Miller Michelle L, Ward Marissa J, Meyer Danie J
Indiana University School of Medicine, Indianapolis IN, USA
Vivo International, Konstanz Baden-Württemberg, Germany.
Violence Vict. 2024 Dec 5. doi: 10.1891/VV-2024-0057.
Posttraumatic stress disorder (PTSD) is associated with some of the poorest mental and physical health outcomes. There is often high dropout from treatment for PTSD, especially among those who have experienced chronic or multiple traumatic events. One increasingly popular PTSD treatment delivery model targeting treatment retention is intensive treatment delivery. Narrative exposure therapy (NET) is an exposure-based PTSD treatment designed to address multiple trauma exposures, but NET has not been systematically delivered in an intensive brief format. The current study aimed to determine the feasibility, acceptability, and preliminary efficacy of intensively delivered NET to a highly traumatized sample (HI-NET). A trauma-exposed clinical sample ( = 8; range of lifetime traumatic events: 5-15; 100% endorsed history of interpersonal violence; mean age = 46; 87% White) participated in daily NET sessions for 1 week. Participants completed self-report measures assessing PTSD, depressive, and dissociation symptoms as well as trauma-related cognitions at baseline, 1 week posttreatment, and 1-, 3-, and 6-month follow-up timepoints. HI-NET was feasible, with all participants attending all sessions. Participants reported high levels of acceptability and satisfaction. Participants showed significant reductions in PTSD symptoms (≥12 points on the PTSD Checklist for [PCL-5]) from baseline ( = 49.00, = 16.34) through 6-month assessment ( = 24.29, = 16.89, =1.88). Depressive symptoms, the frequency and intensity of dissociative symptoms, and dysfunctional trauma-related cognitions all significantly decreased alongside PTSD symptoms. This is the first investigation of an intensive delivery of NET, an evidence-based treatment for PTSD that can target multiple traumatic events. After only six sessions delivered to a highly traumatized sample, there was a significant decrease in PTSD symptoms that remained decreased over time. HI-NET is feasible, acceptable, and efficacious, yet larger clinical trials with more diverse samples are needed.
创伤后应激障碍（PTSD）与一些最糟糕的身心健康结果相关。PTSD治疗的脱落率往往很高，尤其是在那些经历过慢性或多次创伤事件的人群中。一种越来越流行的旨在提高治疗保留率的PTSD治疗模式是强化治疗。叙事暴露疗法（NET）是一种基于暴露的PTSD治疗方法，旨在应对多次创伤暴露，但NET尚未以强化简短形式系统实施。本研究旨在确定对高度受创伤样本密集实施NET（HI-NET）的可行性、可接受性和初步疗效。一个有创伤暴露经历的临床样本（n = 8；终生创伤事件范围：5 - 15；100%认可人际暴力史；平均年龄 = 46岁；87%为白人）参加了为期1周的每日NET治疗。参与者在基线、治疗后1周以及1个月、3个月和6个月的随访时间点完成了自我报告测量，评估PTSD、抑郁和解离症状以及与创伤相关的认知。HI-NET是可行的，所有参与者都参加了所有疗程。参与者报告了高度的可接受性和满意度。从基线（M = 49.00，SD = 16.34）到6个月评估（M = 24.29，SD = 16.89，d = 1.88），参与者的PTSD症状（在PTSD检查表[PCL-5]上≥12分）显著降低。抑郁症状、解离症状的频率和强度以及功能失调的创伤相关认知都与PTSD症状一起显著下降。这是对强化实施NET的首次调查，NET是一种针对PTSD的循证治疗方法，可以针对多次创伤事件。在仅对高度受创伤样本进行六次治疗后，PTSD症状显著下降，且随着时间推移持续下降。HI-NET是可行的、可接受的且有效的，但需要更多不同样本的更大规模临床试验。
