The Research Of Indigenization And Militarization Of PTSD Treatment By Prolonged Exposure

PurposePosttraumatic Stress Disorder(PTSD)is a psychiatric disorder that occurs after a traumatic event.The core symptoms of PTSD are intrusiveness of traumatic event,avoidance of trauma-related stimulus,negative change of cognition and emotion,and hypervigilance and extreme behavior,which severely harm physical and psychological health and caused heavy social burden.PTSD is intimately related to military operations.There has been a steady and continuous increase of military force in our country.The prevalence of PTSD in Chinese troops was elevated with the increasing trend of realworld combat training and deployments.Hence,there is an urgent need to develop an effective psychological intervention for more probable coming PTSD patients.Prolonged exposure(PE),a trauma-focused psychotherapy,was recommended by authoritative clinical guidelines in foreign countries for PTSD treatment.Breath training,imaginal exposure and in vivo exposure are three key elements of PE.Up to now,the studies related to PE have been very limited in our country.In order to provide evidence for indigenization,the current research aimed to firstly study the effect of PE in PTSD treatment in a review method.To boost the PE application in native population,the study secondly adapted standard PE therapy brochure for indigenization and militarization.Thirdly,a pilot study of treatment effect of PE in native people was conducted.The achievements from indigenization and militarization of PE were utilized to intervene the native people with prominent PTSD symptoms by using a comparative method,to provide preliminary evidence for large-scale randomized control trials and dissemination.MethodBy using META-analytical method,PE was compared to control group on PTSD treatment effect.Comparisons of different forms of PE were also performed.In the indigenization and militarization of PE technique,a research group was formed and adopted three steps to conduct the work: preliminary revision,case study with revision,and panel discussion with revision.A comparative method was adopted to conduct 8-week interventions for subjects with prominent PTSD symptoms in the native population.PE group and wait-list groups were arranged and the aim was to examine the effect of group and time.Results1.A total of 18 studies were included with 1397 participants.Standard PE had lower PTSD score than control group at posttreatment(Hedges’ s g=-0.714,p=0.003).PE in other forms had significantly lower PTSD scores than control group(e.g.,relaxation,wait-list)at posttreatment(Hedges’ s g=-0.647,p=0.001).There was generally no significant difference on PTSD score at posttreatment(Hedges’ s g=-0.172,p=0.198)and follow-up(Hedges’ s g=0.012,p=0.909),and dropout rate(Hedges’ s g=-0.122,p=0.174)between PE in other forms and standard PE.PE combined with drug had significantly lower PTSD score(Hedges’ s g=-0.668,p=0.049)and significantly lower(marginally)dropout rate(Hedges’ s g=-0.223,p=0.052)than standard PE in subgroup analysis.The significance of the above results was not affected by studies with high heterogeneity.2.The brochure of PE after indigenization and militarization was completed,consisting of three parts: PE therapy technique,brochure for PE therapist and brochure for practice of client.3.A total of 18 participants were recruited in the study.There were 8 subjects in the PE group and 10 subjects in the wait-list group.Mixed linear model with PTSD score being dependent variable showed the effect of time(F=9.428,p<0.001),group(F=7.339,p=0.015),and interaction of time and group(F=8.444,p<0.001)were significant.In the model of negative emotion score being dependent variable,the effect of time(F=3.351,p=0.004),group(F=10.289,p=0.006),and interaction of time and group(F=3.323,p=0.004)were also significant.Those who finished no less than 6assessments were included into further comparative analysis(n(PE)=6,n(wait-list)=6).PE group had significantly lower interviewed PTSD score at posttreatment compared to pretreatment(42.17 vs 17.67,t=5.400,p=0.003).There was no significant difference on PTSD self-rated score(t=0.034,p=0.972)and negative emotion self-rated score(t=-1.104,p=0.296)at pretreatment in PE group and wait-list group,but significantly lower score in PE group at posttreatment(PTSD: t=-4.202,p=0.002;negative emotion: t=-3.532,p=0.005).The decrease in PTSD score and negative emotion score was significantly larger in the PE group than the control group.Conclusion1.Compared to the control group,PE was more effective in PTSD treatment.There was no significant difference in the treatment effect among various forms of PE.PE augmented by drug could enhance the curative effect.2.PE brochure after indigenization and militarization could provide guidance forResults PTSD intervention.3.Preliminary results from a small sample showed the PE technique was effective in native people with prominent PTSD symptoms and could also alleviate negative emotions.