与记忆解离相关的信念在创伤聚焦治疗中的作用。
The role of dissociation-related beliefs about memory in trauma-focused treatment.
机构信息
Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands.
GGZ Oost Brabant, Boekel, the Netherlands.
出版信息
Eur J Psychotraumatol. 2023;14(2):2265182. doi: 10.1080/20008066.2023.2265182. Epub 2023 Oct 17.
OBJECTIVE
Dysfunctional cognitions play a central role in the development of post-traumatic stress disorder (PTSD). However the role of specific dissociation-related beliefs about memory has not been previously investigated. This study aimed to investigate the role of dissociation-related beliefs about memory in trauma-focused treatment. It was hypothesized that patients with the dissociative subtype of PTSD would show higher levels of dissociation-related beliefs, dissociation-related beliefs about memory would decrease after trauma-focused treatment, and higher pre-treatment dissociation-related beliefs would be associated with fewer changes in PTSD symptoms.
METHOD
Post-traumatic symptoms, dissociative symptoms, and dissociation-related beliefs about memory were assessed in a sample of patients diagnosed with PTSD (= 111) or the dissociative subtype of PTSD ( = 61). They underwent intensive trauma-focused treatment consisting of four or eight consecutive treatment days. On each treatment day, patients received 90 min of individual prolonged exposure (PE) in the morning and 90 min of individual eye movement desensitization and reprocessing (EMDR) therapy in the afternoon. The relationship between dissociation-related beliefs about memory and the effects of trauma-focused treatment was investigated.
RESULTS
Dissociation-related beliefs about memory were significantly associated with PTSD and its dissociative symptoms. In addition, consistent with our hypothesis, patients with the dissociative subtype of PTSD scored significantly higher on dissociation-related beliefs about memory pre-treatment than those without the dissociative subtype. Additionally, the severity of these beliefs decreased significantly after trauma-related treatment. Contrary to our hypothesis, elevated dissociation-related beliefs did not negatively influence treatment outcome.
CONCLUSION
The results of the current study suggest that dissociation-related beliefs do not influence the outcome of trauma-focused treatment, and that trauma-focused treatment does not need to be altered specifically for patients experiencing more dissociation-related beliefs about memory because these beliefs decrease in association with treatment.
目的
认知功能障碍在创伤后应激障碍（PTSD）的发展中起着核心作用。然而，关于记忆的特定分离相关信念的作用尚未得到研究。本研究旨在探讨记忆相关分离信念在创伤聚焦治疗中的作用。假设 PTSD 的分离亚型患者会表现出更高水平的与分离相关的记忆信念，创伤聚焦治疗后与分离相关的记忆信念会减少，并且更高的治疗前与分离相关的记忆信念与 PTSD 症状的变化较少有关。
方法
在一组诊断为 PTSD（n=111）或分离型 PTSD（n=61）的患者中评估创伤后症状、分离症状和记忆相关的分离信念。他们接受了密集的创伤聚焦治疗，包括连续四天或八天的治疗。在每个治疗日，患者在上午接受 90 分钟的个体延长暴露（PE），下午接受 90 分钟的个体眼动脱敏和再处理（EMDR）治疗。研究了记忆相关的分离信念与创伤聚焦治疗效果之间的关系。
结果
记忆相关的分离信念与 PTSD 及其分离症状显著相关。此外，与我们的假设一致，与没有分离亚型的患者相比，分离型 PTSD 患者的记忆相关分离信念在治疗前的得分明显更高。此外，这些信念的严重程度在创伤相关治疗后显著降低。与我们的假设相反，较高的与分离相关的信念并没有对治疗结果产生负面影响。
结论
目前的研究结果表明，与分离相关的信念并不影响创伤聚焦治疗的结果，并且不需要针对记忆相关分离信念体验更多的患者改变创伤聚焦治疗，因为这些信念会随着治疗而减少。
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