Benight Charles C, Shoji Kotaro, Yeager Carolyn M, Weisman Pamela, Boult Terrance E
Department of Psychology, University of Colorado, Colorado Springs, CO, United States.
Trauma, Health, and Hazards Center, University of Colorado, Colorado Springs, CO, United States.
JMIR Ment Health. 2018 Nov 29;5(4):e10309. doi: 10.2196/10309.
Technology offers a unique platform for delivering trauma interventions (ie, eHealth) to support trauma-exposed populations. It is important to evaluate mechanisms of therapeutic change in reducing posttraumatic distress in eHealth for trauma survivors.
This study evaluated a proactive, scalable, and individually responsive eHealth intervention for trauma survivors called My Trauma Recovery. My Trauma Recovery is an eHealth intervention aiming to support trauma survivors and consisting of 6 modules: relaxation, triggers, self-talk, professional help, unhelpful coping, and social support. It was designed to enhance trauma coping self-efficacy (CSE). We tested 3 hypotheses. First, My Trauma Recovery would decrease posttraumatic stress symptoms (PTSS). Second, My Trauma Recovery would increase CSE. And last, changes in CSE would be negatively correlated with changes in PTSS.
A total of 92 individuals exposed to trauma (78/92, 85% females, mean age 34.80 years) participated. Our study was part of a larger investigation and consisted of 3 sessions 1 week apart. Participants completed the baseline online survey assessing PTSS and CSE. Each session included completing assigned modules followed by the online survey assessing CSE. PTSS was remeasured at the end of the last module.
PTSS significantly declined from T1 to T9 (F=23.63, P<.001, η=.21) supporting the clinical utility of My Trauma Recovery. Significant increases in CSE for sessions 1 and 2 (F=7.51, P<.001) were found. No significant change in CSE was found during session 3 (N=92). The residualized scores between PTSS T1 and T9 and between CSE T1 and T9 were calculated. The PTSS residualized score and the CSE residualized score were significantly correlated, r=-.26, P=.01. Results for each analysis with a probable PTSD subsample were consistent.
The findings of our study show that participants working through My Trauma Recovery report clinically lower PTSS after 3 weeks. The results also demonstrate that CSE is an important self-appraisal factor that increased during sessions 1 and 2. These improvements are correlated with reductions in PTSS. Thus, changes in CSE may be an important mechanism for reductions in PTSS when working on a self-help trauma recovery website and may be an important target for eHealth interventions for trauma. These findings have important implications for trauma eHealth interventions.
技术为提供创伤干预措施（即电子健康干预）以支持遭受创伤的人群提供了一个独特的平台。评估电子健康干预措施中减轻创伤幸存者创伤后痛苦的治疗改变机制非常重要。
本研究评估了一种针对创伤幸存者的积极主动、可扩展且个性化响应的电子健康干预措施——“我的创伤恢复”。“我的创伤恢复”是一种旨在支持创伤幸存者的电子健康干预措施，由6个模块组成：放松、触发因素、自我对话、专业帮助、无益应对方式和社会支持。它旨在提高创伤应对自我效能感（CSE）。我们测试了3个假设。第一，“我的创伤恢复”将减轻创伤后应激症状（PTSS）。第二，“我的创伤恢复”将提高CSE。最后，CSE的变化与PTSS的变化呈负相关。
共有92名遭受创伤的个体（78/92，85%为女性，平均年龄34.80岁）参与。我们的研究是一项更大规模调查的一部分，包括3次相隔1周的 sessions。参与者完成了评估PTSS和CSE的基线在线调查。每次session包括完成指定模块，然后进行评估CSE的在线调查。在最后一个模块结束时重新测量PTSS。
PTSS从T1到T9显著下降（F = 23.63，P <.001，η =.21），支持了“我的创伤恢复”的临床效用。发现第1次和第2次session的CSE显著增加（F = 7.51，P <.001）。在第3次session期间（N = 92）未发现CSE有显著变化。计算了PTSS T1和T9之间以及CSE T1和T9之间的残差分数。PTSS残差分数和CSE残差分数显著相关，r = -.26，P =.01。对可能患有创伤后应激障碍的子样本进行的每次分析结果均一致。
我们的研究结果表明，通过“我的创伤恢复”进行干预的参与者在3周后报告的临床PTSS较低。结果还表明，CSE是一个重要的自我评估因素，在第1次和第2次session期间有所增加。这些改善与PTSS的降低相关。因此，CSE的变化可能是在自助创伤恢复网站上降低PTSS的重要机制，并且可能是创伤电子健康干预的重要目标。这些发现对创伤电子健康干预具有重要意义。
