Shayani Danielle R, Alpert Elizabeth, Barnes J Ben, Sloan Denise M, Hayes Adele M
Department of Psychological and Brain Sciences, University of Delaware.
National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System.
Psychol Trauma. 2024 Dec 12. doi: 10.1037/tra0001813.
Cognitive processing therapy (CPT), a 12-session, gold-standard treatment for posttraumatic stress disorder (PTSD), and written exposure therapy (WET), a brief, five-session treatment, have similar treatment efficacy. The aim of the present study was to identify predictors of long-term treatment outcomes of WET and CPT using clients' written narratives.
Narratives from both treatments were coded with the Change and Growth Experiences Scale coding system to identify predictors of long-term PTSD symptom outcomes. Participants were 113 adults with PTSD randomly assigned to receive WET ( = 60) or CPT ( = 53).
In WET, higher average levels of accommodated (balanced, healthy) beliefs predicted lower PTSD symptoms at the 60-week endpoint, as well as a decrease in symptoms over the follow-up symptom slope. In CPT, higher average negative emotions and positive view of self predicted better 60-week PTSD symptom outcomes, as did lower hopelessness, which also predicted a decrease in PTSD symptoms over the follow-up period.
Even without direct cognitive change techniques, adaptive processing of traumatic experiences occurred in WET and predicted PTSD long-term symptom improvement. Both emotional engagement and cognitive change might help to sustain treatment gains in CPT. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
认知加工疗法（CPT）是一种针对创伤后应激障碍（PTSD）的为期12节的金标准治疗方法，而书面暴露疗法（WET）是一种简短的、为期5节的治疗方法，二者具有相似的治疗效果。本研究的目的是通过患者的书面叙述来确定WET和CPT长期治疗效果的预测因素。
使用变化与成长经历量表编码系统对两种治疗方法的叙述进行编码，以确定PTSD症状长期结果的预测因素。参与者为113名患有PTSD的成年人，他们被随机分配接受WET（n = 60）或CPT（n = 53）。
在WET中，更高的平均适应（平衡、健康）信念水平预测了60周终点时更低的PTSD症状，以及随访症状斜率上症状的减少。在CPT中，更高的平均负面情绪和对自我的积极看法预测了更好的60周PTSD症状结果，更低的绝望感也是如此，绝望感还预测了随访期间PTSD症状的减少。
即使没有直接的认知改变技术，WET中也发生了创伤经历的适应性加工，并预测了PTSD长期症状的改善。情感投入和认知改变可能都有助于维持CPT的治疗效果。（PsycInfo数据库记录（c）2024美国心理学会，保留所有权利）
