关键词：创伤后应激障碍;炸弹;认知;恐惧;精神障碍;公共卫生;压力(心理学)
摘 要：Background: Posttraumatic stress disorder (PTSD) is considered a major public health problem in the U.S. because it has fairly high prevalence and because people with PTSD often have problems with their work, relationships, and health. There are effective treatments for PTSD, such as prolonged exposure therapy (which works by inviting people to revisit their memories of traumatic events and to face objectively safe situations they have avoided). However, individuals with PTSD may not get the treatment they need because they live in rural locations with no trained clinicians or because they have transportation problems (for example, the distance makes frequent travel unfeasible or they cannot afford gas). Some individuals with PTSD do not feel comfortable driving (due to fears of roadside bombs) or they may feel uncomfortable in formal hospitals or other crowded places. One new method of giving treatments is by using interactive video equipment (called 'telemedicine'), so that the patient and his therapist can talk with each other and see each other over a monitor. Objectives/Rationale: The goal of the study is to compare exposure therapy in a usual format (face-to-face, in-person therapy) to the therapy in a telemedicine format. This project will help determine whether telemedicine can be used to provide needed therapies to veterans with PTSD in remote locations. Study Design: 210 military veterans with PTSD will receive exposure therapy either by telemedicine or in-person care. Progress: To date, 195 veterans have been enrolled in the study. PTSD symptoms and cognitive functioning are measured before treatment begins, at the completion of therapy, and at a 6 month follow- up assessment. At the end of therapy veterans and therapists are asked how satisfied they were with each type of treatment.