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学术前沿

持续哀伤障碍的叙事重建治疗EJPT201604

发表者:谭忠林 694人已读

本文摘要及全文见欧洲创伤心理学杂志(European Journal of Psychotraumatologyhttps://www.ejpt.net/index.php/ejpt,该杂志为开源期刊。杭州市第七人民医院精神科谭忠林

 

 

1 持续哀伤障碍的叙事重建 (NR) 治疗–理性与个案研究

 

背景:持续哀伤障碍 (PGD) 是一种潜在的失能状态,大约有10%丧失亲人的人会受此影响。已经有证据表明PGD的产生涉及到丧失记忆的整合受到损害,即丧失相关记忆的反复出现,同时伴随记忆混乱。叙事重建,最初被设计用于创伤后应激障碍(PTSD)的综合治疗模式,成分包括暴露于丧失相关记忆,以书面的方式重建丧失记忆的叙事,在丧亲者的记忆中突出个人的显著性。这些被证明在闯入症状的治疗中有效。

目的:根据认知行为治疗的发现,包括认知重建与暴露,在PGD治疗中有效;我们建议年这种新治疗模式,即NR科用于治疗丧失亲人者的闯入性症状。

方法:本文呈现了针对PGD实施NR治疗的基本原理和治疗一位经历父亲死亡后出现PGD的女性患者的个案研究。治疗在大学门诊患者培训部进行。

结果:在治疗前与治疗后以及3月后随访的评估表明NR在减少PGD抑郁症状方面有效。分析自发叙事在治疗前后的记录显示叙事的条理性增加了。

结论:该案例说明NR适合治疗PGD。该结果为NR治疗PGD有效提供了初步支持。对该研究的意义和局限进行了讨论。

Keywords: 叙事重建; PGD; 丧失; PTSD; CBT;个案研究.

Name of translator: Xiwen HuZhonglin Tan

 

Narrative Reconstruction (NR) Therapy for Prolonged Grief Disorder – Rational and Case Study

Tuvia Peri, Ilanit Hasson Ohayon, Sharon Garber, Rivka Tuval-Mashiach, Paul A. Boelen

Background: Prolonged grief disorder (PGD) is a potentially disabling condition affecting approximately ten percent of bereaved people. It has been suggested that the impaired integration of the loss memory, as expressed in recurrent memories of the loss and disorganization of the memory, is involved in the development of PGD. Narrative reconstruction (NR), originally designed for the treatment of Posttraumatic Stress Disorder (PTSD) in an integrative therapy module, and consisting of exposure to the loss memory, detailed written reconstruction of the loss memory narrative and an elaboration of the personal significance of that memory for the bereaved, has been shown to be effective in the treatment of intrusion symptoms.

Objective: In light of findings that cognitive behavior therapy (CBT), including cognitive restructuring and exposure, is effective in the treatment of PGD, we suggest the implementation of a somewhat novel therapy module, NR, for the treatment of intrusive phenomena in bereaved patients.

Method: The rationale for the implementation of NR for PGD and a case study of the treatment of a woman suffering from PGD after the death of her father are presented. Therapy took place in a university outpatient training clinic.

Results: Evaluations conducted before and after treatment and at a three-month follow-up demonstrated the effectiveness of NR in reducing symptoms of PGD and depression. The analysis of spontaneous narratives recorded before and after treatment showed an increased organization of the narratives.

Conclusions: This case report demonstrates an adaptation of NR for the treatment of PGD. The results provide preliminary support for the effectiveness of NR for PGD. The significance of the study and its limitations are discussed.

Keywords: Narrative Reconstruction; PGD; Bereavement; PTSD; CBT; Case Study.

 

 

2经历创伤后的校园表现:2011年乌托亚枪击事件幸存者校园功能的纵向研究

 

背景:恐怖事件幸存者的心理影响已经被充分记录。但是,有关恐怖攻击后青少年幸存者和高中学生学业表现的研究是少见的。

目的:本研究调查了挪威恐怖袭击幸存者的学业表现,旷课和学校支持。

方法:来源于一项纵向访谈研究的数据与顺利完成3年高中学习计划的学生(N=64)的正式登记成绩相联系。采用均数差异统计检验和线性回归来比较幸存者在事件前后的注册成绩与国家平均绩点,同时评价缺勤、自评成绩,并且检验与学校支持的联系。

结果:在事件发生后的一年学生成绩比之前一年更低,同时他们的成绩也低于国家平均绩点(p<0.001< span="">)。但是,他们的成绩在高中最后一年提高了,表明有可能恢复。在事件发生后,与之前的一年相比,缺勤增加了。但是,学生们对学校的支持高度满意。

结论:结果表明创伤事件后一年学生学业能力下降了,但是对于顺利完成高中学习的学生来说,在事件发生两年后学习表现改善了。该发现突显了让经历创伤暴露的学生继续在校园中并且提供持续支持的重要性。在创伤敏感的教学活动中,需要有措施能够保持上课出勤率以及应对学习能力的下降。

Keywords: 恐怖事件,创伤,青少年,校园表现,注册成绩,缺勤,学校支持。

Name of translator: Xiwen Hu, Zhonglin Tan

 

School performance after experiencing trauma: A longitudinal study of school functioning in survivors of the Utøya shootings in 2011

Ida Frugård Strøm, Jon-Håkon Schultz, Jon-Håkon Schultz, Tore Wentzel-Larsen, Tore Wentzel-Larsen, Grete Dyb, Grete Dyb

Background: The psychological impact on survivors of terrorism has been well documented. However, studies on adolescent survivors and the academic performance of high school students following a terrorist attack are lacking.

Objective: This study investigated academic performance, absenteeism and school support of survivors of a terror attack in Norway

Method: Data from a longitudinal interview study were linked to officially registered grades of students (N= 64) who successfully completed their three year senior high school program. Statistical tests of mean differences and linear regression were used to compare the survivors’ registered grades with the national grade point average, before and after the event, as well as to assess absenteeism, self-reported grades and to test the association with school support.

Results: The students’ grades were lower the year after the event than they had been the year before and they were also lower than the national grade point average (p<0.001). However, their grades improved in the last year of high school, indicating possible recovery. Absence from school increased after the event, compared to the previous year. However, students reported high satisfaction with school support.

Conclusion: The results indicate that academic functioning was reduced in the year after the traumatic event, but for students who successfully completed high school, the school situation improved two years after the event. The findings underscore the importance of keeping trauma exposed students in school and providing support over time. A more defined educational approach to maintaining school attendance and educational measures which compensate for learning loss are needed in trauma sensitive teaching.

Key words: Terror event, Trauma, Adolescents, School performance, Registry grades, Absenteeism, School support

 

 

3 DSM-5PTSD检查表心理测量特质:一项试验性研究

 

背景:迄今为止鲜有研究评估最新修订的PTSD检查表(PCL),即DSM-5PTSD检查表(PCL-5)。本试验性研究旨在检验PCL-5烧伤儿童父母中的心理测量特质。

方法:被试父母 (N=62, 平均年龄=38)在儿童烧伤0.85.6 完成自评问卷。采用PCL-5、事件影响量表修订版  (IES-R)、蒙哥马利抑郁量表(MADRS)和压力察觉量表(PSS)测量。收集儿童烧伤严重程度和社会人口变量。

结果:父母PCL-5平均得分为低到中度。PCL-5的内部一致性令人满意,克朗巴哈系数在0.560.77之间,而内部条目对于4PCL-5分量表与PCL-5总体的相关在0.220.73之间。PCL-5表分量表与相应的IES-R分量表之间为中到高度相关,与MADRSPSS也是如此(p<0.05< span="">),但是社会人口和烧伤严重程度表现为低到中度相关。

结论:本研究提供PCL-5使用的初级支持。结果表明PCL-5衡量内部一致性、重测信度和聚合效度方面的心理测量特质令人满意。

Keywords: PTSD; PCL-5; 儿童烧伤; 父母; 生理创伤; 验证

Name of translator:  Xiwen HuZhonglin Tan

 

PSYCHOMETRIC PROPERTIES OF THE PTSD CHECKLIST FOR DSM-5: A PILOT STUDY

Josefin Sveen, Kristina Bondjers and Mimmie Willebrand

Background: To date there is a lack of studies assessing the psychometric properties of the recently revised PTSD Checklist (PCL), the PTSD Checklist for DSM-5 (PCL-5). The aim of this pilot study was to examine the psychometric properties of the PCL-5 in parents of children with burns.

Methods: The participating parents (N=62, mean age=38) completed self-report questionnaires, 0.8–5.6 years after their child’s burn. Measures were the PCL-5, the Impact of Event Scale-Revised (IES-R), the Montgomery–Åsberg Depression Rating Scale (MADRS), and the Perceived Stress Scale (PSS). Burn severity of the child and sociodemographic variables was obtained.

Results: The parents’ average PCL-5 scores were low to moderate. The internal consistency of the PCL-5 was satisfactory, with Cronbach’s alpha ranging from 0.56 to 0.77 and mean inter-item correlations ranging from 0.22 to 0.73 for the four PCL-5 subscales and the PCL-5 total. The PCL-5 subscales were moderately to highly correlated with the corresponding IES-R subscales as well as MADRS and PSS (p<0.05), whereas associations with sociodemographics and burn severity were low to moderate.

Conclusions: This study provides preliminary support for the use of PCL-5. The results indicate satisfactory psychometric properties of the PCL-5 as measured with internal consistency, test–retest reliability, and aspects of convergent validity.

Keywords: PTSD; PCL-5; child burn; parents; physical trauma; validation

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发表于:2016-06-04 19:28

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