眼动脱敏疗法对印度尼西亚创伤后应激障碍的疗效：一项随机对照试验。

The Effectiveness of Eye Movement Desensitization for Post-traumatic Stress Disorder in Indonesia: A Randomized Controlled Trial.

作者信息

Susanty Eka, Sijbrandij Marit, Srisayekti Wilis, Suparman Yusep, Huizink Anja C

机构信息

Faculty of Psychology, Universitas Jenderal Achmad Yani, Cimahi, Indonesia.

Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.

出版信息

Front Psychol. 2022 Apr 25;13:845520. doi: 10.3389/fpsyg.2022.845520. eCollection 2022.

DOI:10.3389/fpsyg.2022.845520

PMID:35548495

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9081880/

Abstract

OBJECTIVE

Post-traumatic stress disorder (PTSD) may affect individuals exposed to adversity. Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based trauma-focused psychotherapy for PTSD. There is still some debate whether the eye movements (EMs) are an effective component of EMDR. The primary aim of this study was to investigate the effectiveness of Eye Movement Desensitization (EMD) treatment in reducing PTSD symptoms compared to a retrieval-only active control condition. We also investigated whether PTSD symptom reduction was associated with reductions in depression and anxiety, and improvements in quality of life.

METHODOLOGY

Adult PTSD patients ( = 91) were recruited at public psychological services in Jakarta, Bandung and Cimahi, Indonesia. PTSD was diagnosed with the Structured Clinical Interview for DSM-5 disorders (SCID-5). Participants were randomized into: EMD ( = 47) or retrieval-only ( = 44). EMD consisted of clinical history and treatment planning, preparation, assessment, EMs, closure, whereas retrieval-only consisted of the same elements except EMs. Data were collected at baseline (T0), 1-week post-treatment (T1), 1-month follow-up (T2), and 3-months follow-up (T3). Outcome measures included the PTSD Checklist for DSM-5 (PCL-5), Hopkins Symptoms Checklist-25 (HSCL-25), and the World Health Organization Quality of Life-BREF (WHOQoL-BREF). Data were analyzed with linear mixed model analysis in R Statistics.

RESULTS

Although there were main effects of time indicating reductions for both EMD and retrieval-only in PCL-5 and HSCL-25 scores, and improvements in WHOQoL-BREF scores at T1, T2, and T3, no significant differences in PCL-5, HSCL-25, and WHOQoL-BREF total scores between the EMD and retrieval-only groups at T1, T2, and T3 were found (all group x time interaction 's > 0.005).

CONCLUSION

Within a clinical sample of PTSD patients in Indonesia, both EMD and retrieval-only was associated with reductions in symptoms of PTSD, anxiety and depression, and improvements in quality of life, although EMs did not add to the efficacy of the treatments. Further research to examine the underlying mechanisms of EMDR's effective treatment elements in clinical samples is needed.

CLINICAL TRIAL REGISTRATION

[www.ClinicalTrials.gov], identifier [ISRCTN55239132].

摘要

目的

创伤后应激障碍（PTSD）可能会影响经历过逆境的个体。眼动脱敏再处理疗法（EMDR）是一种针对PTSD的循证创伤聚焦心理疗法。眼动（EMs）是否为EMDR的有效组成部分仍存在一些争议。本研究的主要目的是调查与仅进行回忆的主动对照条件相比，眼动脱敏（EMD）治疗在减轻PTSD症状方面的有效性。我们还研究了PTSD症状减轻是否与抑郁和焦虑的减轻以及生活质量的改善有关。

方法

在印度尼西亚雅加达、万隆和芝马墟的公共心理服务机构招募成年PTSD患者（n = 91）。使用《精神疾病诊断与统计手册》第五版（DSM-5）结构化临床访谈（SCID-5）诊断PTSD。参与者被随机分为：EMD组（n = 47）或仅回忆组（n = 44）。EMD包括临床病史和治疗计划、准备、评估、眼动、结束环节，而仅回忆组包括除眼动外的相同环节。在基线（T0）、治疗后1周（T1）、1个月随访（T2）和3个月随访（T3）时收集数据。结局指标包括《精神疾病诊断与统计手册》第五版PTSD检查表（PCL-5）、霍普金斯症状清单-25（HSCL-25）和世界卫生组织生活质量简表（WHOQoL-BREF）。使用R统计软件中的线性混合模型分析数据。

结果

尽管存在时间主效应，表明EMD组和仅回忆组的PCL-5和HSCL-25评分均降低，且T1、T2和T3时WHOQoL-BREF评分有所改善，但在T1、T2和T3时，EMD组和仅回忆组在PCL-5、HSCL-25和WHOQoL-BREF总分上未发现显著差异（所有组×时间交互作用的P值 > 0.005）。