CRITICAL ANALYSIS OF THE CURRENT TREATMENT GUIDELINES FOR COMPLEX PTSD IN ADULTS

被引：210

作者：

de Jongh, Ad ^{[1
,2
,3
]}

Resick, Patricia A. ^{[4
]}

Zoellner, Lori A. ^{[5
]}

van Minnen, Agnes ^{[6
,7
]}

Lee, Christopher W. ^{[8
]}

Monson, Candice M. ^{[9
]}

Foa, Edna B. ^{[10
]}

Wheeler, Kathleen ^{[11
]}

ten Broeke, Erik

Feeny, Norah ^{[12
,13
]}

Rauch, Sheila A. M. ^{[14
,15
]}

Chard, Kathleen M. ^{[16
,17
]}

Mueser, Kim T. ^{[18
]}

Sloan, Denise M. ^{[19
,20
]}

van der Gaag, Mark ^{[21
,22
,23
,24
]}

Rothbaum, Barbara Olasov ^{[25
]}

Neuner, Frank ^{[26
]}

de Roos, Carlijn ^{[27
]}

Hehenkamp, Lieve M. J. ^{[28
]}

Rosner, Rita ^{[29
]}

Bicanic, Iva A. E. ^{[28
]}

机构：

[1] Univ Amsterdam, Dept Social Dent ACTA, NL-1081 LA Amsterdam, Netherlands

[2] Vrije Univ Amsterdam, Gustav Mahlerlaan 3004, NL-1081 LA Amsterdam, Netherlands

[3] Univ Salford, Sch Hlth Sci, Manchester, Lancs, England

[4] Duke Univ, Sch Med, Durham, NC USA

[5] Univ Washington, Dept Psychol, Seattle, WA 98195 USA

[6] Radboud Univ Nijmegen, NijCare, Inst Behav Sci, NL-6525 ED Nijmegen, Netherlands

[7] Ctr Anxiety Disorders Overwaal, MHO Pro Persona, Nijmegen, Netherlands

[8] Murdoch Univ, Sch Psychol & Exercise Sci, Murdoch, WA 6150, Australia

[9] Ryerson Univ, Dept Psychol, Toronto, ON, Canada

[10] Univ Pennsylvania Perelman SOM, Dept Psychol, Ctr Treatment & Study Anxiety, Philadelphia, PA USA

[11] Fairfield Univ, Sch Nursing, Fairfield, CT 06430 USA

[12] Cognit Behav Therapy Deventer Bathmen, Bathmen, Netherlands

[13] Case Western Reserve Univ, Dept Psychol Sci, Cleveland, OH 44106 USA

[14] Univ Michigan, Sch Med, VA Ann Arbor Healthcare Syst, Ann Arbor, MI 48109 USA

[15] Univ Michigan, VA Ann Arbor Healthcare Syst, Sch Med, Ann Arbor, MI 48109 USA

[16] Cincinnati VA Med Ctr, Cincinnati, OH USA

[17] Univ Cincinnati, Cincinnati, OH USA

[18] Boston Univ, Coll Hlth & Rehabil Sci, Ctr Psychiat Rehabilitat, Sargent Coll, Boston, MA 02215 USA

[19] VA Boston Healthcare Syst, VA Natl Ctr PTSD, Boston, MA USA

[20] Boston Univ, Sch Med, Dept Psychiat, Boston, MA 02118 USA

[21] Vrije Univ Amsterdam, Dept Clin Psychol, The Hague, Netherlands

[22] Parnassia Psychiat Inst, EMGO Inst Hlth & Care Res, The Hague, Netherlands

[23] Vrije Univ Amsterdam, Dept Clin Psychol, Amsterdam, Netherlands

[24] Parnassia Psychiat Inst, EMGO Inst Hlth & Care Res, Amsterdam, Netherlands

[25] Emory Univ, Sch Med, Dept Psychiat, Atlanta, GA 30322 USA

[26] Univ Bielefeld, Dept Psychol, D-33615 Bielefeld, Germany

[27] MHO Rivierduinen, Psychotrauma Ctr Children & Youth, Leiden, Netherlands

[28] Univ Med Ctr Utrecht, Natl Psychotrauma Ctr Children & Youth, Utrecht, Netherlands

[29] Catholic Univ, Dept Psychol, Eichstatt Ingolstadt, Germany

来源：

DEPRESSION AND ANXIETY | 2016年 / 33卷 / 05期

关键词：

treatment guidelines; PTSD; complex PTSD; phase-based treatment; stabilization; POSTTRAUMATIC-STRESS-DISORDER; COGNITIVE-PROCESSING THERAPY; RANDOMIZED CLINICAL-TRIAL; CHILDHOOD SEXUAL-ABUSE; PROLONGED EXPOSURE; BEHAVIORAL THERAPY; FEMALE SURVIVORS; WOMEN; METAANALYSIS; VICTIMS;

D O I：

10.1002/da.22469

中图分类号：

B849 [应用心理学];

学科分类号：

040203 ;

摘要：

According to current treatment guidelines for Complex PTSD (cPTSD), psychotherapy for adults with cPTSD should start with a stabilization phase. This phase, focusing on teaching self-regulation strategies, was designed to ensure that an individual would be better able to tolerate trauma-focused treatment. The purpose of this paper is to critically evaluate the research underlying these treatment guidelines for cPTSD, and to specifically address the question as to whether a phase-based approach is needed. As reviewed in this paper, the research supporting the need for phase-based treatment for individuals with cPTSD is methodologically limited. Further, there is no rigorous research to support the views that: (1) a phase-based approach is necessary for positive treatment outcomes for adults with cPTSD, (2) front-line trauma-focused treatments have unacceptable risks or that adults with cPTSD do not respond to them, and (3) adults with cPTSD profit significantly more from trauma-focused treatments when preceded by a stabilization phase. The current treatment guidelines for cPTSD may therefore be too conservative, risking that patients are denied or delayed in receiving conventional evidence-based treatments from which they might profit. (C) 2016 Wiley Periodicals, Inc.

引用

页码：359 / 369

页数：11

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