Although cognitive behavioral interventions improve attitudes toward mental health treatment and reduce stigma, little is known about which types of attitudes change, or how this change occurs. Active duty soldiers with PTSD (N = 162) were randomized to 10 sessions of exposure therapy or a waitlist. Soldiers were assessed for PTSD and completed measures of stigma and attitudes towards mental health services before randomization and after 5- and 10- sessions of therapy. At post-treatment, soldiers in exposure therapy demonstrated significant improvements in openness to talking about mental health problems and concerns about what others may think if they knew they were seeking mental health treatment, relative to those in the waitlist. There were significant indirect effects from treatment to changes in stigma and attitudes towards mental health treatment through changes in PTSD symptoms at post-treatment. There was also a significant indirect effect from treatment to changes in stigma at post-treatment through changes in attitudes towards mental health treatment at mid-treatment, suggesting attitude change may occur first. Baseline characteristics did not moderate treatment's change in stigma or attitudes. Improvements in PTSD symptoms and positive changes in attitudes towards mental health treatment appear to separately predict later reductions in stigma.

中文翻译：

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暴露疗法对患有战斗相关创伤后应激障碍的现役美国士兵的耻辱感和心理健康治疗态度的影响。

尽管认知行为干预改善了对心理健康治疗的态度并减少了耻辱感，但人们对哪些类型的态度会改变，或者这种改变是如何发生的知之甚少。患有 PTSD 的现役士兵 (N = 162) 被随机分配到 10 次暴露治疗或候补名单中。在随机分组之前以及经过 5 次和 10 次治疗后，对士兵进行了 PTSD 评估，并完成了对心理健康服务的耻辱感和态度的测量。在治疗后，与候补名单中的人相比，接受暴露治疗的士兵在谈论心理健康问题和担心其他人知道自己正在寻求心理健康治疗时可能会怎么想方面表现出显着改善。通过治疗后 PTSD 症状的变化，治疗对耻辱感和对心理健康治疗态度的改变有显着的间接影响。通过在治疗中期改变对心理健康治疗的态度，治疗对治疗后耻辱感的改变也有显着的间接影响，这表明态度改变可能首先发生。基线特征并未缓和治疗对污名或态度的改变。创伤后应激障碍症状的改善和对心理健康治疗态度的积极变化似乎分别预测了以后耻辱感的减少。通过在治疗中期改变对心理健康治疗的态度，治疗对治疗后耻辱感的改变也有显着的间接影响，这表明态度改变可能首先发生。基线特征并未缓和治疗对污名或态度的改变。创伤后应激障碍症状的改善和对心理健康治疗态度的积极变化似乎分别预测了以后耻辱感的减少。通过在治疗中期改变对心理健康治疗的态度，治疗对治疗后耻辱感的改变也有显着的间接影响，这表明态度改变可能首先发生。基线特征并未缓和治疗对污名或态度的改变。创伤后应激障碍症状的改善和对心理健康治疗态度的积极变化似乎分别预测了以后耻辱感的减少。