PDF(Pubmed)
Abstract：
Background: Imagery rescripting (ImRs) has shown to be an effective treatment for posttraumatic stress disorders (PTSD) resulting from childhood-related trauma. The current theory is that the change of meaning of the trauma memory is central to the treatment. Several authors have suggested that the expression of needs, feelings and actions may act as potential healing factors, but little specific research aimed at (in)validating this hypothesis has been done so far.Objective: In this study we investigated to what extent the expression of inhibited action tendencies and the fulfilling of needs lead to the reduction of PTSD symptoms in clients with early childhood trauma.Method: Recordings of 249 therapy sessions of 24 ImRs treatments were rated with an observation instrument developed for this purpose, after which the scores were related to pre and posttreatment symptoms, assessed with the Impact of Events Scale-Revised (IES-R).Results: Scores on the IES-R decreased from pretreatment to posttreatment. The two subscales of the NATS (At-scale and N-scale)significantly predicted the posttreatment scores on the IES-R after controlling for the influence of pretreatment IES-R scores: the better the expression of inhibited action tendencies and the better the fulfilling of needs, the lower the symptoms after treatment.Conclusions: This pilot study on the underlying mechanisms of ImRs in PTSD treatment has shown that the expression of action tendencies and fulfilling basic needs during ImRs are associated with a decrease in PTSD symptoms after treatment, and that actions and basic needs cannot be viewed separately. Follow-up research could focus on which of the six domains of the Needs and Action tendencies Scale (NATS) has the greatest effect on the reduction of PTSD symptoms. With this information we can further improve the ImRs protocol.
The pilot study of working mechanisms of imaginary rescripting shows that the NATS is a reliable research tool for observing expressed action tendencies and fulfilled needs.The better the action tendencies are expressed during treatment and the better the needs are fulfilled, the lower posttreatment symptoms.It seems useful if practitioners are specifically trained during the ImRs training in performing actions that lead to the fulfilment of basic needs.
The pilot study of working mechanisms of imaginary rescripting shows that the NATS is a reliable research tool for observing expressed action tendencies and fulfilled needs.The better the action tendencies are expressed during treatment and the better the needs are fulfilled, the lower posttreatment symptoms.It seems useful if practitioners are specifically trained during the ImRs training in performing actions that lead to the fulfilment of basic needs.
摘要：
背景：图像重新设定（ImRs）已被证明是一种有效的治疗儿童相关创伤引起的创伤后应激障碍（PTSD）的方法。目前的理论认为，创伤记忆的意义变化是治疗的核心。几位作者提出，需求的表达，感觉和行为可能是潜在的治愈因素，但是到目前为止，针对验证这一假设的具体研究很少。目的：在这项研究中，我们调查了抑制行动倾向的表达和需求的满足在多大程度上导致儿童早期创伤患者PTSD症状的减少。方法：使用为此目的开发的观察仪器对24个ImRs治疗的249个治疗疗程的记录进行评级，之后评分与治疗前和治疗后的症状有关，用事件影响量表修订(IES-R)评估。结果：IES-R的评分从治疗前降低到治疗后降低。在控制预处理IES-R评分的影响后，NATS的两个子量表（At-scale和N-scale）显着预测了IES-R的后处理评分：抑制作用倾向的表达越好，满足需求越好，治疗后症状越低。结论：这项关于ImRs在PTSD治疗中的潜在机制的初步研究表明，在ImRs期间，行动倾向的表达和基本需求的满足与治疗后PTSD症状的减少有关。行动和基本需求不能分开看待。后续研究可以集中在需求和行动倾向量表（NATS）的六个领域中的哪个领域对减轻PTSD症状的影响最大。有了这些信息，我们可以进一步改进ImRs协议。
对想象的工作机制的初步研究表明，NATS是观察表达的行动趋势和满足的需求的可靠研究工具。治疗期间的行动倾向表现得越好，需求得到更好的满足，治疗后症状较低。如果在ImRs培训期间对从业人员进行专门培训，以执行导致满足基本需求的行动，这似乎很有用。
对想象的工作机制的初步研究表明，NATS是观察表达的行动趋势和满足的需求的可靠研究工具。治疗期间的行动倾向表现得越好，需求得到更好的满足，治疗后症状较低。如果在ImRs培训期间对从业人员进行专门培训，以执行导致满足基本需求的行动，这似乎很有用。
