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书写暴露疗法与辩证行为疗法技能训练作为创伤后应激障碍与饮食失调共病女性的一种新型综合干预措施:两个案例研究

Written Exposure Therapy and Dialectical Behavior Therapy Skills Training as a Novel Integrated Intervention for Women With Co-Occurring PTSD and Eating Disorders: Two Case Studies.

作者信息

Tilstra-Ferrell Emily L, Salim Selime R, López Cristina, Foster Anna, Hahn Christine K

机构信息

Medical University of South Carolina.

出版信息

Cogn Behav Pract. 2025 Aug;32(3):397-414. doi: 10.1016/j.cbpra.2024.02.004. Epub 2024 May 1.

Abstract

Approximately one quarter of people with posttraumatic stress disorder (PTSD) also have an eating disorder (ED). Yet, there is scant research on interventions addressing PTSD and EDs (PTSD-ED) simultaneously. Two case studies illustrate the treatment of two women with PTSD-ED using Written Exposure Therapy (WET) for PTSD combined with targeted skills from Dialectical Behavior Therapy (DBT) for Eating Disorders (i.e., dialectical abstinence, self-soothing, pro/cons, mindful urge-surfing, coping ahead). Data include pre-, posttreatment, and 6- to 8-week follow-up scores of PTSD and ED symptoms. Client One completed five sessions. At intake, she met criteria for PTSD and Other Specified Feeding and Eating Disorder based on information gathered in a clinical interview and self-report measures. She reported reductions in both PTSD and ED symptoms at posttreatment and at a 6- to 8-week follow-up. Client Two completed seven sessions. At intake, she met criteria for PTSD and Binge Eating Disorder (BED) based on information gathered in a clinical interview and self-report measures. She reported reductions in symptoms of PTSD and BED at her final session and at a 6- to 8-week follow-up. Results from the presented case studies suggest WET for PTSD combined with DBT skills for EDs shows promise for reducing co-occurring PTSD and ED. Future studies should formally assess the feasibility, acceptability, and effectiveness of integrated WET and DBT skills for the treatment of PTSD-ED.

摘要

约四分之一的创伤后应激障碍(PTSD)患者同时患有饮食失调(ED)。然而,针对同时治疗PTSD和ED(PTSD-ED)的干预措施的研究却很少。两项案例研究展示了对两名患有PTSD-ED的女性的治疗过程,采用针对PTSD的书面暴露疗法(WET),并结合针对饮食失调的辩证行为疗法(DBT)的特定技能(即辩证节制、自我安抚、利弊分析、正念冲动应对、提前应对)。数据包括PTSD和ED症状的治疗前、治疗后以及6至8周随访评分。客户一完成了五个疗程。在 intake时,根据临床访谈和自我报告测量收集的信息,她符合PTSD和其他特定进食和饮食障碍的标准。她报告说在治疗后以及6至8周随访时,PTSD和ED症状都有所减轻。客户二完成了七个疗程。在 intake时,根据临床访谈和自我报告测量收集的信息,她符合PTSD和暴食症(BED)的标准。她报告说在最后一个疗程以及6至8周随访时,PTSD和BED症状有所减轻。所呈现的案例研究结果表明,针对PTSD的WET与针对ED的DBT技能相结合,有望减少PTSD和ED的共病情况。未来的研究应正式评估综合WET和DBT技能治疗PTSD-ED的可行性、可接受性和有效性。

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