Leiden University Medical Centre, Leiden University, Leiden, the Netherlands.
Alberta Health Services, Edmonton, Ottawa, Canada.
Brain Behav. 2022 Aug;12(8):e2694. doi: 10.1002/brb3.2694. Epub 2022 Jul 18.
Military members and veterans are at elevated risk of treatment-resistant posttraumatic stress disorder (TR-PTSD) due to higher rates of exposure to potentially traumatic events during the course of duty. Knowledge of TR-PTSD is limited, and specific protocols or evidence-based TR-PTSD therapies are lacking. Multimodal motion-assisted memory desensitization and reconsolidation (3MDR) therapy is an emerging intervention for combat-related TR-PTSD. The purpose of this study was to preliminarily assess the effectiveness of 3MDR in addressing TR-PTSD in Canadian military members and veterans.
This study is a longitudinal mixed-methods clinical trial. English-speaking military members and veterans aged 18-60 with TR-PTSD were recruited to participate. The intervention consisted of six sessions of 3MDR therapy. Quantitative data were collected pretreatment, posttreatment, and longitudinally at 1, 3, and 6 months after completion of 3MDR.
Results from the first 11 participants to complete the 3MDR protocol exhibited statistically significant improvement (surviving multiple comparison correction) in clinically administered and self-reported scores for PTSD (CAPS-5 and PCL-5), moral injury (MISS-M-SF), depression (PHQ-9), anxiety (GAD-7), emotional regulation (DERS-18), and resilience (CD-RS-25).
The preliminary and exploratory results from this clinical trial support the growing body of literature illustrating 3MDR as an effective treatment for military-related TR-PTSD. These results are notable given participants' previous lack of success with frontline psychotherapeutic and pharmacological interventions. Given that there are currently very limited treatment options for TR-PTSD, 3MDR could prove to be a valuable treatment option for military members and veterans with TR-PTSD.
由于在服役期间更高的创伤后应激障碍（PTSD）暴露率，军人和退伍军人面临着治疗抵抗性 PTSD（TR-PTSD）的风险增加。对 TR-PTSD 的了解有限，缺乏特定的协议或循证治疗 TR-PTSD 的方法。多模态运动辅助记忆脱敏和再巩固（3MDR）疗法是一种新兴的针对与战斗相关的 TR-PTSD 的干预措施。本研究的目的是初步评估 3MDR 治疗加拿大军人和退伍军人 TR-PTSD 的有效性。
这是一项纵向混合方法临床试验。招募了年龄在 18-60 岁之间、患有 TR-PTSD 的讲英语的军人和退伍军人参加。干预措施包括 6 次 3MDR 治疗。在治疗结束后 1、3 和 6 个月，进行了定量数据收集，同时也收集了治疗前、治疗后和纵向的数据。
完成 3MDR 方案的前 11 名参与者的结果显示，在 PTSD（CAPS-5 和 PCL-5）、道德伤害（MISS-M-SF）、抑郁（PHQ-9）、焦虑（GAD-7）、情绪调节（DERS-18）和韧性（CD-RS-25）的临床评估和自我报告评分上，均有统计学意义上的显著改善（通过多次比较校正幸存）。
本临床试验的初步和探索性结果支持越来越多的文献表明，3MDR 是治疗与军事相关的 TR-PTSD 的有效方法。这些结果值得注意，因为参与者之前在一线心理治疗和药物干预方面没有取得成功。鉴于目前 TR-PTSD 的治疗选择非常有限，3MDR 可能成为 TR-PTSD 的军人和退伍军人的一种有价值的治疗选择。
