叙事暴露疗法在叙利亚创伤后应激障碍难民中应用的可行性和效果研究

The feasibility and preliminary efficacy of narrative exposure therapy on post-traumatic stress disorder among Syrian refugees in Jordan

目的创伤后应激障碍(osttraumatic stress disorder,PISD)、焦虑和抑郁是难民中常见的心理健康障碍,需要及时给予心理健康支持,以防止短期和长期的不良后果。本研究旨在评估叙事暴露疗法在减少居住在约旦的叙利亚难民的创伤后应激障碍、抑郁和焦虑症状方面的可行性和初步疗效。方法采用随机对照试验。共有40例年龄为18~64岁、被诊断患有PISD的叙利亚难民被随机分配到干预组(n=20)或对照组(n=20)。干预组应用叙事暴露疗法,每周1次,平均为10次;对照组接受育儿培训,并在本研究结束后接受相同的干预。干预前后应用哈佛创伤问卷(Harvard Trauma Questionnaire)阿拉伯语版评估PTSD症状,应用霍普金斯症状清单-25(Hopkins Symptoms Checklist-25)阿拉伯语版评估抑郁和焦虑症状。采用独立样本t检验评估两组间得分差异。结果与对照组相比,干预后干预组的PTSD(t=-10.00,P<0.001).焦虑(t=-9.46,P<0.001)和抑郁(=-6.00,P<0.001)评分明显降低。PTSD、抑郁和焦虑的效应量值(Cohen's d)分别为0.73、0.79和0.97。所有研究参与者全程参与研究,未发生不良事件。结论本研究结果为未来在更大范围实施叙事暴露疗法提供了有力的支持。叙事暴露疗法对于难民和其他患有PTSD焦虑和抑郁的患者来说可能是一种可行且賄用的方法。

Objectives:Post-traumatic stress disorder(PTSD),anxiety,and depression are common mental health disorders among refugees,and all require immediate mental health support to prevent short-and longterm detrimental health outcomes.The purpose of this study was to evaluate the feasibility and preliminary efficacy of narrative exposure therapy(NET)in reducing symptoms of PTSD,depression,and anxiety among Syrian refugees residing in Jordan.Methods:A two-arm randomized control trial was utilized.A total of 40 Syrian refugees aged 18 to 64 diagnosed with PTSD were randomly allocated to either the NET intervention group(n?20)or the waitlist control group(n?20)using a computer-generated allocation list with 1:1 allocation.PTSD symptoms were evaluated using the Arabic rendition of the Harvard Trauma Questionnaire,while depression and anxiety symptoms were appraised using the Arabic adaptation of the Hopkins Symptoms Checklist-25.Descriptive statistics were employed to characterize the sample and survey data.Independent t-tests were conducted to assess mean score differences in PTSD,anxiety,and depression between the intervention and control groups.Results:Post NET intervention,significant reductions in PTSD(t?10.00,P<0.001),anxiety(t?9.46,P<0.001),and depression(t?6.00,P<0.001)scores were observed in the intervention group compared to the control group.Effect sizes were moderate for the trauma(Cohen’s d?0.73)and depression(Cohen’s d?0.79)symptoms and notably large for anxiety symptoms(Cohen’s d?0.97).There were no adverse events related to study participation.The intervention achieved a 100%participant retention rate.Conclusions:The results pertaining to retention rate,adherence to the study protocol,data completeness,cultural congruence,and participants’satisfaction provided strong support for the future implementation of the full-scale RCT.NET may be a feasible and helpful approach for refugees and other patients with PTSD,anxiety,and depression.