Kelly Megan M, Reilly Erin D, Ameral Victoria, Richter Stephanie, Fukuda Seiya
VISN 1 New England Mental Illness Research, Education, and Clinical Center, VA Bedford Healthcare System, Bedford, MA 01730, USA.
Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA.
J Clin Med. 2022 Jun 17;11(12):3482. doi: 10.3390/jcm11123482.
Veterans with PTSD often have substantial interpersonal difficulties and low levels of social support, which puts them at increased risk of mortality, but few treatments address global social impairment for veterans with PTSD. This study is a pilot randomized trial of Acceptance and Commitment Therapy to Improve Social Support for Veterans with PTSD (ACT-SS), a psychotherapy that targets social avoidance and eroded social relationships, compared to Person-Centered Therapy (PCT), a non-directive psychotherapy. Participants were randomized to twelve sessions of either ACT-SS ( = 21) or PCT ( = 19). The results showed that veterans with PTSD had high ratings of satisfaction for both treatments. Contrary to the PCT group, participants in the ACT-SS group showed a significant improvement in the quality of social relationships, engagement in social and leisure activities, and PTSD symptoms from the baseline assessment to the end of treatment and a three-month follow-up. Veterans in the ACT-SS group, but not the PCT group, also showed significant improvements in mindfulness and valued living and a reduction in experiential avoidance from baseline to the end of treatment, with sustained improvements in valued living at the three-month follow-up. Overall, the present study demonstrated the feasibility, acceptability, and positive preliminary outcomes of ACT-SS for veterans with PTSD.
患有创伤后应激障碍（PTSD）的退伍军人通常存在严重的人际困难且社会支持水平较低，这使他们面临更高的死亡风险，但很少有治疗方法能解决PTSD退伍军人的整体社会功能损害问题。本研究是一项关于“接受与承诺疗法改善PTSD退伍军人社会支持（ACT-SS）”的试点随机试验，这是一种针对社交回避和受损社会关系的心理治疗方法，与非指导性心理治疗“以人为中心疗法（PCT）”进行对比。参与者被随机分配接受12节ACT-SS治疗（n = 21）或PCT治疗（n = 19）。结果显示，患有PTSD的退伍军人对两种治疗的满意度都很高。与PCT组相反，ACT-SS组的参与者从基线评估到治疗结束及三个月随访期间，在社会关系质量、参与社交和休闲活动以及PTSD症状方面均有显著改善。ACT-SS组的退伍军人（而非PCT组）从基线到治疗结束时在正念和有价值生活方面也有显著改善，体验性回避减少，且在三个月随访时，有价值生活持续改善。总体而言，本研究证明了ACT-SS对PTSD退伍军人的可行性、可接受性及积极的初步疗效。
