Au Malin, Lipschutz Rebecca, Mekawi Yara, Lathan Emma C, Dixon H Drew, Carter Sierra, Hinrichs Rebecca, Bradley Bekh, Kaslow Nadine J, Nugent Nicole R, Powers Abigail
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 69 Jesse Hill Jr Drive, Atlanta, GA 30303, USA.
Faculty of Psychology and Neuroscience, Maastricht University, Minderbroedersberg 4-6, 6211 LK Maastricht, Netherlands.
J Mood Anxiety Disord. 2024 Dec;8. doi: 10.1016/j.xjmad.2024.100092. Epub 2024 Nov 8.
Low-income, urban-dwelling Black adults are disproportionately affected by traumatic experiences, post-traumatic stress disorder (PTSD), and depression and encounter inequities in treatment access. In addition to the benefits Mindfulness-Based Cognitive Therapy (MBCT) for depression, there is preliminary evidence of successful symptom reduction in PTSD via MBCT across two prior pilot studies in veterans. Studies examining the effects of MBCT among trauma-exposed Black adults remains limited, and examination of effects across specific PTSD clusters is almost nonexistent. We examined the preliminary efficacy of adapted MBCT versus waitlist control (WLC) on PTSD and depression symptoms in a pilot randomized controlled trial (RCT). Black adults ( = 80; 86.10 % women) with repeated trauma exposure, who screened positive for PTSD and depression, were recruited from an urban public hospital and randomized to 8-week adapted MBCT or WLC. Symptoms were measured pretreatment and posttreatment with the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and the Beck Depression Inventory-II (BDI-II). Mixed model analyses were conducted with an intent-to-treat approach, examining change in PTSD and depression scores between MBCT and WLC over time. There was no significant difference in total PTSD and depression symptom change between MBCT and WLC. CAPS-5 avoidance symptoms showed a nominally significant decrease in the MBCT group ([1, 68.10] = 5.98, = .017; [71.60] = 3.61, < .001). Findings suggest MBCT might be helpful for addressing avoidance symptoms among Black adults with comorbid PTSD and depression. Although lacking power to draw final conclusions about treatment efficacy, this study provides preliminary data suggesting the importance of future fully powered trials.
低收入、居住在城市的黑人成年人受创伤经历、创伤后应激障碍(PTSD)和抑郁症的影响尤为严重,并且在治疗机会方面面临不平等。除了基于正念的认知疗法(MBCT)对抑郁症有疗效外,此前两项针对退伍军人的初步研究表明,MBCT能成功减轻PTSD症状。考察MBCT对遭受创伤的黑人成年人影响的研究仍然有限,几乎不存在针对PTSD特定症状群影响的研究。我们在一项初步随机对照试验(RCT)中考察了适应性MBCT与候补对照(WLC)对PTSD和抑郁症状的初步疗效。从一家城市公立医院招募了有多次创伤暴露经历、PTSD和抑郁症筛查呈阳性的黑人成年人(n = 80;86.10%为女性),并将他们随机分为接受为期8周的适应性MBCT组或WLC组。在治疗前和治疗后,使用《精神疾病诊断与统计手册》第5版临床医生用PTSD量表(CAPS - 5)和贝克抑郁量表第二版(BDI - II)测量症状。采用意向性分析方法进行混合模型分析,考察MBCT组和WLC组随时间推移PTSD和抑郁得分的变化。MBCT组和WLC组在PTSD和抑郁症状总变化上没有显著差异。CAPS - 5回避症状在MBCT组有显著下降([1, 68.10] = 5.98,p = .017;[71.60] = 3.61,p < .001)。研究结果表明,MBCT可能有助于解决患有PTSD和抑郁症的黑人成年人的回避症状。尽管本研究没有足够的效力得出关于治疗效果的最终结论,但提供了初步数据,表明未来进行充分效力试验的重要性。