Change processes associated with functional improvement in a web-based version of Skills Training in Affective and Interpersonal Regulation (webSTAIR) for trauma-exposed veterans.

IF 4.5 1区心理学 Q1 PSYCHOLOGY, CLINICAL Journal of consulting and clinical psychology Pub Date : 2024-10-01 DOI:10.1037/ccp0000906

Kathryn S Macia, Eve B Carlson, Daniel M Blonigen, Jan Lindsay, Marylène Cloitre

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Abstract

Objective: In spite of the evidence that both symptom reduction and functional improvement are important for supporting recovery from trauma, psychotherapy process research has largely focused on mechanisms of symptom reduction. A better understanding of how change occurs in treatments that emphasize functional improvement rather than trauma processing is critical for optimizing effective, patient-centered care.

Method: This study involved secondary analysis of data collected in three multisite trials of a 10-module web-based version of Skills Training in Affective and Interpersonal Regulation, a skills-focused transdiagnostic intervention. The sample included 314 trauma-exposed veterans (38% male; 64% non-Hispanic White) who screened positive for elevated symptoms of posttraumatic stress disorder and/or depression. Latent change score modeling examined prospective relationships between changes from pre-to-mid and mid-to-post treatment in four potential mechanisms (emotion regulation, interpersonal problems, posttraumatic stress disorder symptoms, and depression symptoms) and the association of these changes with overall functional improvement (at posttreatment and follow-up).

Results: Emotion regulation change during the first half of treatment predicted interpersonal and symptom improvements during the second half of treatment, but not vice versa. Changes in each potential mechanism were uniquely associated with functional improvement and together statistically accounted for 78% additional variance in functional improvement beyond what was associated with baseline functioning and covariates.

Conclusions: Results support emotion regulation as an early mechanism of transdiagnostic therapeutic change in web-based version of Skills Training in Affective and Interpersonal Regulation and highlight the relevance of all four potential mechanisms to functional improvement. The study contributes to an understanding of how change occurs in skills-focused interventions for trauma-exposed individuals. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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针对受过创伤的退伍军人的情感和人际关系调节技能培训（webSTAIR）网络版中与功能改善相关的变化过程。

目的：尽管有证据表明，减轻症状和改善功能对于支持创伤康复都很重要，但心理治疗过程的研究却主要集中在减轻症状的机制上。更好地了解强调功能改善而非创伤处理的治疗中如何发生变化，对于优化有效的、以患者为中心的护理至关重要：本研究对情感和人际关系调节技能培训（一种以技能为重点的跨诊断干预方法）的 10 个模块网络版的三项多站点试验所收集的数据进行了二次分析。样本包括 314 名受到创伤的退伍军人（38% 为男性；64% 为非西班牙裔白人），他们的创伤后应激障碍和/或抑郁症状均呈阳性。隐性变化评分模型研究了四种潜在机制（情绪调节、人际关系问题、创伤后应激障碍症状和抑郁症状）从治疗前中期到治疗中期后的变化之间的前瞻性关系，以及这些变化与整体功能改善（治疗后和随访时）之间的关联：结果：治疗前半期的情绪调节变化预示着治疗后半期人际关系和症状的改善，但反之亦然。每种潜在机制的变化都与功能改善有着独特的联系，并且在统计学上，除了与基线功能和协变量相关的变化外，它们还共同解释了功能改善中78%的额外差异：研究结果表明，情绪调节是情感和人际关系调节技能训练网络版跨诊断治疗改变的早期机制，并强调了所有四种潜在机制与功能改善的相关性。这项研究有助于人们理解，针对受到创伤的个体进行的以技能为重点的干预是如何产生变化的。(PsycInfo Database Record (c) 2024 APA，保留所有权利）。

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来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

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.