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曾经在犯罪现场遭到犯罪人威胁或伤害的受害人 ,可能会因为这种遇害经历而产生各种各样的应激障碍。描述犯罪受害人有可能发生的应激障碍的临床表现 ,介绍国内外常用的评估工具 ,总结能够有效干预犯罪受害人应激障碍的方法 ,并做出简要评价 相似文献
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高尔夫球“击落”战斗机的故事发生在1988年。当时在贝宁共和国首都波多若夫的空军机场对面有一个高尔夫球场。一天,高尔夫球场临时工马蒂厄·博尹正在球场上练习打高尔夫球。几乎与此同时,对面机场的跑道上,空军机械师龙宁·艾拉德伊驾驶一架战斗机拔地而起。马蒂厄·博尹“啪”地一棒把高尔夫球击向天空,谁知这只高尔夫球竟击中了一只飞行中的麻雀。这只被击中的麻雀落下来时正好撞在了刚刚起飞的战斗机的挡风玻璃上。龙宁·艾拉德伊看到这突然飞来的“天外来客”大吃一惊。慌乱之中,他将这只被高尔夫球击落的死麻雀当成了“炮弹”或… 相似文献
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急性应激障碍和创伤后应激障碍是近些年创伤后研究的重要内容.为了更加全面地评估遭遇创伤事件患者的情况,本文将从年龄、性别、种族和文化因素、生理与心理共病、过去受伤史、攻击行为、自伤和自杀行为7个方面阐述影响应激障碍的因素,以期在影响应激治疗因素层面为临床治疗提供依据. 相似文献
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回顾了近20年来军事应激下的有关认知工效学研究,主要包括五部分：基本理论;应激对认知的影响;研究方法;处理应激的方法;总结。其中在研究方法中重点是对已有事故的分析,竞争性游戏和虚拟现实技术。在减少应激对认知不良影响的方法中值得注意的是：对抗应激人员的选拔、对人员的训练和能够对抗应激的人－机系统的开发。对于我军今后类似研究提供了思路和可能入手点 相似文献
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创伤后应激障碍研究进展 总被引：13，自引：0，他引：13
文章概括了国内外近年来对创伤后应激障碍的研究,分别介绍了其基本概念、临床分型、理论模型、评估诊断,以及治疗方法。对这一心理障碍的进一步研究能充实心理咨询治疗的课题,并具有重要的社会意义。 相似文献
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评估经历两次撞击的集体特大交通事故中36名伤员1周内的创伤后应激障碍症状.以PCL-C为提纲,结合伤员自身、家属和同病房伤员的描述由评估者经过个体晤谈后完成评定.结果显示伤员最常见的症状是:创伤提示异常心理痛苦(83.33％),闯入性回忆(69.44％),回避创伤提示物品或境遇(66.67％),惊跳反应(63.89％),回避创伤相关思考(61.11％)和睡眠障碍(61.11％);63.89％的伤员PCL-C总分≥41;维吾尔族伤员创伤后应激障碍症状严重程度高于汉族伤员. 相似文献
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创伤后应激障碍与物质使用障碍共病率高,现有的治疗方法疗效差,总结20年来创伤后应激障碍与物质使用障碍共病研究中病因学方面的新认识,通过对病因的哲学思考可以为今后的治疗方向提供一条思路:两病同治;应提倡药物治疗、认知干预和社会支持综合的治疗手段。 相似文献
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目的:探讨新疆地区突发灾难事件后医学院大学生创伤后应激障碍发生的特点,为高校学生心理健康指导及民族团结教育提供科学依据。方法:采用PTSD筛查问卷及开放式访谈调查方法对750名医学本科生进行研究。结果:在7.5暴力事件突发后,医学生PTSD的发生率达到12.8%。总体来看,以学生的PTSD症状中,回避维度平均分高于警觉维度的平均分。在性别、民族、学院、年级以及被试的性质上,被试的PTSD存在显著差异。医学生在7.5事件中充当的角色性质、所处学院、所处年级三个变量能联合预测PTSD症状2.7%的变异量。结论:高校学生工作者及高校教师应该根据医学生的特点,及时有效地采取危机干预措施,减少和避免创伤后应激障碍的发生,促进学生心理健康,引导学生建立积极的民族团结意识。 相似文献
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Natalie Purcell Kristine Burkman Jessica Keyser Phillip Fucella Shira Maguen 《Journal of aggression, maltreatment & trauma》2018,27(6):645-673
This paper evaluates the Impact of Killing (IOK) treatment—a psychological intervention designed to address moral injury and trauma associated with killing in war. Using qualitative data from interviews with 28 combat veterans, we examine IOK’s impact, how it differs from other trauma-focused treatments, and how it can be improved to better meet veterans’ needs. We found that many veterans processed their killing experiences for the first time in IOK, even though all had previously completed evidence-based treatments for posttraumatic stress disorder. Several described killing in war as the most distressing and transformative trauma of their lives, and all affirmed the value of an intervention focused directly and explicitly on moral injury and killing. IOK helped veterans to acknowledge their grief, shame, and distress; gently but critically examine their thoughts and beliefs about killing in war; and make strides toward acceptance, reconciliation, and forgiveness. 相似文献
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R. Gregory Lande Lisa Banks Williams Jennifer L. Francis Cynthia Gragnani Melanie L. Morin 《Journal of aggression, maltreatment & trauma》2013,22(5):530-538
This study describes the characteristics and global effectiveness of treatment of a military intensive outpatient treatment program for posttraumatic stress disorder (PTSD). Thirty-nine military personnel completed treatment outcome questionnaires. Results showed a statistically significant reduction in depression and PTSD symptoms after the participants completed 3 weeks of intensive outpatient therapy. The findings have clinical and research implications for the length, intensity, and focus of PTSD treatment. 相似文献
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《Cognitive and behavioral practice》2023,30(3):326-340
Despite consistent evidence that Cognitive Processing Therapy (CPT) is an efficacious treatment for posttraumatic stress disorder (PTSD), the effects among active-duty service members and veterans have been smaller than for civilians. Modifications to standard delivery may be needed to increase treatment engagement and completion, which could improve outcomes in this population. Delivering CPT in a massed format may reduce barriers to care and enable more rapid symptom reduction, yet clinicians and patients may have concerns about the tolerability and practicality of such interventions. This case series describes a course of CPT delivered in 5 days in a mixed group and individual format among 4 active-duty military service members as part of a larger randomized clinical trial. Although the pattern of symptom change differed between patients, most demonstrated clinically significant reductions in PTSD and depression symptoms during the 5-day treatment. Patients reported that the pace was tolerable and that the mixed group and individual format was beneficial. Although further research is needed to understand the longer-term outcomes of massed CPT, this therapy format has important implications for the future delivery of treatments for PTSD. 相似文献
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《Behavior Therapy》2023,54(3):476-495
Stepped care approaches have been developed to increase treatment accessibility for individuals with posttraumatic stress disorder (PTSD). However, despite guidelines recommending stepped care, it is currently unclear how the approach compares to other treatments for PTSD in terms of symptom reduction, cost, and client-rated acceptability. We conducted a systematic review and meta-analysis of randomized controlled and open trials evaluating stepped care prevention (i.e., targeting those with recent trauma exposure at risk of developing PTSD) and treatment approaches for adults and adolescents/children with PTSD. Eight prevention and four treatment studies were included. There was considerable variation in the sample types, stepped approaches, and control conditions. Most studies found no significant differences between stepped care (both prevention and treatment) and control (active and usual care) in terms of PTSD severity, loss of PTSD diagnosis, depression severity, and quality of life at the final follow-up. There was some evidence to suggest that stepped care was more cost-effective, and as acceptable or more acceptable compared to controls. Interpretations were tempered by high statistical heterogeneity, risk of bias, and lack of recommended evidence-based treatments. Stepped care can make PTSD treatment more accessible; however, more high-quality research is needed comparing stepped care to active controls. 相似文献
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Anne C. Wagner Candice M. Monson Tae L. Hart 《Journal of aggression, maltreatment & trauma》2016,25(8):831-853
One of the most important factors predicting the presence of posttraumatic stress disorder (PTSD) after trauma exposure is social support, yet the construct is theoretically complex and remains variably defined. To better inform the trauma literature on the impact of social factors, a theoretical review of social support and PTSD was conducted, and implications for measurement and intervention are outlined. Type of trauma, sex of participant, timing of social support, and support providers are described as significant moderators of the association between social factors and PTSD. The developmental trajectory of the association between social factors and PTSD occurrence is outlined, emphasizing the positive influence of social support initially following trauma, and the deterioration effect of PTSD symptoms on social support over the longer term. Possibilities for future research and intervention at multiple levels and at different time points are described. 相似文献
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Sandra M. Escolas Barbara L. Pitts Martin A. Safer Paul T. Bartone 《Military psychology》2013,25(2):116-123
This study examined the protective effects of hardiness (dispositional resilience) on self-reported posttraumatic stress disorder (PTSD) symptoms in a sample of postdeployed service members. Hardiness was negatively related to PTSD symptoms. Time in the military, number of deployments, and total time spent on deployment were all positively related to PTSD symptoms. Hardiness moderated the effects of time in the military on PTSD symptoms, such that time in the military had no effect on those who were high in hardiness. Hardiness did not moderate the effects of either deployment measure. Suggestions to modify current military resilience training programs to most effectively enhance the benefits of hardiness are discussed. 相似文献
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Julie A. Niziurski Kim Berg Johannessen Dorthe Berntsen 《Memory (Hove, England)》2018,26(8):1093-1104
During military deployment, soldiers are confronted with both negative and positive events. What is remembered and how it affects an individual is influenced by not only the perceived emotion of the event, but also the emotional state of the individual. Here we examined the most negative and most positive deployment memories from a company of 337 soldiers who were deployed together to Afghanistan. We examined how the level of emotional distress of the soldiers and the valence of the memory were related to the emotional intensity, experience of reliving, rehearsal and coherence of the memories, and how the perceived impact of these memories changed over time. We found that soldiers with higher levels of post-traumatic stress disorder (PTSD) symptoms were more affected by both their negative and positive memories, compared with soldiers with lower levels of PTSD symptoms. Emotional intensity of the most negative memory increased over time in the group with highest levels of PTSD symptoms, but dropped in the other groups. The present study adds to the literature on emotion and autobiographical memory and how this relationship interacts with an individual’s present level of emotional distress and the passage of time. 相似文献
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Post-traumatic stress disorder (PTSD) is of great interest to public health, due to the high burden it places on both the individual and society. We meta-analyzed randomized-controlled trials to examine the effectiveness of early trauma-focused cognitive-behavioral treatment (TFCBT) for preventing chronic PTSD. Systematic bibliographic research was undertaken to find relevant literature from on-line databases (Pubmed, PsycINFO, Psyndex, Medline). Using a mixed-effect approach, we calculated effect sizes (ES) for the PTSD diagnoses (main outcome) as well as PTSD and depressive symptoms (secondary outcomes), respectively. Calculations of ES from pre-intervention to first follow-up assessment were based on 10 studies. A moderate effect (ES = 0.54) was found for the main outcome, whereas ES for secondary outcomes were predominantly small (ES = 0.27–0.45). The ES for the main outcome decreased to small (ES = 0.34) from first follow-up to long-term follow-up assessment. The mean dropout rate was 16.7% pre- to post-treatment. There was evidence for the impact of moderators on different outcomes (e.g., the number of sessions on PTSD symptoms). Future studies should include survivors of other trauma types (e.g., burn injuries) rather than predominantly survivors of accidents and physical assault, and should compare early TFCBT with other interventions that previously demonstrated effectiveness. 相似文献
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Keith R. Aronson Janet A. Welsh Anna Fedotova Nicole R. Morgan Daniel F. Perkins Wendy Travis 《Military psychology》2013,25(6):465-475
The Institute of Medicine has stressed the need for evaluations of evidence-based treatments (EBTs) for posttraumatic stress disorder (PTSD) among active duty service members (AD) using a variety of evaluation approaches (Institute of Medicine, 2012). The current study examined the clinical files of 134 service members who completed treatment for PTSD using either prolonged exposure (PE) or cognitive processing therapy at an outpatient clinic. At the completion of each session, therapists made a clinical rating as to whether or not the session was protocol adherent. The total number of treatment sessions and the proportion of sessions rated as being protocol adherent were calculated. Multi-level models estimated the change in patient PTSD and other psychological symptoms over time as a function of clinician-rated protocol adherence and total number of sessions. Approximately 65% of clinic encounters were rated by therapists as being protocol adherent. Significant reductions in PTSD and psychological symptoms were associated with protocol adherence, and this was particularly true for patients who began treatment above clinical thresholds for both PTSD and other psychological symptoms. However, as the number of sessions increased, the impact of protocol adherence was attenuated. Patient characteristics, including gender, ethnicity, and co-morbidity for other psychiatric disorders were not related to symptom change trajectories over time. These findings suggest that protocol adherence and efficiency in delivery of EBTs for the treatment of PTSD with AD is critical. 相似文献
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Despite efforts to understand the antecedents, correlates, and consequences of posttraumatic growth (PTG), the role of time since a traumatic event (time since event) vis-à-vis PTG is not well understood. Part of a larger project exploring experiences following emotionally distressing events among military veterans (N = 197) using Amazon’s Mechanical Turk (Mturk), in the current study, we sought to clarify associations between the time since event and PTG. We used cluster-analytic techniques and analyses of variance to (a) determine the number of clusters, and (b) assess differences in core constructs of PTG and participant characteristics across clusters. Results revealed 4 significantly different groups (i.e., clusters) characterized by differential associations between PTG and time since event. These groups also differed significantly in challenge to core beliefs, level of PTSD symptoms, intrusive and deliberate rumination, and age. The immediate moderate-growth group (Cluster 1) experienced moderate levels of PTG over shorter periods of time, severe PTSD symptoms, and was significantly younger. The low-growth group (Cluster 2) was characterized by minimal PTG, regardless of time, the least challenge to core beliefs, and low amounts of intrusive and deliberate rumination. The long-term small-growth group (Cluster 3) was primarily characterized by small amounts of PTG over longer periods of time. The high-growth group (Cluster 4) was characterized by high PTG, regardless of time, greater challenge to core beliefs, the highest amount of deliberate rumination, and the highest number of PTSD symptoms. Findings underscore heterogeneity within military veterans’ experiences of PTG over time. 相似文献