Gielkens Ellen M J, de Jongh Ad, Sobczak Sjacko, Rossi Gina, van Minnen Agnes, Voorendonk Eline M, Rozendaal Linda, van Alphen Sebastiaan P J
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.
J Clin Med. 2021 Mar 17;10(6):1246. doi: 10.3390/jcm10061246.
To examine the treatment outcome of an intensive trauma-focused treatment program for post-traumatic stress disorder (PTSD) in older and younger adults.
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.
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).
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).
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。
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。
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。
