|
دانلود مقاله ترجمه شده اثر روان درمانی اختلال استرس پس از ضربه روحی بر اختلالات خواب
تاثیرات روان درمانی های مربوط به اختلال استرس پس از ضربه روحی بر اختلال های خواب نتایج برگرفته از آزمایش بالینی تصادفی
|
|
| دسته بندی | پزشکی |
| فرمت فایل | |
| حجم فایل | 800 کیلو بایت |
| تعداد صفحات فایل | 27 |
فهرست مقاله:
چکیده
1-مقدمه
1-1 اهداف مطالعه
2- روش ها
1-2 شرکت کنندگان
2-2شرایط درمان
1-2-2 درمان ادراکی به ازای درمان ادراکی اختلال استرس پس از ضربه روحی
2-2-2 درمان پشتیبانی متمرکز بر هیجان
3-2-2 لیست انتظار 14 هفته
3-2سنجش ها
1-3-2 سنجش های عمده کامل شده توسط تمامی گروه ها
1-1-3-2 علائم اختلال استرس پس از ضربه روحی
2-1-3-2 مدت خواب گود گزارشی
2-3-2 سنجش های مازاد تکمیل شده توسط تمامی گروه ها
1-2-3-2 کیفیت خواب خودگزارشی
3-2-3-2 علائم مرتبط
1-3-3-2 وقایع خواب ( مدت خواب گزارش شده در روز)
4-2 تحلیل داده ها
3- نتایج
1-3 سوال 1
1-1-3مدت خواب
2-1-3 شدت علائم اختلال پس از استرس ضربه روحی( به جز خواب)
3-1-3 سنجش های مازاد خواب
2-3:آیا میزان تغییر خواب به این بستگی دارد که آیا مداخله گری متمرکز بر آسیب روحی بوده یا نیست؟
1-2-3 مدت خواب
2-2-3 شدت علائم اختلال استرس پس از ضربه روحی ( به جز خواب)
3-2-3 سنجش های خواب مازاد
3-3 سوال 3
1-1-3-3 مدت خواب
2-3-3 تحلیل وقایع خواب در درمان ادراکی فشرده: قبل و بعد از مداخله گری به روز رسانی حافظه
-3 سوال 4.
5-3 سوال 5
4- بحث
1-4 محدودیت ها و جهت گیری های آتی
|
بخشی از ترجمه فارسی مقاله: 1-مقدمه |
|
بخشی از مقاله انگلیسی: 1. Introduction Sleep disturbances, such as difficulty falling and staying asleep and nightmares are two of the diagnostic symptoms of posttraumatic stress disorder (PTSD) (American Psychiatric Association, 2013). Sleep problems in PTSD include reduced self-reported and objective sleep duration and lower reported sleep quality (for review see Cox & Olatunji, 2016) and up to 60% of people with PTSD and insomnia complaints also meet criteria for an insomnia disorder (Ohayon & Shapiro, 2000). Trauma-focused psychological therapies are the first-line recommended treatments for individuals suffering from PTSD, including when comorbid insomnia is present. It is therefore important to understand the effects of trauma-focused PTSD treatments on sleep outcomes in order to maximize PTSD treatment efficacy. Only a small number of studies have investigated the effects of trauma-focused PTSD therapies on sleep outcomes (e.g., Belleville, Guay, & Marchand, 2011; Brownlow et al., 2016; Galovski, Monson, Bruce, & Resick, 2009; Galovski et al., 2016; Gutner, Casement, Gilbert, & Resick, 2013; Levrier, Marchand, Belleville, Dominic, & Guay, 2016; Lommen et al., 2015; Nishith et al., 2003; Raboni, Tufik, & Suchecki, 2006; Zayfert & DeViva, 2004). Improvement in sleep has been found for prolonged exposure (PE) and cognitive processing therapy (CPT) for PTSD (Brownlow et al., 2016; Galovski et al., 2016, 2009; Gutner et al., 2013), eye-movement desensitization and reprocessing therapy (Raboni et al., 2006), other cognitive behavioural therapies (Belleville et al., 2011; Levrier et al., 2016; Nishith et al., 2003; Zayfert & DeViva, 2004), and cognitive therapy for PTSD (CTPTSD) (Lommen et al., 2015). Direct comparisons of two evidencebased, trauma-focused PTSD therapies, CPT and PE, found no differences in sleep improvement between treatments (Galovski et al., 2009; Gutner et al., 2013). However, studies have also found that despite improvements in self-reported sleep duration and/or quality (Belleville et al., 2011; Galovski et al., 2009; Gutner et al., 2013; Lommen et al., 2015), nightmares (e.g., Gutner et al., 2013; Levrier et al., 2016), and insomnia symptoms (e.g., Gutner et al., 2013), sleep difficulties are commonly residual after PTSD therapy (Belleville et al., 2011; Galovski et al., 2016, 2009; Gutner et al., 2013), including in those who have recovered from PTSD (Zayfert & DeViva, 2004). It would therefore be important to investigate further which PTSD therapies, and which aspects of PTSD therapy, best promote sleep improvements, and whether sleep problems are residual to the same extent across different psychotherapies for PTSD. To our knowledge, no study has yet compared the effects of trauma and nontrauma-focused psychotherapy for PTSD on sleep, in adults. If trauma-focused therapy has superior effects on sleep compared to nontrauma-focused therapy, this may suggest that the focus on trauma memories and their meaning in these treatments may contribute to sleep improvements. It is also of interest to explore whether sleep improvement coincides with certain procedures in treatment that aim to change the “here and now” quality of trauma memories, such as the updating memories procedure in CT-PTSD (Ehlers & Clark, 2000). In this procedure, the individually most upsetting moments in memory are linked to less threatening meanings that the patient and therapist have identified from the course of events (e.g., “I did not die”) or through cognitive restructuring (e.g., “I could not have prevented the trauma even if I had acted differently”). Furthermore, few studies have investigated which symptom changes are associated with sleep improvements with traumafocused PTSD therapy (e.g., Lommen et al., 2015). Understanding whether treatment changes symptoms that have been associated with sleep disturbances in PTSD, such as arousal (see Sinha, 2016) and trauma-related nightmares (e.g., Woodward, Arsenault, Murray, & Bliwise, 2000), would be informative. Finally, research demonstrating the importance of sleep in learning and memory, emotional processing (Diekelmann, Biggel, Rasch, & Born, 2012; Wagner, Hallschmid, Rasch, & Born, 2006; Walker & van der Helm, 2009; Yoo, Hu, Gujar, Jolesz, & Walker, 2007), and retention and generalization of fear extinction learning (Kleim et al., 2013; Pace-Schott, Verga, Bennett, & Spencer, 2012) has contributed to concerns that reduced sleep duration may have a detrimental effect on response to psychological PTSD treatments. Many of the trauma-focused treatments for PTSD involve some form of exposure to trauma memories and reminders (Schnyder et al., 2017), and it is possible that reduced sleep duration may interfere with the effects of exposure through impairing retention of fear extinction learning. Poor sleep may also interfere by impacting an individual’s ability to retain learning from the treatment session through reducing concentration and attention in therapy, or interfering with consolidation of new information from the session, such as updated information and meanings in the trauma memory. There is also some evidence that poor sleep quality predicts a slower response to PTSD treatment, in people with PTSD and comorbid major depression (Lommen et al., 2015). However, recent studies have also found that nightmares did not impact the efficiency of CBT for PTSD (Levrier et al., 2016), and that while sleep-directed hypnosis before CPT for PTSD improved sleep more than a control condition, it did not lead to greater improvements in PTSD symptoms after CPT (Galovski et al., 2016), and thus initial evidence is so far inconclusive. Further research is needed into the effects of reduced sleep duration on PTSD treatment outcomes. |
