Gielkens Ellen M J, Sobczak Sjacko, Rossi Gina, van Alphen Sebastiaan P J
Clinical Center of Excellence for Older Adults With Personality Disorders, Mondriaan Mental Health Center.
Personality and Psychopathology Research Group (PEPS), Department of Psychology, Vrije Universiteit Brussel (VUB).
Psychol Trauma. 2024 Dec;16(Suppl 3):S568-S581. doi: 10.1037/tra0001402. Epub 2022 Dec 1.
The aim of this study is to investigate the feasibility of eye movement desensitization and reprocessing (EMDR) therapy in older adults with posttraumatic stress disorder (PTSD), and to explicitly include information about presence of the comorbid psychiatric and somatic disorders as well as a history of traumatic events at treatment start.
A nonrandomized feasibility study in a multicenter design was conducted with 25 older PTSD patients (60-84 years). Treatment consisted of weekly 1-hour EMDR sessions for PTSD during 3, 6, or maximum 9 months. PTSD diagnosis was assessed with Clinician Administered PTSD Scale for (CAPS-5) and PTSD Symptom Scale-Self Report (PSS-SR). We also operationalized PTSD symptom change on CAPS-5 and PSS-SR in and . Remission was defined as loss of diagnosis and no longer having any PTSD symptoms according to minimum severity scores on CAPS-5 (< 12) and PSS-SR (≤ 10). Comorbid psychiatric disorders were assessed pre- (and post-)treatment and somatic disorders and presence of traumatic (childhood) events were assessed pretreatment.
Comorbidity rates of depressive (64%), anxiety (56%), other psychiatric (32%), personality (60%), and somatic disorders (96%) were high in our sample of older adults. A linear mixed model approach showed a significant decrease in CAPS-5 scores from pre- to posttreatment for the total sample [(1, 24) = 150.304, < .001; Cohen's = 2.59]. No significant main effects of therapy duration (3, 6, or 9 months), pretreatment intensity of psychopathology (BSI), or their interaction was found (all > .05). Eighty percent lost their PTSD diagnosis and remission rate was 52% for CAPS-5 and 37.5% for PSS-SR. Remission (not loss of PTSD-diagnosis) showed a negative correlation with the number of experienced traumatic childhood events.
EMDR therapy showed large treatment effect on PTSD symptom severity in older adults and this was unrelated to therapy duration and presence of comorbid psychiatric and somatic disorders pretreatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
本研究旨在探讨眼动脱敏再处理(EMDR)疗法对患有创伤后应激障碍(PTSD)的老年人的可行性,并明确纳入有关治疗开始时共病的精神和躯体疾病以及创伤事件史的信息。
采用多中心设计进行了一项非随机可行性研究,研究对象为25名患有PTSD的老年人(60 - 84岁)。治疗包括为期3、6或最长9个月的每周1小时针对PTSD的EMDR治疗。使用临床医生管理的PTSD量表(CAPS - 5)和PTSD症状量表 - 自我报告(PSS - SR)评估PTSD诊断。我们还对CAPS - 5和PSS - SR中PTSD症状的变化进行了量化。缓解定义为根据CAPS - 5(< 12)和PSS - SR(≤ 10)的最低严重程度评分失去诊断且不再有任何PTSD症状。在治疗前(和治疗后)评估共病的精神障碍,在治疗前评估躯体疾病和创伤(童年)事件的存在情况。
在我们的老年样本中,抑郁(64%)、焦虑(56%)、其他精神(32%)、人格(60%)和躯体疾病(96%)的共病率很高。线性混合模型方法显示,总样本从治疗前到治疗后CAPS - 5评分显著降低[(1, 24) = 150.304,p <.001;科恩d = 2.59]。未发现治疗持续时间(3、6或9个月)、治疗前精神病理学强度(BSI)或它们的相互作用有显著的主效应(所有p >.05)。80%的人失去了PTSD诊断,CAPS - 5的缓解率为52%,PSS - SR的缓解率为37.5%。缓解(而非失去PTSD诊断)与经历的童年创伤事件数量呈负相关。
EMDR疗法对老年人PTSD症状严重程度显示出较大的治疗效果,这与治疗持续时间以及治疗前共病的精神和躯体疾病无关。(PsycInfo数据库记录(c)2024美国心理学会,保留所有权利)