University of North Texas.
University of North Texas.
Behav Ther. 2018 Sep;49(5):756-767. doi: 10.1016/j.beth.2017.11.010. Epub 2017 Dec 7.
Depression is a highly prevalent psychological disorder experienced disproportionately by college student military veterans with many deleterious effects including risk for suicide. Treatment can help, but the debilitating nature of depression often makes seeking in-person treatment difficult and many are deterred by stigma, inconvenience, concerns about privacy, or a preference to manage problems themselves. The current study examines the efficacy of a computer-guided Problem-Solving Treatment (ePST) for reducing symptoms of depression, posttraumatic stress disorder (PTSD), and insomnia in student military veterans. Twenty-four student veterans (Mean = 32.7) with symptoms of depression were randomly assigned either to a treatment group receiving six weekly sessions of ePST or to a minimal contact control group (MCC). Participants completed the Patient Health Questionnaire-9 (PHQ-9) depression scale at baseline and then weekly through post-ePST or post-MCC. PTSD and insomnia questionnaires were also completed at baseline and posttreatment. A linear mixed model regression showed a statistically significant Group (ePST vs. MCC) × Time (pretreatment through posttreatment) interaction for depression, with the ePST showing substantial improvements in depressive symptoms over the 6-week period. Significant improvements were also seen in PTSD and insomnia symptoms. Results suggest that ePST can effectively treat depression, PTSD, and insomnia symptoms in student military veterans and may be a viable alternative for those who are not able to access live therapy. Future work should examine the durability of treatment effects and utility for more severe depression and suicide prevention.
抑郁是一种高度普遍的心理障碍，在大学生退伍军人中不成比例地经历，有许多不良影响，包括自杀风险。治疗可以有所帮助，但抑郁的致残性质常常使得寻求面对面治疗变得困难，许多人因耻辱感、不便、对隐私的担忧或自己管理问题的偏好而退缩。本研究考察了计算机引导的问题解决治疗（ePST）在减少学生退伍军人的抑郁、创伤后应激障碍（PTSD）和失眠症状方面的疗效。24 名有抑郁症状的学生退伍军人（平均年龄=32.7）被随机分配到接受六次每周 ePST 治疗的治疗组或接受最小接触对照组（MCC）。参与者在基线时完成了患者健康问卷-9（PHQ-9）抑郁量表，然后每周在 ePST 或 MCC 后完成。基线和治疗后还完成了 PTSD 和失眠问卷。线性混合模型回归显示，抑郁的组（ePST 与 MCC）×时间（治疗前至治疗后）交互作用具有统计学意义，ePST 在 6 周内显示出抑郁症状的显著改善。PTSD 和失眠症状也有显著改善。结果表明，ePST 可以有效地治疗学生退伍军人的抑郁、PTSD 和失眠症状，对于那些无法接受现场治疗的人来说，可能是一种可行的替代方案。未来的工作应该研究治疗效果的持久性和对更严重的抑郁和自杀预防的实用性。
