Hamilton Tristin, Burback Lisa, Smith-MacDonald Lorraine, Jones Chelsea, Brown Matthew R G, Mikolas Cynthia, Tang Emily, O'Toole Kaitlin, Vergis Priyanka, Merino Anna, Weiman Kyle, Vermetten Eric H G J M, Brémault-Phillips Suzette
Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Front Psychiatry. 2021 Dec 22;12:779829. doi: 10.3389/fpsyt.2021.779829. eCollection 2021.
Military members and Veterans are at risk of developing combat-related, treatment-resistant posttraumatic stress disorder (TR-PTSD) and moral injury (MI). Conventional trauma-focused therapies (TFTs) have shown limited success. Novel interventions including Multi-modal Motion-assisted Memory Desensitization and Reconsolidation therapy (3MDR) may prove successful in treating TR-PTSD. To qualitatively study the experiences of Canadian military members and Veterans with TR-PTSD who received the 3MDR intervention. This study explored qualitative data from a larger mixed-method waitlist control trial testing the efficacy of 3MDR in military members and veterans. Qualitative data were recorded and collected from 3MDR sessions, session debriefings and follow-up interviews up to 6 months post-intervention; the data were then thematically analyzed. Three themes emerged from the data: (1) the participants' experiences with 3MDR; (2) perceived outcomes of 3MDR; and (3) keys to successful 3MDR treatment. Participants expressed that 3MDR provided an immersive environment, active engagement and empowerment. The role of the therapist as a coach and "fireteam partner" supports the participants' control over their therapy. The multi-modal nature of 3MDR, combining treadmill-walking toward self-selected trauma imagery with components of multiple conventional TFTs, was key to helping participants engage with and attribute new meaning to the memory of the traumatic experience. Preliminary thematic analysis of participant experiences of 3MDR indicate that 3MDR has potential as an effective intervention for combat-related TR-PTSD, with significant functional, well-being and relational improvements reported post-intervention. Military members and Veterans are at risk of developing TR-PTSD, with worse outcomes than in civilians. Further research is needed into 3MDR and its use with other trauma-affected populations.
军人和退伍军人有患与战斗相关的、难治性创伤后应激障碍（TR-PTSD）和道德损伤（MI）的风险。传统的以创伤为重点的疗法（TFTs）成效有限。包括多模式运动辅助记忆脱敏与重新巩固疗法（3MDR）在内的新型干预措施可能在治疗TR-PTSD方面取得成功。为了定性研究接受3MDR干预的患有TR-PTSD的加拿大军人和退伍军人的经历。本研究探索了来自一项更大规模的混合方法等待名单对照试验的定性数据，该试验测试了3MDR对军人和退伍军人的疗效。定性数据记录并收集自3MDR治疗环节、环节汇报以及干预后长达6个月的随访访谈；然后对数据进行主题分析。数据中出现了三个主题：（1）参与者对3MDR的体验；（2）3MDR的感知结果；（3）3MDR治疗成功的关键。参与者表示3MDR提供了一个沉浸式环境、积极参与和赋权。治疗师作为教练和“火力小组伙伴”的角色支持参与者对其治疗的掌控。3MDR的多模式性质，即将朝着自我选择的创伤意象在跑步机上行走与多种传统TFTs的组成部分相结合，是帮助参与者参与并赋予创伤经历记忆新意义的关键。对参与者3MDR体验的初步主题分析表明，3MDR有潜力作为一种针对与战斗相关的TR-PTSD的有效干预措施，干预后报告有显著的功能、幸福感和人际关系改善。军人和退伍军人有患TR-PTSD的风险，且结果比平民更糟。需要对3MDR及其在其他受创伤人群中的应用进行进一步研究。
