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比较针对老年人和年轻人创伤后应激障碍(PTSD)症状严重程度的强化创伤聚焦治疗效果

Comparing Intensive Trauma-Focused Treatment Outcome on PTSD Symptom Severity in Older and Younger Adults.

作者信息

Gielkens Ellen M J, de Jongh Ad, Sobczak Sjacko, Rossi Gina, van Minnen Agnes, Voorendonk Eline M, Rozendaal Linda, van Alphen Sebastiaan P J

机构信息

Clinical Center of Excellence for Older Adults with Personality Disorders, Mondriaan, 6419 PJ Heerlen-Maastricht, The Netherlands.

Personality and Psychopathology Research Group (PEPS), Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium.

出版信息

J Clin Med. 2021 Mar 17;10(6):1246. doi: 10.3390/jcm10061246.

Abstract

OBJECTIVE

To examine the treatment outcome of an intensive trauma-focused treatment program for post-traumatic stress disorder (PTSD) in older and younger adults.

METHODS

A non-randomized outcome study was conducted with 62 consecutively admitted older PTSD patients (60-78 years) and 62 younger PTSD patients (19-58 years), matched on gender and availability of follow-up data. Patients participated in an intensive eight-day trauma-focused treatment program consisting of eye movement desensitization and reprocessing (EMDR), prolonged exposure (PE), physical activity, and group psycho-education. PTSD symptom severity (Clinician-Administered PTSD Scale-5 (CAPS-5)) was assessed, at pre- and post-treatment, and for a subsample ( = 31 older; = 31 younger patients) at six-month follow-up.

RESULTS

A repeated-measures ANCOVA (centered CAPS pre-treatment score as covariate) indicated a significant decrease in CAPS-5-scores from pre- to post-treatment for the total sample (partial = 0.808). The treatment outcome was not significantly different across age groups (partial = 0.002). There were no significant differences in treatment response across age groups for the follow-up subsample (pre- to post-treatment partial < 0.001; post-treatment to follow-up partial = 0.006), and the large decrease in CAPS-5 scores from pre- to post-treatment (partial = 0.76) was maintained at follow-up (partial = 0.003).

CONCLUSION

The results suggest that intensive trauma-focused treatment is applicable for older adults with PTSD with a large within-effect size comparable to younger participants. Further research on age-related features is needed to examine whether these results can be replicated in the oldest-old (>80).

摘要

目的

研究针对老年人和年轻人创伤后应激障碍(PTSD)的强化创伤聚焦治疗方案的治疗效果。

方法

进行了一项非随机结果研究,纳入62例连续入院的老年PTSD患者(60 - 78岁)和62例年轻PTSD患者(19 - 58岁),根据性别和随访数据可用性进行匹配。患者参加了为期八天的强化创伤聚焦治疗方案,包括眼动脱敏再处理(EMDR)、延长暴露(PE)、体育活动和团体心理教育。在治疗前和治疗后评估PTSD症状严重程度(临床医生管理的PTSD量表-5(CAPS-5)),并对一个子样本(31例老年患者;31例年轻患者)进行六个月的随访评估。

结果

重复测量协方差分析(以治疗前CAPS评分作为协变量进行中心化)表明,总样本的CAPS-5评分从治疗前到治疗后显著降低(偏η² = 0.808)。各年龄组的治疗效果无显著差异(偏η² = 0.002)。随访子样本中各年龄组的治疗反应无显著差异(治疗前到治疗后偏η² < 0.001;治疗后到随访偏η² = 0.006),并且从治疗前到治疗后CAPS-5评分的大幅下降(偏η² = 0.76)在随访时得以维持(偏η² = 0.003)。

结论

结果表明,强化创伤聚焦治疗适用于患有PTSD的老年人,其内部效应量与年轻参与者相当。需要对与年龄相关的特征进行进一步研究,以检验这些结果是否能在年龄更大的老年人(>80岁)中得到重复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4776/8002665/d86771ac7fd8/jcm-10-01246-g001.jpg

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