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一项针对创伤后应激障碍症状的智能手机应用程序的随机对照试验。

A randomized controlled trial of a smartphone app for posttraumatic stress disorder symptoms.

作者信息

Kuhn Eric, Kanuri Nitya, Hoffman Julia E, Garvert Donn W, Ruzek Josef I, Taylor C Barr

机构信息

Veterans Affairs Palo Alto Health Care System.

Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine.

出版信息

J Consult Clin Psychol. 2017 Mar;85(3):267-273. doi: 10.1037/ccp0000163.

Abstract

OBJECTIVE

Posttraumatic stress disorder (PTSD) is highly prevalent in the population, but relatively few affected individuals receive treatment for it. Smartphone applications (apps) could help address this unmet need by offering sound psychoeducational information and evidence-based cognitive behavioral coping tools. We conducted a randomized controlled trial to assess the efficacy of a free, publicly available smartphone app (PTSD Coach) for self-management of PTSD symptoms.

METHOD

One hundred 20 participants who were an average of 39 years old, mostly women (69.2%) and White (66.7%), recruited primarily through online advertisements, were randomized to either a PTSD Coach (n = 62) or a waitlist condition (n = 58) for 3 months. Web-administered self-report measures of PTSD, PTSD symptom coping self-efficacy, depression, and psychosocial functioning were conducted at baseline, posttreatment, and 3 months following treatment.

RESULTS

Following the intent-to-treat principle, repeated-measures analyses of variance (ANOVAs) revealed that at posttreatment, PTSD Coach participants had significantly greater improvements in PTSD symptoms (p = .035), depression symptoms (p = .005), and psychosocial functioning (p = .007) than did waitlist participants; however, at posttreatment, there were no significant mean differences in outcomes between conditions. A greater proportion of PTSD Coach participants achieved clinically significant PTSD symptom improvement (p = .018) than waitlist participants.

CONCLUSION

PTSD Coach use resulted in significantly greater improvements in PTSD symptoms and other outcomes relative to a waitlist condition. Given the ubiquity of smartphones, PTSD Coach may provide a wide-reaching, convenient public health intervention for individuals with PTSD symptoms who are not receiving care. (PsycINFO Database Record

摘要

目的

创伤后应激障碍(PTSD)在人群中高度流行,但接受治疗的患者相对较少。智能手机应用程序(应用)可以通过提供合理的心理教育信息和循证认知行为应对工具来满足这一未被满足的需求。我们进行了一项随机对照试验,以评估一款免费的、公开可用的智能手机应用程序(PTSD Coach)对PTSD症状自我管理的疗效。

方法

通过在线广告招募了120名平均年龄为39岁的参与者,其中大多数为女性(69.2%)且为白人(66.7%),将他们随机分为PTSD Coach组(n = 62)或等待列表组(n = 58),为期3个月。在基线、治疗后和治疗后3个月进行网络管理的PTSD、PTSD症状应对自我效能、抑郁和心理社会功能的自我报告测量。

结果

遵循意向性分析原则,重复测量方差分析(ANOVA)显示,在治疗后,PTSD Coach组参与者在PTSD症状(p = 0.035)、抑郁症状(p = 0.005)和心理社会功能(p = 0.007)方面的改善显著大于等待列表组参与者;然而,在治疗后,两组之间的结果没有显著的平均差异。与等待列表组参与者相比,PTSD Coach组中更多比例的参与者在临床上实现了PTSD症状的显著改善(p = 0.018)。

结论

与等待列表组相比,使用PTSD Coach导致PTSD症状和其他结果有显著更大的改善。鉴于智能手机的普及,PTSD Coach可能为未接受治疗的有PTSD症状的个体提供广泛、便捷的公共卫生干预措施。(PsycINFO数据库记录)

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