Department of Behavioral Sciences, Rush University Medical Center.
Prevail Health Solutions.
Psychol Trauma. 2017 Aug;9(Suppl 1):42-50. doi: 10.1037/tra0000184. Epub 2016 Sep 22.
PTSD and depression are related to perceived physical health impairment in veterans, but little is known about the effects of psychological treatment on impairment. We examined the impact of an interactive online treatment for veterans with trauma-related distress, including (a) whether treatment effects include reduced perceived physical impairment, and (b) how these treatment effects are related to symptoms of PTSD and depression.
A randomized controlled trial assessed the impact on perceived physical health impairment of interactive online treatment for veterans with symptoms of PTSD and depression. Veterans were randomized to either the Vets Prevail program (n = 209), or a no-treatment control (n = 94) completing measures of depression and PTSD symptomology as well as perceived physical health impairment at 6 and 12 weeks following baseline assessment We conducted a series of multiple and single mediation analyses to examine how the effects of Vets Prevail on these outcomes are related.
Compared with control, Vets Prevail was (a) associated with significant reductions in perceived physical health impairment, and (b) this relationship was mediated by reductions in symptoms of PTSD, but not depression. Further analysis showed that perceived physical health impairment also mediated the relationships between intervention and PTSD and depression symptoms.
Findings indicate that Vets Prevail reduces perceptions of physical health impairment by reducing PTSD symptomology. It is also possible that treatment initiated more complex, bidirectional relationships such that improvements in psychological distress and in perceived physical health impairment reinforced each other over time. Findings demonstrate that Vets Prevail may help veterans overcome traditional barriers to care and achieve improvements in multiple areas of functioning. (PsycINFO Database Record
创伤后应激障碍和抑郁与退伍军人感知到的身体健康受损有关，但人们对心理治疗对损伤的影响知之甚少。我们研究了一种针对创伤后应激障碍相关困扰的退伍军人的互动式在线治疗的影响，包括：（a）治疗效果是否包括感知身体损伤的减少；（b）这些治疗效果与创伤后应激障碍和抑郁症状的关系如何。
一项随机对照试验评估了针对 PTSD 和抑郁症状的退伍军人的互动式在线治疗对感知身体健康受损的影响。退伍军人被随机分配到 VetsPrevail 计划（n=209）或无治疗对照组（n=94），在基线评估后 6 周和 12 周完成抑郁和 PTSD 症状以及感知身体健康受损的测量。我们进行了一系列多重和单一中介分析，以检查 VetsPrevail 对这些结果的影响是如何相关的。
与对照组相比，VetsPrevail 与感知身体健康受损的显著减少相关，（b）这种关系通过 PTSD 症状的减少来介导，但不是抑郁。进一步的分析表明，感知身体健康受损也介导了干预和 PTSD 以及抑郁症状之间的关系。
研究结果表明，VetsPrevail 通过减少 PTSD 症状来降低对身体健康受损的感知。也有可能是治疗引发了更复杂的双向关系，即随着时间的推移，心理困扰和感知身体健康受损的改善相互加强。研究结果表明，VetsPrevail 可能有助于退伍军人克服传统的护理障碍，并在多个功能领域取得改善。
