Department of Psychiatry, Academic Medical Center, Center for Anxiety Disorders, Research Group Psychotrauma, Amsterdam, the Netherlands.
Eur J Psychotraumatol. 2011;2. doi: 10.3402/ejpt.v2i0.8294. Epub 2011 Nov 4.
Injured trauma victims are at risk of developing Posttraumatic Stress Disorder (PTSD) and other post-trauma psychopathology. So far, interventions using cognitive behavioral techniques (CBT) have proven most efficacious in treating early PTSD in highly symptomatic individuals. No early intervention for the prevention of PTSD for all victims has yet proven effective. In the acute psychosocial care for trauma victims, there is a clear need for easily applicable, accessible, cost-efficient early interventions.
To describe the design of a randomized controlled trial (RCT) evaluating the effectiveness of a brief Internet-based early intervention that incorporates CBT techniques with the aim of reducing acute psychological distress and preventing long-term PTSD symptoms in injured trauma victims.
In a two armed RCT, 300 injured trauma victims from two Level-1 trauma centers in Amsterdam, the Netherlands, will be assigned to an intervention or a control group. Inclusion criteria are: being 18 years of age or older, having experienced a traumatic event according to the diagnostic criteria of the DSM-IV and understanding the Dutch language. The intervention group will be given access to the intervention's website (www.traumatips.nl), and are specifically requested to login within the first month postinjury. The primary clinical study outcome is PTSD symptom severity. Secondary outcomes include symptoms of depression and anxiety, quality of life, and social support. In addition, a cost-effectiveness analysis of the intervention will be performed. Data are collected at one week post-injury, prior to first login (baseline), and at 1, 3, 6 and 12 months. Analyses will be on an intention-to-treat basis.
The results will provide more insight into the effects of preventive interventions in general, and Internet-based early interventions specifically, on acute stress reactions and PTSD, in an injured population, during the acute phase after trauma. We will discuss possible strengths and limitations.
受伤的创伤患者有发生创伤后应激障碍（PTSD）和其他创伤后精神病理学的风险。到目前为止，使用认知行为技术（CBT）的干预措施已被证明对治疗高度症状个体的早期 PTSD 最有效。还没有针对所有受害者的 PTSD 预防的早期干预措施被证明是有效的。在创伤患者的急性心理社会护理中，迫切需要易于应用、可及且具有成本效益的早期干预措施。
描述一项随机对照试验（RCT）的设计，该试验评估了一种简短的基于互联网的早期干预措施的有效性，该措施结合了 CBT 技术，旨在减轻受伤创伤患者的急性心理困扰并预防长期 PTSD 症状。
在一项两臂 RCT 中，将来自荷兰阿姆斯特丹的两个 1 级创伤中心的 300 名受伤创伤患者分配到干预组或对照组。纳入标准为：年龄在 18 岁或以上，根据 DSM-IV 的诊断标准经历过创伤事件，并且理解荷兰语。干预组将获得干预网站（www.traumatips.nl）的访问权限，并特别要求在受伤后第一个月内登录。主要临床研究结果是 PTSD 症状严重程度。次要结果包括抑郁和焦虑症状、生活质量和社会支持。此外，还将对干预措施进行成本效益分析。数据在受伤后一周、首次登录前（基线）以及 1、3、6 和 12 个月时收集。分析将基于意向治疗原则进行。
研究结果将更深入地了解一般预防性干预措施，特别是针对受伤人群的基于互联网的早期干预措施，在创伤后急性阶段对急性应激反应和 PTSD 的影响。我们将讨论可能的优势和局限性。
