Faillace Department of Psychiatry, University of Texas Health Science Center at Houston, United States; Ralph H. Johnson VA Medical Center, Charleston, SC, United States.
Department of Psychology, University of Nebraska-Lincoln, NE, United States.
J Anxiety Disord. 2021 Oct;83:102461. doi: 10.1016/j.janxdis.2021.102461. Epub 2021 Aug 8.
Posttraumatic stress disorder (PTSD) is common in women who experienced Military Sexual Trauma (MST). Despite Veterans Affairs Medical Center-wide screening and tailored MST services, substantial barriers to care exist, and about 50 % of those who start evidence-based treatment for PTSD drop out prematurely. Home-based telemedicine (HBT) may reduce logistical and stigma related barriers to mental health care, thereby reducing dropout. The current randomized clinical trial (NCT02417025) for women veterans with MST-related PTSD (N = 136) compared the efficacy of HBT delivery of Prolonged Exposure (PE) to in-person delivery of PE on measures of PTSD and depression, as well as on "PE dose" received. Hypotheses predicted that women in the HBT PE group would complete more sessions, and evince greater PTSD and depression symptom reduction compared to in-person PE. Results revealed that there were no differences in dose received or PTSD symptom reduction between in-person and HBT conditions; however, dose (i.e., more sessions) was related to reduced PTSD symptom severity. Future research should examine other factors associated with high PTSD treatment dropout among MST patients.
创伤后应激障碍（PTSD）在经历过军事性创伤（MST）的女性中很常见。尽管退伍军人事务医疗中心进行了广泛的筛查，并提供了针对性的 MST 服务，但仍存在大量的护理障碍，大约有 50%的 PTSD 接受基于证据的治疗的患者提前退出。基于家庭的远程医疗（HBT）可能会减少与心理健康护理相关的后勤和耻辱感障碍，从而减少患者退出治疗的情况。目前针对与 MST 相关 PTSD 的女性退伍军人（N = 136）的随机临床试验（NCT02417025）比较了 HBT 提供的延长暴露（PE）与面对面提供的 PE 在 PTSD 和抑郁测量上的疗效，以及“PE 剂量”的接受情况。假设预测 HBT-PE 组的女性会完成更多的疗程，并且与面对面 PE 相比，PTSD 和抑郁症状的减轻程度更大。结果表明，面对面和 HBT 条件之间在接受的剂量或 PTSD 症状减轻方面没有差异；然而，剂量（即更多疗程）与 PTSD 症状严重程度的降低有关。未来的研究应探讨与 MST 患者 PTSD 治疗高退出率相关的其他因素。
