Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland.
Department of Psychology, Uppsala University, Uppsala, Sweden.
J Affect Disord. 2022 Apr 15;303:64-73. doi: 10.1016/j.jad.2022.01.108. Epub 2022 Jan 30.
Intrusive memories (IMs) of traumatic events are a key symptom of posttraumatic stress disorder (PTSD), and contribute to its maintenance. This translational proof-of-principle study tested whether a single-session behavioural intervention reduced the number of childbirth-related IMs (CB-IMs) and childbirth-related PTSD (CB-PTSD) symptoms, in women traumatised by childbirth. The intervention was assumed to disrupt trauma memory reconsolidation.
In this pre-post study, 18 participants, whose traumatic childbirth had occurred between seven months and 6.9 years before, received an intervention combining childbirth-related reminder cues (including the return to maternity unit) with a visuospatial task. They recorded their daily CB-IMs in the two weeks pre-intervention (diary 1), the two weeks post-intervention (diary 2; primary outcome), and in week 5 and 6 post-intervention (diary 3). CB-PTSD symptom severity was assessed five days pre-intervention and one month post-intervention.
Compared to diary 1, 15/18 participants had ≥ 50% fewer CB-IMs in diary 2. The median (IQR) reduction of the number of CB-IMs was 81.89% (39.58%) in diary 2, and persisted in diary 3 (n = 17). At one month post-intervention, CB-PTSD symptom severity was reduced by ≥ 50% in 10/18 participants. Of the 8 participants with a CB-PTSD diagnosis pre-intervention, none met diagnostic criteria post-intervention. The intervention was rated as highly acceptable.
The design limits the causal interpretation of observed improvements.
This is the first time such a single-session behavioural intervention was tested for old and real-life single-event trauma. The promising results justify a randomized controlled trial, and may be a first step toward an innovative CB-PTSD treatment.
创伤后应激障碍(PTSD)的一个关键症状是对创伤事件的侵入性记忆(IM),且其会导致 PTSD 的持续存在。这项转化原理验证研究旨在检验单次行为干预是否能减少分娩相关创伤(CB)的 IM 数量和分娩相关 PTSD(CB-PTSD)症状,这些女性曾遭受分娩创伤。干预措施假设可以破坏创伤记忆的再巩固。
在这项前后研究中,18 名参与者在分娩创伤发生后 7 个月至 6.9 年前接受了一项干预措施,该措施将分娩相关的提醒线索(包括返回产科病房)与视觉空间任务相结合。在干预前两周(日记 1)、干预后两周(日记 2;主要结果)和干预后第 5 周和第 6 周(日记 3),她们记录了自己每天的 CB-IM。在干预前 5 天和干预后 1 个月评估了 CB-PTSD 症状严重程度。
与日记 1 相比,15/18 名参与者在日记 2 中的 CB-IM 减少了≥50%。日记 2 中 CB-IM 数量的中位数(IQR)减少了 81.89%(39.58%),且在日记 3 中持续减少(n=17)。在干预后 1 个月,18 名参与者中有 10 名的 CB-PTSD 症状严重程度降低了≥50%。在干预前患有 CB-PTSD 诊断的 8 名参与者中,没有人在干预后符合诊断标准。该干预措施被评为高度可接受。
设计限制了对观察到的改善的因果解释。
这是首次对旧的和现实生活中的单一事件创伤进行单次行为干预的测试。有希望的结果证明了进行随机对照试验的合理性,并且可能是分娩 PTSD 创新治疗的第一步。