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Journal of Zhejiang University SCIENCE B

ISSN 1673-1581(Print), 1862-1783(Online), Monthly

Repetitive transcranial magnetic stimulation combined with imaginal exposure therapy for adolescents with acute stress disorder: case report

Abstract: Acute stress disorder (ASD) is a transient psychiatric disorder that may arise subsequent to abrupt, extreme trauma exposure, and serves as a reliable indicator for the subsequent development of posttraumatic stress disorder (PTSD) (Bryant, 2011; Battle, 2013). It exhibits rapid progression in the aftermath of trauma and persists for a duration of days or weeks (not exceeding one month), manifesting symptoms of dissociation, re-experiencing, avoidance, and hyperarousal (Bielas et al., 2018). In the absence of efficacious and prompt intervention, ASD is linked to substantial morbidity and functional impairment (McLean et al., 2022). However, there is a deficiency in terms of providing sensitive diagnosis and effective treatment for adolescents diagnosed with ASD, with the majority of current approaches being derived from PTSD treatment. The prevailing strategies for addressing PTSD in children and young individuals primarily involve psychological intervention and pharmaceuticals, including selective serotonin reuptake inhibitors (SSRIs) (Smith et al., 2013). Nevertheless, the efficacy of SSRIs in adolescents with ASD remains suboptimal (Robb et al., 2010; Locher et al., 2017; Boaden et al., 2020).

Key words: rTMS; Imaginal exposure; Adolescents; Acute stress disorder; Case report

Chinese Summary  <1> 病例报告:重复经颅磁刺激联合影像暴露治疗青少年急性应激障碍

赵苗苗1,2,3, 李颖1,2,3, 赵昊阳1,2,3, 蒋超楠1,2,3, 黄满丽1,2,3
1浙江大学医学院附属第一医院精神科, 浙江省精神障碍管理重点实验室, 中国杭州市, 310003
2浙江大学脑研究所, 中国杭州市, 310003
3浙江省数学心理健康工程中心, 中国杭州市, 310003
摘要:青少年急性应激障碍(ASD)的症状通常是不典型且偏离常态的,因此未能得到足够重视。及时干预有可能减轻ASD向创伤后应激障碍(PTSD)发展。但对青少年急性应激障碍的诊断和治疗,尚缺乏经验支持和令人信服的证据。本文所述案例围绕两名被诊断为ASD的青少年展开,患者分别经历了反复出现的侵入性痛苦回忆、忍受负面情绪、逃避和睡眠中断。两名青少年在接受重复经颅磁刺激(rTMS)和想象暴露的联合治疗后,精神症状显著改善。此外,在1个月的随访期间,两例患者病情均保持稳定。上述病例表明,rTMS和想象暴露的结合有望成为青少年ASD的治疗策略,值得开展进一步研究。

关键词组:接受重复经颅磁刺激(rTMS);想象暴露;青少年;急性应激障碍(ASD);病例报告


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DOI:

10.1631/jzus.B2300765

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On-line Access:

2025-01-14

Received:

2023-10-19

Revision Accepted:

2024-02-20

Crosschecked:

2024-06-11

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