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技能训练在情感和人际调节叙事治疗中的应用:以日本 ICD-11 复杂创伤后应激障碍相关童年期受虐女性为研究对象的一项试点研究。

Skills Training in Affective and Interpersonal Regulation Narrative Therapy for women with ICD-11 complex PTSD related to childhood abuse in Japan: a pilot study.

机构信息

Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.

Japan Society for the Promotion of Science, Tokyo, Japan.

出版信息

Eur J Psychotraumatol. 2022 Jun 8;13(1):2080933. doi: 10.1080/20008198.2022.2080933. eCollection 2022.

Abstract

BACKGROUND

Skills Training in Affective and Interpersonal Regulation (STAIR) Narrative Therapy (SNT) has shown efficacy in alleviating symptoms of posttraumatic stress disorder (PTSD) and improving emotion regulation and interpersonal skills among individuals with complex trauma, such as childhood abuse. Although this therapy is expected to be effective for patients with complex PTSD (CPTSD), no study has directly assessed diagnostic and symptom outcomes. Moreover, the potential of therapy to achieve good outcomes in non-Western countries remains unclear.

OBJECTIVE

This pilot study examined the feasibility, safety, and outcomes of SNT for CPTSD among women with a history of childhood abuse in a Japanese clinical setting.

METHODS

Ten women aged 21-54 years ( = 29.1 years) with childhood-abuse-related ICD-11 CPTSD were enrolled in this study. The International Trauma Interview and International Trauma Questionnaire were administered to diagnose CPTSD and assess its severity. Symptoms of dissociation and depression, difficulties in emotion regulation and interpersonal relationships, quality of life, and negative cognitions were assessed pretreatment, midtreatment (after the STAIR phase), and immediately posttreatment (after the Narrative Therapy phase), in addition to 3 months after treatment.

RESULTS

Seven of the 10 participants completed the treatment. The therapists' adherence to the therapy protocol was 96.4%, ranging from 93.6% to 100% across therapists. Serious adverse events were not observed. Among the seven completers, six at posttreatment and all at follow-up no longer met CPTSD diagnosis. Exploratory analyses using the linear mixed-effects model showed significant improvements at posttreatment and follow-up for almost all the variables.

CONCLUSIONS

The results provide preliminary evidence for the feasibility and safety of SNT for CPTSD in a Japanese clinical setting. This study is the first to report the use of SNT for individuals diagnosed with ICD-11 CPTSD using reliable clinician and self-report measures.

HIGHLIGHTS

This study examined the feasibility and safety of STAIR Narrative Therapy for women with ICD-11 CPTSD related to childhood abuse in a Japanese clinical setting.High therapy adherence was observed.No serious adverse events occurred.

摘要

背景

情感与人际调节技能训练(STAIR)叙事治疗(SNT)已被证明能有效减轻创伤后应激障碍(PTSD)症状,并改善经历过复杂创伤(如儿童期虐待)的个体的情绪调节和人际交往能力。尽管这种疗法有望对患有复杂创伤后应激障碍(CPTSD)的患者有效,但尚无研究直接评估其诊断和症状结果。此外,该疗法在非西方国家取得良好效果的潜力尚不清楚。

目的

本研究旨在考察 SNT 对日本临床环境中经历过儿童期虐待的 CPTSD 女性的可行性、安全性和疗效。

方法

本研究纳入了 10 名年龄在 21-54 岁(平均 29.1 岁)、有儿童期虐待相关 ICD-11 CPTSD 病史的女性。采用国际创伤访谈和国际创伤问卷进行诊断,并评估其严重程度。在治疗前、治疗中期(STAIR 阶段后)和治疗即刻(叙事治疗阶段后),以及治疗后 3 个月,评估了患者的分离和抑郁症状、情绪调节和人际关系困难、生活质量和负性认知。

结果

10 名参与者中有 7 名完成了治疗。治疗师对治疗方案的依从性为 96.4%,各治疗师的依从性在 93.6%-100%之间。未观察到严重不良事件。7 名完成治疗的患者中,6 名在治疗后和所有患者在随访时均不再符合 CPTSD 诊断。使用线性混合效应模型进行的探索性分析显示,大多数变量在治疗后和随访时均有显著改善。

结论

本研究结果为 SNT 在日本临床环境中治疗 CPTSD 的可行性和安全性提供了初步证据。这是首次使用可靠的临床医生和自我报告评估工具,报告 SNT 用于 ICD-11 CPTSD 患者的治疗。

重点

本研究考察了 STAIR 叙事治疗对日本临床环境中经历过儿童期虐待的 ICD-11 CPTSD 女性的可行性和安全性。

观察到较高的治疗依从性。

未发生严重不良事件。

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