患者的SIMS得分升高（即“过度报告者”）。过度报告者组的PTSD症状显著减轻，且这些治疗结果与其他患者相比无显著差异。尽管一些患者（35.5%）在治疗后仍为过度报告者，但治疗期间SIMS得分显著下降。
结果表明，强化的以创伤为重点的治疗不仅总体上是一种可行且安全的PTSD治疗方法，而且对那些过度报告症状的患者也是如此。
