创伤中心创伤敏感瑜伽与认知加工疗法治疗女性退伍军人与军事性创伤相关 PTSD 的试点研究结果。
Findings from a pilot study of Trauma Center Trauma-Sensitive Yoga versus cognitive processing therapy for PTSD related to military sexual trauma among women Veterans.
机构信息
Veterans Affairs Portland Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR 97239, USA; Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA.
Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, GA, USA.
出版信息
Complement Ther Med. 2022 Nov;70:102850. doi: 10.1016/j.ctim.2022.102850. Epub 2022 Jul 9.
OBJECTIVE
The study objective was to explore the preliminary efficacy of trauma-sensitive yoga compared to cognitive processing therapy (CPT) for women Veterans with posttraumatic stress disorder (PTSD) related to military sexual trauma (MST) in a pilot randomized control trial (RCT). We then compared these results to published interim results for the subsequent full-scale RCT.
METHOD
The analytic sample included women Veterans (N = 41) with PTSD related to MST accessing healthcare in a southeastern Veterans Affairs Health Care System. The majority were African American, non-Hispanic (80.5 %). The protocol-driven group interventions, Trauma Center Trauma-Sensitive Yoga (TCTSY; n = 17) and the evidence-based control condition, CPT (n = 24), were delivered weekly for 10 and 12 sessions, respectively. Multilevel linear models (MLM) were used to compare changes over time between the two groups.
RESULTS
The primary outcomes presented here are PTSD symptom severity and diagnosis, assessed using the Clinician Administered PTSD Scale (CAPS) and the PTSD Symptom Checklist (PCL) total scores. PTSD symptom severity on both clinician-administered (CAPS) and self-reported (PCL) measures, improved significantly (p < .005) over time, with large within group effect sizes (0.90-0.99) consistent with the subsequent RCT. Participants in the TCTSY group showed clinically meaningful improvements earlier than the CPT group participants from baseline on the CAPS and PCL Total scores.
CONCLUSIONS
Results support published findings of the effectiveness of TCTSY in the treatment for PTSD related to MST among women Veterans, particularly African American women. TCTSY warrants consideration as an adjunctive, precursor, or concurrent treatment to evidence-based psychotherapies. Future research should include patient preference, men with sexual trauma, and civilian populations.
目的
本研究旨在探索创伤敏感瑜伽（Trauma-sensitive yoga）对比认知加工疗法（Cognitive processing therapy，CPT）对患有与军事性创伤（Military sexual trauma，MST）相关的创伤后应激障碍（Posttraumatic stress disorder，PTSD）的女性退伍军人的初步疗效。该研究采用试点随机对照试验（Randomized control trial，RCT）的方式进行，之后我们将这些结果与后续全面 RCT 的已发表中期结果进行了比较。
方法
分析样本包括在东南部退伍军人事务医疗保健系统就诊的患有 MST 相关 PTSD 的女性退伍军人（N=41）。她们大多数为非裔美国人，非西班牙裔（80.5%）。按照方案进行的团体干预，创伤中心创伤敏感瑜伽（Trauma Center Trauma-sensitive yoga，TCTSY；n=17）和基于证据的对照组，认知加工疗法（Cognitive processing therapy，CPT；n=24），每周进行一次，分别持续 10 次和 12 次。多水平线性模型（Multilevel linear models，MLM）用于比较两组之间随时间的变化。
结果
本研究的主要结果为 PTSD 症状严重程度和诊断，采用临床医生管理 PTSD 量表（Clinician Administered PTSD Scale，CAPS）和 PTSD 症状清单（PTSD Symptom Checklist，PCL）总分进行评估。临床医生管理的（CAPS）和自我报告的（PCL）措施的 PTSD 症状严重程度均随时间显著改善（p<0.005），组内效应量较大（0.90-0.99），与后续 RCT 一致。TCTSY 组的参与者在 CAPS 和 PCL 总分上从基线开始就比 CPT 组的参与者更早地出现了有临床意义的改善。
结论
研究结果支持 TCTSY 对女性退伍军人中与 MST 相关 PTSD 的有效性的已发表研究结果，尤其是对非裔美国女性。TCTSY 值得作为基于证据的心理治疗的辅助、前期或同期治疗进行考虑。未来的研究应包括患者偏好、有性创伤的男性和普通人群。
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