Feasibility of a trauma-focused internet- and mobile-based intervention for youth with posttraumatic stress symptoms.

IF 4.2 2区 医学 Q1 PSYCHIATRY European Journal of Psychotraumatology Pub Date : 2024-01-01 Epub Date: 2024-07-03 DOI:10.1080/20008066.2024.2364469
Christina Schulte, Cedric Sachser, Rita Rosner, David Daniel Ebert, Anna-Carlotta Zarski
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Abstract

Background: Many youth with posttraumatic stress symptoms (PTSS) do not receive evidence-based care. Internet- and Mobile-Based Interventions (IMIs) comprising evidence-based trauma-focused components can address this gap, but research is scarce. Thus, we investigated the feasibility of a trauma-focused IMI for youth with PTSS.Methods: In a one-arm non-randomized prospective proof-of-concept study, 32 youths aged 15-21 years with clinically relevant PTSS (CATS ≥ 21) received access to a trauma-focused IMI with therapist guidance, comprising nine sessions on an eHealth platform accessible via web-browser. We used a feasibility framework assessing recruitment capability, sample characteristics, data collection, satisfaction, acceptability, study management abilities, safety aspects, and efficacy of the IMI in PTSS severity and related outcomes. Self-rated assessments took place pre-, mid-, post-intervention and at 3-month follow-up and clinician-rated assessments at baseline and post-intervention.Results: The sample mainly consisted of young adult females with interpersonal trauma and high PTSS levels (CATS, M = 31.63, SD = 7.64). The IMI sessions were found useful and comprehensible, whereas feasibility of trauma processing was perceived as difficult. Around one-third of participants (31%) completed the IMI's eight core sessions. The study completer analysis showed a significant reduction with large effects in self-rated PTSS at post-treatment [t(21) = 4.27; p < .001; d = 0.88] and follow-up [t(18) = 3.83; p = .001; d = 0.84], and clinician-rated PTSD severity at post-treatment [t(21) = 4.52; p < .001; d = 0.93]. The intention-to-treat analysis indicated significant reductions for PTSS at post-treatment and follow-up with large effect sizes (d = -0.97- -1.02). All participants experienced at least one negative effect, with the most common being the resurfacing of unpleasant memories (n = 17/22, 77%).Conclusion: The study reached highly burdened young adults. The IMI was accepted in terms of usefulness and comprehensibility but many youths did not complete all sessions. Exploration of strategies to improve adherence in trauma-focused IMIs for youth is warranted, alongside the evaluation of the IMI's efficacy in a subsequent randomized controlled trial.

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针对有创伤后应激症状的青少年开展以创伤为重点的互联网和移动干预的可行性。
背景:许多患有创伤后应激症状(PTSS)的青少年得不到循证治疗。基于互联网和移动设备的干预(IMI)包含以创伤为重点的循证内容,可以弥补这一不足,但这方面的研究还很少。因此,我们研究了针对患有 PTSS 的青少年的以创伤为重点的 IMI 的可行性:在一项单臂非随机前瞻性概念验证研究中,32 名年龄在 15-21 岁、患有临床相关的 PTSS(CATS ≥ 21)的青少年在治疗师的指导下接受了以创伤为重点的 IMI,其中包括通过网络浏览器访问的电子健康平台上的 9 个疗程。我们采用了一个可行性框架,对招募能力、样本特征、数据收集、满意度、可接受性、研究管理能力、安全性以及 IMI 对 PTSS 严重程度和相关结果的疗效进行了评估。在干预前、干预中、干预后和3个月随访时进行自评,在基线和干预后进行临床医生评定:结果:样本主要由有人际创伤和较高创伤后应激障碍水平的年轻女性组成(CATS,M = 31.63,SD = 7.64)。参与者认为 IMI 课程有用且易于理解,而创伤处理的可行性则被认为是困难的。约三分之一的参与者(31%)完成了 IMI 的八个核心环节。研究完成者分析表明,在治疗后[t(21) = 4.27; p d = 0.88]和随访[t(18) = 3.83; p = .001; d = 0.84],自我评定的创伤后应激障碍严重程度和临床医生评定的创伤后应激障碍严重程度[t(21) = 4.52; p d = 0.93]均有显著降低,且影响较大。意向治疗分析表明,在治疗后和随访期间,创伤后应激障碍严重程度显著降低,且效应大小较大(d = -0.97--1.02)。所有参与者都经历了至少一次负面影响,最常见的是不愉快记忆的重现(n = 17/22,77%):结论:这项研究覆盖了负担沉重的年轻人。IMI在实用性和可理解性方面都得到了认可,但许多年轻人并没有完成所有疗程。除了在随后的随机对照试验中评估 IMI 的疗效外,还需要探索提高青少年对以创伤为重点的 IMI 坚持率的策略。
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来源期刊
CiteScore
7.60
自引率
12.00%
发文量
153
审稿时长
18 weeks
期刊介绍: The European Journal of Psychotraumatology (EJPT) is a peer-reviewed open access interdisciplinary journal owned by the European Society of Traumatic Stress Studies (ESTSS). The European Journal of Psychotraumatology (EJPT) aims to engage scholars, clinicians and researchers in the vital issues of how to understand, prevent and treat the consequences of stress and trauma, including but not limited to, posttraumatic stress disorder (PTSD), depressive disorders, substance abuse, burnout, and neurobiological or physical consequences, using the latest research or clinical experience in these areas. The journal shares ESTSS’ mission to advance and disseminate scientific knowledge about traumatic stress. Papers may address individual events, repeated or chronic (complex) trauma, large scale disasters, or violence. Being open access, the European Journal of Psychotraumatology is also evidence of ESTSS’ stand on free accessibility of research publications to a wider community via the web. The European Journal of Psychotraumatology seeks to attract contributions from academics and practitioners from diverse professional backgrounds, including, but not restricted to, those in mental health, social sciences, and health and welfare services. Contributions from outside Europe are welcome. The journal welcomes original basic and clinical research articles that consolidate and expand the theoretical and professional basis of the field of traumatic stress; Review articles including meta-analyses; short communications presenting new ideas or early-stage promising research; study protocols that describe proposed or ongoing research; case reports examining a single individual or event in a real‑life context; clinical practice papers sharing experience from the clinic; letters to the Editor debating articles already published in the Journal; inaugural Lectures; conference abstracts and book reviews. Both quantitative and qualitative research is welcome.
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