A home-based telehealth randomized controlled trial of skills training in affective and interpersonal regulation versus present-centered therapy for women veterans who have experienced military sexual trauma.

IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Journal of consulting and clinical psychology Pub Date : 2024-05-01 Epub Date: 2024-01-15 DOI:10.1037/ccp0000872
Marylene Cloitre, Danielle Morabito, Kathryn Macia, Sarah Speicher, Jessilyn Froelich, Katelyn Webster, Annabel Prins, Diana Villasenor, Asha Bauer, Christie Jackson, Laura Fabricant, Shannon Wiltsey-Stirman, Leslie Morland
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Abstract

Objective: This randomized trial tested the effectiveness of Skills Training in Affective and Interpersonal Regulation (STAIR) compared to present-centered therapy (PCT) delivered virtually to women veterans who had experienced military sexual trauma (MST) and screened positive for posttraumatic stress disorder (PTSD).

Method: One hundred sixty-one eligible women veterans were randomized into the study. The primary outcome was clinician-assessed PTSD severity (Clinician-Administered PTSD Scale-5), while secondary outcomes included social support and several other symptom measures at posttreatment through 2- and 4-month follow-up.

Results: PTSD severity decreased in both conditions by posttreatment but significantly more (p = .028, d = 0.39) in STAIR (d = 1.12 [0.87, 1.37]) than PCT (d = .78 [0.54, 1.02]). STAIR was also superior in improving social support and emotion regulation and reducing depression and negative cognitions. Improvement in psychosocial functioning was moderate and did not differ between conditions. All changes were maintained through 2- and 4-month follow-ups. Dropout rates were low and did not differ (19.0% and 12.2%, respectively).

Conclusion: STAIR provided superior outcomes compared to PCT regarding PTSD, social support, and multiple types of mental health problems among women veterans with MST. The application of STAIR to other populations with social support and related concerns warrants investigation. The substantial effect sizes for PTSD symptoms in both treatments suggest that they are practical alternatives for individuals who do not wish to participate in trauma-focused therapy and may increase engagement in mental health services. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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一项以家庭为基础的远程医疗随机对照试验,针对经历过军队性创伤的女性退伍军人进行情感和人际关系调节方面的技能培训与以现在为中心的治疗。
试验目的这项随机试验测试了情感和人际关系调节技能培训(STAIR)与当前中心疗法(PCT)的有效性比较,后者是以虚拟方式提供给经历过军队性创伤(MST)并筛查出创伤后应激障碍(PTSD)的女性退伍军人:方法:161 名符合条件的女性退伍军人被随机纳入研究。主要结果是临床医生评估的创伤后应激障碍严重程度(临床医生管理的创伤后应激障碍量表-5),次要结果包括治疗后 2 个月和 4 个月随访期间的社会支持和其他一些症状测量:治疗后,两种情况下的创伤后应激障碍严重程度都有所下降,但 STAIR(d = 1.12 [0.87, 1.37])的下降幅度(p = .028,d = 0.39)明显高于 PCT(d = .78 [0.54, 1.02])。STAIR 在改善社会支持和情绪调节、减少抑郁和消极认知方面也更胜一筹。社会心理功能的改善程度适中,在不同条件下没有差异。所有的变化都在 2 个月和 4 个月的随访中得以保持。辍学率较低且无差异(分别为 19.0% 和 12.2%):结论:与 PCT 相比,STAIR 在创伤后应激障碍、社会支持以及患有创伤后应激障碍的女性退伍军人的多种心理健康问题方面提供了更好的结果。将 STAIR 应用于其他有社会支持和相关问题的人群值得研究。这两种治疗方法对创伤后应激障碍症状的显著效果表明,对于那些不愿意参加以创伤为中心的治疗的人来说,这两种治疗方法是切实可行的替代疗法,而且可以提高心理健康服务的参与度。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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来源期刊
CiteScore
9.00
自引率
3.40%
发文量
94
期刊介绍: The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.
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