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将体育活动纳入创伤后应激障碍强化创伤聚焦治疗:一项随机对照试验的结果

Adding physical activity to intensive trauma-focused treatment for post-traumatic stress disorder: results of a randomized controlled trial.

作者信息

Voorendonk Eline M, Sanches Sarita A, Tollenaar Marieke S, Hoogendoorn Elisabeth A, de Jongh Ad, van Minnen Agnes

机构信息

Research Department, PSYTREC, Bilthoven, Netherlands.

Behavioral Science Institute (BSI), Radboud University Nijmegen, Nijmegen, Netherlands.

出版信息

Front Psychol. 2023 Jul 20;14:1215250. doi: 10.3389/fpsyg.2023.1215250. eCollection 2023.

Abstract

INTRODUCTION

This randomized controlled trial examined the effectiveness of physical activity added to an intensive trauma-focused treatment (TFT) for post-traumatic stress disorder (PTSD) in comparison to adding non-physical control activities.

METHODS

A total of 119 patients with PTSD were randomly assigned to a physical activity condition (PA; = 59) or a non-physical activity control condition (nPA; = 60). The 8-day intensive TFT programme consisted of daily prolonged exposure, EMDR therapy, and psychoeducation, which was complemented with physical activities versus controlled mixtures of guided (creative) tasks. As a primary outcome, the change in clinician and self-reported PTSD symptoms from pre-to post-treatment and at 6 months follow-up were measured.

RESULTS

Intent-to-treat linear mixed-effects models showed no significant differences between the PA and nPA conditions on change in PTSD severity. Clinician and self-reported PTSD symptoms significantly decreased for both conditions, with large effect sizes (e.g., CAPS-5  = 2.28). At post-treatment, 80.0% in the PA, and 82.7% in the nPA condition no longer met the diagnostic criteria for PTSD. Regarding the loss of Complex PTSD diagnoses this was 92.5% and 95.0%, respectively.

CONCLUSION

Either with additional physical or non-physical activities, intensive TFT is very effective for the treatment of (Complex) PTSD, as reflected by large effect sizes and loss of diagnostic status in both groups.

CLINICAL TRIAL REGISTRATION

Trialregister.nl Identifier: Trial NL9120.

摘要

引言

本随机对照试验比较了在强化创伤聚焦治疗(TFT)基础上增加体育活动与增加非体育对照活动对创伤后应激障碍(PTSD)的治疗效果。

方法

总共119名PTSD患者被随机分配到体育活动组(PA;n = 59)或非体育活动对照组(nPA;n = 60)。为期8天的强化TFT方案包括每日长时间暴露、眼动脱敏再处理疗法(EMDR)和心理教育,并辅以体育活动,对照组则是指导性(创造性)任务的组合。作为主要结果,测量了治疗前后及6个月随访时临床医生报告和自我报告的PTSD症状变化。

结果

意向性分析的线性混合效应模型显示,PA组和nPA组在PTSD严重程度变化方面无显著差异。两组的临床医生报告和自我报告的PTSD症状均显著下降,效应量较大(例如,CAPS-5 = 2.28)。治疗后,PA组80.0%的患者和nPA组82.7%的患者不再符合PTSD诊断标准。关于复杂性PTSD诊断的消除率,两组分别为92.5%和95.0%。

结论

无论是增加体育活动还是非体育活动,强化TFT对(复杂性)PTSD的治疗都非常有效,两组的大效应量和诊断状态的消除都证明了这一点。

临床试验注册

Trialregister.nl标识符:试验NL9120。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6699/10400339/eb8b7641108f/fpsyg-14-1215250-g001.jpg

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