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无责研究:一项双臂随机对照试验,评估针对经历过身体/性暴力或性虐待的青少年的在线心理教育计划的效果。基本原理、研究设计和方法。

BLAME-LESS STUDY: a two-arm randomized controlled trial evaluating the effects of an online psychoeducation programme for adolescents who have experienced physical/sexual violence or sexual abuse. Rationale, study design, and methods.

机构信息

Karakter, Child and Adolescent Psychiatry, Almelo, the Netherlands.

Psychotrauma Expertise Centre (PSYTREC), Bilthoven, the Netherlands.

出版信息

Eur J Psychotraumatol. 2024;15(1):2315794. doi: 10.1080/20008066.2024.2315794. Epub 2024 Feb 19.

Abstract

Victims of physical/sexual violence or sexual abuse commonly experience defense responses that result in feelings of guilt and shame. Although trauma-focused interventions are effective in treating post-traumatic stress disorder symptoms, the presence of trauma-related shame and guilt can potentially hinder the process of disclosure during treatment, thus diminishing their overall effectiveness. It is hypothesized that providing psychoeducation about common defense responses will reduce feelings of shame and guilt, thereby increasing receptivity to trauma-focused treatment. This paper describes the rationale, study design, and methods of the BLAME-LESS study. The effects of a brief online psychoeducation program will be compared with a waiting-list control group. The intervention aims to reduce feelings of trauma-related shame and guilt that adolescents experience regarding their own defense responses during and after physical/sexual violence or sexual abuse. Adolescents (12 - 18 years old) with a history of physical/sexual violence or sexual abuse who suffer from trauma-related feelings of shame and guilt can participate in the study. The study follows a two-arm RCT that includes 34 participants. The primary outcomes includes trauma-related feelings of shame and guilt. The secondary outcomes includes PTSD symptoms, anxiety and depression symptoms, traumatic cognitions, readiness to disclose details of memories of the trauma, and motivation to engage in trauma-focused therapy. Assessments take place after screening, at baseline, two weeks after allocation to the intervention or waiting-list, and, only for the waiting-list participants, seven weeks after allocation to the intervention. There is a need for treatment approaches that target trauma-related feelings of shame and guilt. A recently developed brief online psychoeducation program on defense responses during and after trauma offers victims of physical/sexual violence or sexual abuse a free and accessible way to obtain reliable and valid information. The proposed RCT will evaluate the effectiveness of this online psychoeducation program. Request is pending.

摘要

身体/性暴力或性虐待的受害者通常会经历防御反应,从而产生内疚和羞耻感。虽然以创伤为中心的干预措施在治疗创伤后应激障碍症状方面非常有效,但与创伤相关的羞耻感和内疚感的存在可能会阻碍治疗过程中的披露,从而降低其整体效果。有人假设,提供有关常见防御反应的心理教育将减少羞耻感和内疚感,从而提高对以创伤为中心的治疗的接受度。本文介绍了 BLAME-LESS 研究的基本原理、研究设计和方法。将比较一个简短的在线心理教育方案与等待名单对照组的效果。该干预旨在减少青少年在身体/性暴力或性虐待期间和之后对自己防御反应的与创伤相关的羞耻感和内疚感。可以参加研究的是有身体/性暴力或性虐待史、且有与创伤相关的羞耻感和内疚感的青少年(12-18 岁)。该研究遵循一项包括 34 名参与者的双臂 RCT。主要结果包括与创伤相关的羞耻感和内疚感。次要结果包括 PTSD 症状、焦虑和抑郁症状、创伤性认知、披露创伤记忆细节的准备情况,以及参与以创伤为中心的治疗的动机。评估在筛选后、基线时、分配到干预组或等待名单后两周以及仅为等待名单参与者分配到干预组后七周进行。需要针对与创伤相关的羞耻感和内疚感的治疗方法。最近开发的一个关于创伤期间和之后防御反应的简短在线心理教育方案为身体/性暴力或性虐待的受害者提供了一种免费且易于获取的方式来获取可靠和有效的信息。拟议的 RCT 将评估该在线心理教育方案的有效性。正在申请中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1ef/10878330/1de27206f887/ZEPT_A_2315794_F0001_OC.jpg

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