El efecto de la psicoterapia de grupo en la salud mental de los militares con trastorno de estrés postraumático
Palabras clave:
psicoterapia, salud mental, estrés, enfermedades relacionadas con el estrés, militares
Resumen
El objetivo del artículo es determinar las condiciones para el uso eficaz de la psicoterapia de grupo en el trabajo con militares con trastorno de estrés postraumático (TEPT). La investigación empleó los métodos de prueba y experimento formativo. La muestra estuvo formada por militares con síntomas de trastorno de estrés postraumático. El programa de psicoterapia de grupo demostró una eficacia desigual. La efectividad del trabajo individual y grupal para reducir los síntomas de reexperimentar el evento es moderada. Las manifestaciones de evitar situaciones traumáticas no cambiaron significativamente en el proceso de influencia grupal, mientras que se registró una influencia positiva moderada en el caso de aplicar un enfoque individual. La psicoterapia de grupo es la más eficaz para trabajar con los síntomas de excitación emocional de los militares, que resultan de un trauma. La importancia de la implementación de los resultados obtenidos radica en el desarrollo de programas y protocolos de psicoterapia eficaces destinados a superar el trastorno de estrés postraumático de los veteranos y combatientes. La investigación futura puede centrarse en ampliar la muestra de investigación y la implementación de una combinación experimental de psicoterapia individual y grupal en el trabajo con militares con trastorno de estrés postraumático.
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Cowden, R. C., Chapman, I. M., Houghtaling, A., & Worthington, Jr. E. L. (2021). Effects of a group experiential therapy program on the psychological health of military veterans: A preliminary investigation. Person-Centered & Experiential Psychotherapies, 20(2), 119-138. https://doi.org/10.1080/14779757.2020.1846599
Forbes, D., Creamer, M., Bisson, J. I., Cohen, J. A., Crow, B. E., Foa, E. B., Friedman, M. J., Keane, T. M., Kudler, H. S., & Ursano, R. J. (2010). A guide to guidelines for the treatment of PTSD and related conditions. Journal of Traumatic Stress, 23(5), 537–552. https://doi.org/10.1002/jts.20565
Giourou, E., Skokou, M., Andrew, S. P., Alexopoulou, K., Gourzis, P., & Jelastopulu, E. (2018). Complex posttraumatic stress disorder: The need to consolidate a distinct clinical syndrome or to reevaluate features of psychiatric disorders following interpersonal trauma? World Journal of Psychiatry, 8(1), 12-19. https://doi.org/10.5498/wjp.v8.i1.12
Inoue, C., Shawler, E., Jordan, C. H., Moore, M. J., & Jackson, C. A. (2023). Veteran and military mental health issues. Treasure Island (FL): StatPearls Publishing
Jowf, G. I., Ahmed, Z. T., Reijnders, R. A., de Nijs, L., & Eijssen, L. M. T. (2023). To predict, prevent, and manage Post-Traumatic Stress Disorder (PTSD): A review of pathophysiology, treatment, and biomarkers. International Journal of Molecular Sciences, 24(6), 5238. https://doi.org/10.3390/ijms24065238
Kang, T. S., Goodwin, R., Hamama-Raz, Y., Leshem, E., & Ben-Ezra, M. (2023). Disability and post-traumatic stress symptoms in the Ukrainian general population during the 2022 Russian invasion. Epidemiology and Psychiatric Sciences, 32, e21. https://doi.org/10.1017/S204579602300015X
Kokun, O. M., Ahaev, N. A., Pishko, I. O., Lozinska, N. S., & Ostapchuk, V. V. (2017). Psychological work with servicemen - participants of the anti-terrorist operation at the stage of recovery: Methodical guide. Kyiv: NDC SE ZSU. https://core.ac.uk/download/pdf/84274034.pdf
Kurapov, A., Kalaitzaki, A., Keller, V., Danyliuk, I., & Kowatsch, T. (2023). The mental health impact of the ongoing Russian-Ukrainian war 6 months after the Russian invasion of Ukraine. Frontiers in Psychiatry, 14, 1134780. https://doi.org/10.3389/fpsyt.2023.1134780
Levi, O., Ben Yehuda, A., Pine, D. S., & Bar-Haim, Y. (2022). A sobering look at treatment effectiveness of military-related Posttraumatic Stress Disorder. Clinical Psychological Science, 10(4), 690-699. https://doi.org/10.1177/21677026211051314
Liu, J. J. W., Nazarov, A., Easterbrook, B., Plouffe, R. A., Le, T., Forchuk, C., Brandwood, A., St Cyr, K., Auger, E., Balderson, K., Bilodeau, M., Burhan, A. M., Enns, M. W., Smith, P., Hosseiny, F., Dupuis, G., Roth, M., Mota, N., Lavoie, V., & Richardson, J. D. (2021). Four decades of military Posttraumatic Stress: Protocol for a Meta-analysis and systematic review of treatment approaches and efficacy. JMIR Research Protocols, 10(10), e33151. https://doi.org/10.2196/33151
Lok, A., Frijling, J. L., & van Zuiden, M. (2018). Posttraumatic stress disorder: current insights in diagnostics, treatment and prevention. Ned Tijdschr Geneeskd, 161, D1905. https://pubmed.ncbi.nlm.nih.gov/29328008/
Maercker, A., Cloitre, M., Bachem, R., Schlumpf, Y. R., Khoury, B., Hitchcock, C., & Bohus, M. (2022). Complex post-traumatic stress disorder. Lancet, 400(10345), P60-72. https://doi.org/10.1016/S0140-6736(22)00821-2
Maercker, A., Hecker, T., Augsburger, M., & Kliem, S. (2018). ICD-11 prevalence rates of Posttraumatic Stress Disorder and complex Posttraumatic Stress Disorder in a German nationwide sample. The Journal of Nervous and Mental Disease, 206(4), 270–276. https://doi.org/10.1097/NMD.0000000000000790
Mann, S.K., & Marwaha, R. (2023). Posttraumatic Stress Disorder. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559129/
Marmarosh, C. L., Sandage, S., Wade, N., Captari, L. E., & Crabtree, S. (2022). New horizons in group psychotherapy research and practice from third wave positive psychology: A practice-friendly review. Research in Psychotherapy: Psychopathology, Process and Outcome, 25(3), 643. https://doi.org/10.4081/ripppo.2022.643
Morland, L., Hynes, A. K., Mackintosh, M. A., Resick, P. A., & Chard, K. M. (2011). Group cognitive processing therapy delivered to veterans via telehealth: A pilot cohort. Journal of Traumatic Stress, 24(4), 465-469. https://doi.org/10.1002/jts.20661
Quirke, E., Klymchuk, V., Suvalo, O., Bakolis, I., & Thornicroft, G. (2021). Mental health stigma in Ukraine: Cross-sectional survey. Global Mental Health, 8, e11. https://doi.org/10.1017/gmh.2021.9
Resick, P. A., Wachen, J. S., Dondanville, K. A., Pruiksma, K. E., Yarvis, J. S., Peterson, A. L., Mintz, J., & STRONG STAR Consortium. (2017). Effect of group vs individual cognitive processing therapy in active-duty military seeking treatment for posttraumatic stress disorder: A randomized clinical trial. JAMA Psychiatry, 74(1), 28-36. https://doi.org/10.1001/jamapsychiatry.2016.2729
Romaniuk, О.О. (2021). (2021). Postтraumatic stress disorder as a consequence of the influence of combat stress on military servants. Bulletin of National Defense University of Ukraine, 58(5), 161–165. https://doi.org/10.33099/2617-6858-2020-58-5-161-165
Rosendahl, J., Alldredge, C. T., Burlingame, G. M., & Strauss, B. (2021). Recent developments in group psychotherapy research. American Journal of Psychotherapy, 74(2), 52-59. https://doi.org/10.1176/appi.psychotherapy.20200031
Schwartze, D., Barkowski, S., Strauss, B., Knaevelsrud, C., & Rosendahl, J. (2019). Efficacy of group psychotherapy for posttraumatic stress disorder: Systematic review and meta- analysis of randomized controlled trials. Psychotherapy Research, 29(4), 415-431. https://doi.org/10.1080/10503307.2017.1405168
Seleznova, V., Pinchuk, I., Feldman, I., Virchenko, V., Wang, B., & Skokauskas, N. (2023). The battle for mental well-being in Ukraine: Mental health crisis and economic aspects of mental health services in wartime. International Journal of Mental Health Systems, 17, 28. https://doi.org/10.1186/s13033-023-00598-3
Spiller, T. R., Duek, O., Buta, E., Gross, G., Smith, N. B., & Harpaz-Rotem, I. (2023). Comparative effectiveness of group v. individual trauma-focused treatment for posttraumatic stress disorder in veterans. Psychological Medicine, 53(10), 4561-4568. https://doi.org/10.1017/S0033291722001441
Springer, K. S., Levy, H. C., & Tolin D. F. (2018). Remission in CBT for adult anxiety disorders: A meta-analysis. Clinical Psychology Review, 61, 1–8. https://doi.org/10.1016/j.cpr.2018.03.002
Steenkamp, M. M., Litz, B. T., Hoge, C. W., & Marmar, C. R. (2015). Psychotherapy for military-related PTSD: A review of randomized clinical trials. JAMA, 314(5), 489–500. https://doi.org/10.1001/jama.2015.8370
Thimm, J.C., & Antonsen, L. (2014). Effectiveness of cognitive behavioral group therapy for depression in routine practice. BMC Psychiatry, 14(1), 292. https://doi.org/10.1186/s12888-014- 0292-x
Trivedi, R. B., Post, E. P., Sun, H., Pomerantz, A., Saxon, A. J., Piette, J. D., Maynard, C., Arnow, B., Curtis, I., Fihn, S. D., & Nelson, K. (2015). Prevalence, comorbidity, and prognosis of mental health among US veterans. American Journal of Public Health, 105(12), 2564–2569. https://doi.org/10. 2105/AJPH.2015.302836
US Department of Veteran Affairs. (2020). PTSD Treatment Basics. https://www.ptsd.va.gov/understand_tx/tx_basics.asp Whittingham, M., Lefforge, N., & Marmarosh, C. (2021). Group psychotherapy as a specialty: An inconvenient truth. American Journal of Psychotherapy, 74, 60-66. https://doi.org/10.1176/appi.psychotherapy.20200037
Yalom, I. D., & Leszcz, M. (2020). The theory and practice of group psychotherapy. New York: Basic Books. Zasiekina, L., Zasiekin, S., & Kuperman, V. (2023). Post-traumatic stress disorder and moral injury among Ukrainian civilians during the ongoing war. Journal of Community Health, 48(5), 784-792. https://doi.org/10.1007/s10900-023-01225-5
Bryant, R. A., Friedman, M. J., Spiegel, D., Ursano, R., & Strain, J. (2011). A review of acute stress disorder in DSM-5. Depression and Anxiety, 28(9), 802-17. https://doi.org/10.1002/da.20737
Burlingame, G. M., & Strauss, B. (2021). Efficacy of small group treatments. In: L. G. Castonguay, M. Barkham, & W. Lutz (Eds.), Bergin and Garfield’s handbook of psychotherapy and behavior change (pp. 583–624). New York: Wiley.
Coventry, P. A., Meader, N., Melton, H., Temple, M., Dale, H., Wright, K., Cloitre, M., Karatzias, T., Bisson, J., Roberts, N. P., Brown, J., Barbui, C., Churchill, R., Lovell, K., McMillan, D., & Gilbody, S. (2020). Psychological and pharmacological interventions for posttraumatic stress disorder and comorbid mental health problems following complex traumatic events: Systematic review and component network meta-analysis. PLoS Medicine, 17(8), e1003262. https://doi.org/10.1371/journal.pmed.1003262
Cowden, R. C., Chapman, I. M., Houghtaling, A., & Worthington, Jr. E. L. (2021). Effects of a group experiential therapy program on the psychological health of military veterans: A preliminary investigation. Person-Centered & Experiential Psychotherapies, 20(2), 119-138. https://doi.org/10.1080/14779757.2020.1846599
Forbes, D., Creamer, M., Bisson, J. I., Cohen, J. A., Crow, B. E., Foa, E. B., Friedman, M. J., Keane, T. M., Kudler, H. S., & Ursano, R. J. (2010). A guide to guidelines for the treatment of PTSD and related conditions. Journal of Traumatic Stress, 23(5), 537–552. https://doi.org/10.1002/jts.20565
Giourou, E., Skokou, M., Andrew, S. P., Alexopoulou, K., Gourzis, P., & Jelastopulu, E. (2018). Complex posttraumatic stress disorder: The need to consolidate a distinct clinical syndrome or to reevaluate features of psychiatric disorders following interpersonal trauma? World Journal of Psychiatry, 8(1), 12-19. https://doi.org/10.5498/wjp.v8.i1.12
Inoue, C., Shawler, E., Jordan, C. H., Moore, M. J., & Jackson, C. A. (2023). Veteran and military mental health issues. Treasure Island (FL): StatPearls Publishing
Jowf, G. I., Ahmed, Z. T., Reijnders, R. A., de Nijs, L., & Eijssen, L. M. T. (2023). To predict, prevent, and manage Post-Traumatic Stress Disorder (PTSD): A review of pathophysiology, treatment, and biomarkers. International Journal of Molecular Sciences, 24(6), 5238. https://doi.org/10.3390/ijms24065238
Kang, T. S., Goodwin, R., Hamama-Raz, Y., Leshem, E., & Ben-Ezra, M. (2023). Disability and post-traumatic stress symptoms in the Ukrainian general population during the 2022 Russian invasion. Epidemiology and Psychiatric Sciences, 32, e21. https://doi.org/10.1017/S204579602300015X
Kokun, O. M., Ahaev, N. A., Pishko, I. O., Lozinska, N. S., & Ostapchuk, V. V. (2017). Psychological work with servicemen - participants of the anti-terrorist operation at the stage of recovery: Methodical guide. Kyiv: NDC SE ZSU. https://core.ac.uk/download/pdf/84274034.pdf
Kurapov, A., Kalaitzaki, A., Keller, V., Danyliuk, I., & Kowatsch, T. (2023). The mental health impact of the ongoing Russian-Ukrainian war 6 months after the Russian invasion of Ukraine. Frontiers in Psychiatry, 14, 1134780. https://doi.org/10.3389/fpsyt.2023.1134780
Levi, O., Ben Yehuda, A., Pine, D. S., & Bar-Haim, Y. (2022). A sobering look at treatment effectiveness of military-related Posttraumatic Stress Disorder. Clinical Psychological Science, 10(4), 690-699. https://doi.org/10.1177/21677026211051314
Liu, J. J. W., Nazarov, A., Easterbrook, B., Plouffe, R. A., Le, T., Forchuk, C., Brandwood, A., St Cyr, K., Auger, E., Balderson, K., Bilodeau, M., Burhan, A. M., Enns, M. W., Smith, P., Hosseiny, F., Dupuis, G., Roth, M., Mota, N., Lavoie, V., & Richardson, J. D. (2021). Four decades of military Posttraumatic Stress: Protocol for a Meta-analysis and systematic review of treatment approaches and efficacy. JMIR Research Protocols, 10(10), e33151. https://doi.org/10.2196/33151
Lok, A., Frijling, J. L., & van Zuiden, M. (2018). Posttraumatic stress disorder: current insights in diagnostics, treatment and prevention. Ned Tijdschr Geneeskd, 161, D1905. https://pubmed.ncbi.nlm.nih.gov/29328008/
Maercker, A., Cloitre, M., Bachem, R., Schlumpf, Y. R., Khoury, B., Hitchcock, C., & Bohus, M. (2022). Complex post-traumatic stress disorder. Lancet, 400(10345), P60-72. https://doi.org/10.1016/S0140-6736(22)00821-2
Maercker, A., Hecker, T., Augsburger, M., & Kliem, S. (2018). ICD-11 prevalence rates of Posttraumatic Stress Disorder and complex Posttraumatic Stress Disorder in a German nationwide sample. The Journal of Nervous and Mental Disease, 206(4), 270–276. https://doi.org/10.1097/NMD.0000000000000790
Mann, S.K., & Marwaha, R. (2023). Posttraumatic Stress Disorder. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559129/
Marmarosh, C. L., Sandage, S., Wade, N., Captari, L. E., & Crabtree, S. (2022). New horizons in group psychotherapy research and practice from third wave positive psychology: A practice-friendly review. Research in Psychotherapy: Psychopathology, Process and Outcome, 25(3), 643. https://doi.org/10.4081/ripppo.2022.643
Morland, L., Hynes, A. K., Mackintosh, M. A., Resick, P. A., & Chard, K. M. (2011). Group cognitive processing therapy delivered to veterans via telehealth: A pilot cohort. Journal of Traumatic Stress, 24(4), 465-469. https://doi.org/10.1002/jts.20661
Quirke, E., Klymchuk, V., Suvalo, O., Bakolis, I., & Thornicroft, G. (2021). Mental health stigma in Ukraine: Cross-sectional survey. Global Mental Health, 8, e11. https://doi.org/10.1017/gmh.2021.9
Resick, P. A., Wachen, J. S., Dondanville, K. A., Pruiksma, K. E., Yarvis, J. S., Peterson, A. L., Mintz, J., & STRONG STAR Consortium. (2017). Effect of group vs individual cognitive processing therapy in active-duty military seeking treatment for posttraumatic stress disorder: A randomized clinical trial. JAMA Psychiatry, 74(1), 28-36. https://doi.org/10.1001/jamapsychiatry.2016.2729
Romaniuk, О.О. (2021). (2021). Postтraumatic stress disorder as a consequence of the influence of combat stress on military servants. Bulletin of National Defense University of Ukraine, 58(5), 161–165. https://doi.org/10.33099/2617-6858-2020-58-5-161-165
Rosendahl, J., Alldredge, C. T., Burlingame, G. M., & Strauss, B. (2021). Recent developments in group psychotherapy research. American Journal of Psychotherapy, 74(2), 52-59. https://doi.org/10.1176/appi.psychotherapy.20200031
Schwartze, D., Barkowski, S., Strauss, B., Knaevelsrud, C., & Rosendahl, J. (2019). Efficacy of group psychotherapy for posttraumatic stress disorder: Systematic review and meta- analysis of randomized controlled trials. Psychotherapy Research, 29(4), 415-431. https://doi.org/10.1080/10503307.2017.1405168
Seleznova, V., Pinchuk, I., Feldman, I., Virchenko, V., Wang, B., & Skokauskas, N. (2023). The battle for mental well-being in Ukraine: Mental health crisis and economic aspects of mental health services in wartime. International Journal of Mental Health Systems, 17, 28. https://doi.org/10.1186/s13033-023-00598-3
Spiller, T. R., Duek, O., Buta, E., Gross, G., Smith, N. B., & Harpaz-Rotem, I. (2023). Comparative effectiveness of group v. individual trauma-focused treatment for posttraumatic stress disorder in veterans. Psychological Medicine, 53(10), 4561-4568. https://doi.org/10.1017/S0033291722001441
Springer, K. S., Levy, H. C., & Tolin D. F. (2018). Remission in CBT for adult anxiety disorders: A meta-analysis. Clinical Psychology Review, 61, 1–8. https://doi.org/10.1016/j.cpr.2018.03.002
Steenkamp, M. M., Litz, B. T., Hoge, C. W., & Marmar, C. R. (2015). Psychotherapy for military-related PTSD: A review of randomized clinical trials. JAMA, 314(5), 489–500. https://doi.org/10.1001/jama.2015.8370
Thimm, J.C., & Antonsen, L. (2014). Effectiveness of cognitive behavioral group therapy for depression in routine practice. BMC Psychiatry, 14(1), 292. https://doi.org/10.1186/s12888-014- 0292-x
Trivedi, R. B., Post, E. P., Sun, H., Pomerantz, A., Saxon, A. J., Piette, J. D., Maynard, C., Arnow, B., Curtis, I., Fihn, S. D., & Nelson, K. (2015). Prevalence, comorbidity, and prognosis of mental health among US veterans. American Journal of Public Health, 105(12), 2564–2569. https://doi.org/10. 2105/AJPH.2015.302836
US Department of Veteran Affairs. (2020). PTSD Treatment Basics. https://www.ptsd.va.gov/understand_tx/tx_basics.asp Whittingham, M., Lefforge, N., & Marmarosh, C. (2021). Group psychotherapy as a specialty: An inconvenient truth. American Journal of Psychotherapy, 74, 60-66. https://doi.org/10.1176/appi.psychotherapy.20200037
Yalom, I. D., & Leszcz, M. (2020). The theory and practice of group psychotherapy. New York: Basic Books. Zasiekina, L., Zasiekin, S., & Kuperman, V. (2023). Post-traumatic stress disorder and moral injury among Ukrainian civilians during the ongoing war. Journal of Community Health, 48(5), 784-792. https://doi.org/10.1007/s10900-023-01225-5
Publicado
2024-04-25
Cómo citar
Motoziuk, L., Chorna, N., Lukashuk, M., Vlasov, V., & Sobkova, S. (2024). El efecto de la psicoterapia de grupo en la salud mental de los militares con trastorno de estrés postraumático. Revista De La Universidad Del Zulia, 15(43), 44-60. https://doi.org/10.46925//rdluz.43.04
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