University of Ottawa, School of Psychology, Ottawa, Ontario, Canada; Research Center of the Douglas Mental Health University Institute, Montreal, Québec, Canada.
Research Center of the Douglas Mental Health University Institute, Montreal, Québec, Canada; University of Sherbrooke, Department of Psychology, Longueuil, Québec, Canada.
J Affect Disord. 2022 Nov 15;317:98-106. doi: 10.1016/j.jad.2022.08.082. Epub 2022 Aug 27.
In a sustained relationship, romantic betrayal is a catastrophic event that can precipitate an adjustment disorder (AD). Surprisingly, there exists no empirically validated treatment for AD, despite its high prevalence in clinical practice. Considering the promise of memory reactivation under propranolol (i.e., reconsolidation interference) for treating posttraumatic stress disorder, we sought to extend this finding to AD, given that in both disorders, symptoms stem from an identified stressor.
A single-blind interrupted time series design was used to examine the efficacy of memory reactivation under propranolol to alleviate symptoms of AD. After being placed on a 4-week waitlist, sixty-one participants received 5 weekly 25-min treatments during which they recalled the betrayal event, 1 h after having orally ingested the beta-blocker propranolol.
Segmented regression analyses on the intent-to-treat sample revealed that AD symptoms significantly decreased during the treatment phase (pre/post Cohen's d = 1.44), compared to the waitlist phase (d = 0.01). Significant pre/post reductions in anxio-depressive symptomatology were also found. Improvement was maintained at the 4-month follow-up on all outcomes.
Memory reactivation under propranolol shows promise in reducing symptoms of AD. This study provides the theoretical framework and necessary effect sizes to inform larger, double-blind, placebo-controlled clinical trials.
在稳定的关系中，浪漫的背叛是灾难性的事件，可能会导致适应障碍（AD）。令人惊讶的是，尽管 AD 在临床实践中很普遍，但仍没有经过验证的治疗方法。考虑到普萘洛尔（即再巩固干扰）在治疗创伤后应激障碍方面激活记忆的潜力，鉴于在这两种疾病中，症状都源于已确定的应激源，我们试图将这一发现扩展到 AD。
采用单盲中断时间序列设计来检验普萘洛尔下记忆再激活缓解 AD 症状的疗效。在进行为期 4 周的等待名单后，61 名参与者接受了 5 次每周 25 分钟的治疗，在此期间他们回忆了背叛事件，并在口服β受体阻滞剂普萘洛尔 1 小时后进行。
意向治疗样本的分段回归分析显示，AD 症状在治疗阶段（前后 Cohen's d = 1.44）显著下降，与等待名单阶段（d = 0.01）相比。焦虑抑郁症状也显著减轻。在所有结果上，在 4 个月的随访中，改善均得到维持。
普萘洛尔下的记忆再激活在减轻 AD 症状方面显示出前景。本研究为更大规模的双盲、安慰剂对照临床试验提供了理论框架和必要的效应量。
