Using Therapeutic Riding as an Intervention for Combat Veterans: An International Classification of Functioning,Disability, and Health (ICF) Approach

The aim of the study was to examine the effects of therapeutic horseback riding on posttraumatic stress symptoms, quality of life, and functioning of combat veterans using the International Classification of Functioning, Disability, and Health (ICF) as a framework. Fifty-one veterans and active duty service members participated in an 8-week therapeutic riding program. The study findings revealed clinically significant decrease in PTSD symptoms, improved social functioning, vitality, less interference of emotions on daily activities, and increased participation. Qualitative themes discovered included improved confidence, trust, acceptance of self and others, and gratitude. Qualitative and quantitative data linked to the ICF components.     

PTSD在中国的研究进展

PTSD是近十年来在中国精神病学界逐渐引起重视的一种反应性精神障碍。随着国外对PTSD的深入研究以及中国心理卫生事业的发展,相关领域的学者开始从事这一方面的研究并取得了不少成就。文章对中国PTSD的流行病学、神经生物学基础、病因学以及诊断和治疗等各个方面的研究作了初步总结和探讨。     

Clinical Validation of the Swedish Version of the Quality of Life Inventory in Crime Victims with Posttraumatic Stress Disorder and a Nonclinical Sample

The Swedish version of the Quality of Life Inventory (QOLI) was cross-culturally validated with a crime victim sample (N = 53) with posttraumatic stress disorder (PTSD) and a nonclinical group (N = 100) with no lifetime and current psychiatric disorder from the general population in the Stockholm county of Sweden. The QOLI showed excellent internal consistencies in the clinical and the nonclinical sample. In addition, PTSD participants displayed a significantly lower self-perceived quality of life in 13 out of 16 domains of life than the nonclinical individuals. Furthermore, the QOLI was inversely correlated with interview and self-report measures of PTSD symptoms, depression, and anxiety. Overall, the results support the utility of the Swedish QOLI version as a potentially useful measure of self-perceived quality of life in Swedish clinical and nonclinical samples. The results are discussed in relation to the Swedish cross-cultural validation of the QOLI, methodological limitations and future directions.     

Path analytic examination of a cognitive model of PTSD

Ehlers and Clark (2000) developed a cognitive model of posttraumatic stress disorder (PTSD) symptom maintenance which implicated the role of posttraumatic cognitions and aspects of the trauma memory in maintaining symptoms via an increased sense of current threat. The aim of the current study was to empirically test a variant of this model using path analysis. Participants in the current study were 514 undergraduates at a midwestern university who reported experiencing at least one traumatic event. Path analyses examined various models of the possible relationships between one’s posttraumatic cognitions and the centrality of the traumatic event to the sense of self (considered an aspect of memory integration) in predicting current level of PTSD symptoms. Results indicate that both event centrality and posttraumatic cognitions are unique and independent predictors of current symptom level. Overall, the results of this study support aspects of Ehlers and Clark’s cognitive model of PTSD; cognitive appraisals of the self and centrality of the event were highly related to levels of distress. However, the current study suggests that overly integrated trauma memories may lead to greater distress and not poorly integrated ones as suggested by Ehlers and Clark.     

A test of written emotional disclosure as an intervention for posttraumatic stress disorder

This study examined the efficacy of the written emotional disclosure (WED) procedure with a sample of young adults who met diagnostic criteria for posttraumatic stress disorder (PTSD). Participants were randomly assigned to either WED or a control writing condition and were assessed at baseline and one month following the writing sessions. During each writing session, participants’ heart rate was recorded; participants also provided self-report ratings of emotional responding. Findings indicated no significant group differences for PTSD and depression symptom severity at follow-up assessment. Relative to control participants, WED participants displayed significantly greater heart rate activity and reported greater emotional responding during the first writing session; however, no reduction in emotional responding occurred for either condition from the first to the last writing session. Taken together, these findings indicate that WED may not be an efficacious intervention for PTSD. Suggestions are made for future work in this area.     

中小学教师PTSD和PTG的影响因素研究：灾难前-中-后的视角

采用事件影响量表、创伤后成长问卷、社会支持问卷、应对方式问卷等对汶川地震1年后极重灾区的106名中小学教师进行调查,考察前灾难因子、灾难当下因子和后灾难因子等对教师创伤后应激障碍（PTSD）和创伤后成长（PTG）的影响。结果发现：（1）灾后中小学教师的PTSD处于中低水平、PTG处于中上水平,其中女教师的PTSD和PTG水平高于男教师,班主任教师PTSD水平高于非班主任教师,有过被困经历的教师PTSD水平高于没有被困经历的教师,有亲朋或学生受伤的教师其PTSD和PTG水平均高于无亲朋或学生受伤的教师;（2）社会支持对PTSD没有显著的预测作用,社会支持中的信息支持可以促进PTG,而情感支持和实质性支持对PTG没有显著的影响;（3）逃避的应对方式能显著地正向预测PTSD,问题解决的应对方式能显著正向地预测PTG,而寻求帮助的应对方式对PTSD和PTG都不具有显著的影响。     

青少年创伤后心理反应的影响机制及其干预研究

汶川地震后青少年的心理反应受到社会的普遍关注。本文作者及其团队对汶川地震后青少年的心理反应进行了为期6年的研究,以期为震后青少年的心理恢复和发展提供帮助。本文主要介绍了6年来本团队在创伤后心理反应的理论分析、青少年创伤后心理反应的状况及其相互关系、影响因素及其机制、干预策略等方面所进行的探索,较为全面地阐述了创伤后青少年主要的心理反应及其研究的理论基础,概括了青少年创伤后应激障碍、抑郁和创伤后成长的状况及其发展趋势,深入分析了影响青少年创伤后应激障碍和创伤后成长的影响机制,提出了针对创伤后青少年的心理干预策略,并探究了未来研究需要关注的内容。     

主动反刍、创伤后应激障碍与创伤后成长的关系:一项来自汶川地震后青少年的长程追踪研究

本文以追踪研究的方式, 在汶川地震后3.5年、4.5年和5.5年三个时间点, 采用反刍问卷、创伤后应激障碍问卷和创伤后成长问卷对汶川地震后245名中学生进行调查。通过建立交叉滞后模型, 考察主动反刍、创伤后应激障碍与创伤后成长的相互作用关系。结果发现, 震后3.5~5.5年间, 创伤后应激障碍对主动反刍具有跨时间点的正向预测作用, 主动反刍对创伤后应激障碍跨时间点的预测作用不显著;主动反刍与创伤后成长之间存在跨时间点的相互正向预测关系;创伤后应激障碍与创伤后成长之间跨时间点的直接预测作用不显著, 但震后3.5年的创伤后应激障碍可以通过震后4.5年的主动反刍间接地正向预测震后5.5年的创伤后成长;创伤后应激障碍与创伤后成长的横断关系随着时间历程的变化而逐渐减弱。     

中国创伤后应激反应量表在大学生群体中的应用

采用以中国文化为背景编制的“中国自然灾难幸存者创伤后应激反应量表(CPI)”, 对芦山地震灾区某大学1057名学生进行测试, 考察CPI在地震后大学生人群的应用, 并探讨PTSD的影响因素。结果发现, 性别、主观害怕体验和D型人格等因素能够预测PTSD症状的发生。CPI在地震受灾的大学生群体中具有良好的信效度, 可用于PTSD症状严重程度的评估。