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A randomised multiple baseline cases series of a novel imagery rescripting protocol for intrusive trauma memories in people with psychosis
Journal of Behavior Therapy and Experimental Psychiatry ( IF 2.662 ) Pub Date : 2021-11-13 , DOI: 10.1016/j.jbtep.2021.101699
Rachel Clarke 1 , Rebecca Kelly 1 , Amy Hardy 1
Affiliation  

Background and objectives

There has been limited investigation of therapies targeting trauma-related psychological mechanisms hypothesised to play a role in post-traumatic and psychosis symptoms. Imagery rescripting (ImRs) is a therapeutic technique which involves transforming images, such as episodic memories, to modify associated distressing beliefs. This study is the first ImRs study for psychosis to incorporate experimental controls. We used a novel ImRs protocol, targeting present-focused, self-referential distressing meanings associated with intrusive trauma memories. A multiple baseline case series design investigated whether the protocol was feasible, safe, acceptable and effective.

Methods

12 participants with a psychosis diagnosis and intrusive trauma memories were assessed and randomised to a monitoring period (one, two or three weeks), followed by three ImRs sessions (over three weeks), a further two-week monitoring period with a post-therapy assessment a week after completing therapy. Memory phenomenology was assessed daily during monitoring. Post-traumatic stress symptoms and wellbeing were assessed pre and post therapy.

Results

ImRs was feasible, safe and rated as highly acceptable. No participants dropped-out of the brief, targeted intervention. There were moderate effects on the frequency, distress, controllability and appraisals of trauma memories. Notably, ten participants showed reliable change, and seven clinically significant change, in post-traumatic stress symptoms.

Limitations

Assessments were not blinded and impact on psychosis was not examined.

Conclusions

The study indicates that a brief, novel ImRs protocol targeting present-focused, self-referential meanings is a promising intervention for intrusive trauma memories. Future research should investigate its integration into trauma-focused therapy for psychosis and impact on psychosis severity.



中文翻译:

用于精神病患者侵入性创伤记忆的新型图像重写方案的随机多基线病例系列

背景和目标

针对假设在创伤后和精神病症状中起作用的创伤相关心理机制的疗法的研究有限。意象改写 (ImRs) 是一种治疗技术,它涉及转换图像,例如情景记忆,以修改相关的令人痛苦的信念。这项研究是第一个纳入实验对照的精神病 ImRs 研究。我们使用了一种新颖的 ImRs 协议,针对与侵入性创伤记忆相关的以现在为中心、自我参照的痛苦意义。多基线病例系列设计调查了该方案是否可行、安全、可接受和有效。

方法

对 12 名患有精神病诊断和侵入性创伤记忆的参与者进行评估,并将其随机分配到一个监测期(一、二或三周),然后是三个 ImR 会议(超过三周),另外一个为期两周的监测期和治疗后完成治疗一周后进行评估。在监测期间每天评估记忆现象学。治疗前和治疗后评估了创伤后应激症状和幸福感。

结果

ImRs 是可行的、安全的并且被评为高度可接受的。没有参与者退出简短的、有针对性的干预。对创伤记忆的频率、痛苦、可控性和评估有中等影响。值得注意的是,10 名参与者在创伤后应激症状方面表现出可靠的变化,其中 7 名出现了临床上显着的变化。

限制

评估没有设盲,也没有检查对精神病的影响。

结论

该研究表明,针对以当前为中心的自我参照意义的简短、新颖的 ImRs 协议是侵入性创伤记忆的一种有希望的干预措施。未来的研究应调查其与以创伤为中心的精神病治疗的整合以及对精神病严重程度的影响。

更新日期:2021-11-20
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