Department of Psychiatry, Psychosomatic and Psychotherapy, University of Lübeck, Lübeck, Germany.
Department of Psychiatry and Psychotherapy, Christian-Albrechts-Universität zu Kiel, Kiel, Germany.
Eur J Psychotraumatol. 2024;15(1):2397890. doi: 10.1080/20008066.2024.2397890. Epub 2024 Sep 12.
The relationship between trauma-related negative cognitions and post-traumatic stress disorder (PTSD) symptoms has been studied frequently. Several studies found a mediating effect of trauma-related negative cognitions on symptom reduction in studies on different psychotherapeutic treatments, however, this relationship has never been studied in imagery rescripting (ImRs) or eye movement desensitization and reprocessing (EMDR). To analyse the role of trauma-related negative cognitions in the treatment of PTSD due to childhood trauma with EMDR and ImRs. = 155 patients with PTSD due to childhood trauma aged between 18 and 65 ( = 38.54) participated in a randomized clinical trial and were treated with either EMDR or ImRs in Australia, Germany, and the Netherlands between October 2014 and June 2019. We analysed the relationship between PTSD symptoms (Clinician-administered PTSD Scale for DSM-5, CAPS-5 and Impact of Event Scale revised; IES-R, completed twice for index trauma and for all other traumas) and trauma-related negative cognitions (Post-Traumatic Cognitions Inventory, PTCI) using Granger Causality analyses with linear mixed models on person-centered variables. Assessments were conducted pre-treatment, post-treatment (12 sessions in 6 weeks), eight weeks post-treatment, and one year after the pre-treatment assessment. Changes in negative cognitions (PTCI) preceded changes in PTSD symptoms (unidirectional) as measured by the CAPS and the IES-R for index trauma. For the IES-R related to all other traumas, a unidirectional relationship was found in which changes in PTSD symptoms preceded changes in negative cognitions. No moderating effect of treatment was found. On the level of PTCI subscales only changes in cognitions about oneself preceeded changes in PTSD symptoms. The results support the idea of a general role of trauma-related negative cognitions in the treatment of PTSD. The analyses should be replicated with a higher frequency of assessments.
创伤后负性认知与创伤后应激障碍（PTSD）症状之间的关系已被频繁研究。一些研究发现，在不同心理治疗研究中，创伤后负性认知对症状减轻有中介作用，但这一关系从未在影像重述（ImRs）或眼动脱敏再处理（EMDR）中研究过。本研究旨在分析 EMDR 和 ImRs 治疗儿童期创伤后 PTSD 中，创伤后负性认知的作用。 = 155 名年龄在 18 至 65 岁（ = 38.54）之间的儿童期创伤后 PTSD 患者参加了一项随机临床试验，并于 2014 年 10 月至 2019 年 6 月在澳大利亚、德国和荷兰接受 EMDR 或 ImRs 治疗。我们使用线性混合模型对以个体为中心的变量进行格兰杰因果分析，分析 PTSD 症状（DSM-5 临床医生管理 PTSD 量表、CAPS-5 和修订后的事件影响量表；IES-R，两次完成，一次用于索引创伤，一次用于所有其他创伤）和创伤后负性认知（创伤后认知量表，PTCI）之间的关系。评估在治疗前、治疗后（6 周内 12 次）、治疗后 8 周和治疗前评估后 1 年进行。CAPS 和 IES-R 测量的索引创伤 PTSD 症状的变化（单向）先于负性认知的变化。对于与所有其他创伤相关的 IES-R，发现 PTSD 症状的变化先于负性认知的变化呈单向关系。未发现治疗的调节作用。在 PTCI 子量表的水平上，只有关于自己的认知变化先于 PTSD 症状的变化。研究结果支持创伤后负性认知在 PTSD 治疗中具有普遍作用的观点。这些分析应该用更高的评估频率进行复制。
