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在新冠疫情时代提高美国退伍军人的治疗寻求意愿:一项随机对照试验。

Increasing treatment-seeking intentions of US veterans in the Covid-19 era: A randomized controlled trial.

机构信息

Department of Psychiatry, New York State Psychiatric Institute, Columbia University Vagelos College of Physicians & Surgeons, New York, New York, USA.

School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.

出版信息

Depress Anxiety. 2021 Jun;38(6):639-647. doi: 10.1002/da.23149. Epub 2021 Mar 18.

Abstract

BACKGROUND

Veterans have higher rates of anxiety, depression, and posttraumatic stress disorder (PTSD), and may be vulnerable to mental health consequences of the Covid-19 pandemic. More than half of veterans who meet mental illness criteria do not seek help. This study screened for clinical symptoms and evaluated the efficacy of a brief, online social-contact-based video intervention in increasing treatment-seeking intentions among veterans. We hypothesized that the video-based intervention would increase treatment-seeking intentions more than written vignette and control conditions.

METHODS

One hundred seventy-two veterans were randomized to either a (a) brief video-based intervention; (b) written vignette intervention, or (c) nonintervention control group. In the 3-min video, a veteran previously diagnosed with PTSD described his symptom reactivation by Covid-19, his barriers to care, and how therapy helped him to cope. Assessments were conducted at baseline, postintervention, and at 14- and 30-day follow-ups.

RESULTS

A total of 91 (53%) veterans reported high levels of clinical symptoms, especially those self-reporting Covid-19 exposure. The brief video-based intervention yielded greater increase in treatment-seeking intentions among veterans. Within the video group, women showed an increase in treatment-seeking intentions from baseline to postintervention only, whereas men showed a more sustained effect, from baseline to Day 14.

CONCLUSIONS

Surveyed veterans reported high symptoms levels. A brief video intervention increased treatment-seeking intention, likely through identification and emotional engagement with the video protagonist. This easily disseminable video-based intervention has the potential to increase likelihood of seeking care. Future research should examine longer term sustainability and changes in help-seeking behavior.

摘要

背景

退役军人焦虑、抑郁和创伤后应激障碍(PTSD)的发病率较高,可能容易受到新冠疫情对心理健康影响的后果。超过一半符合精神疾病标准的退役军人并未寻求帮助。本研究对临床症状进行了筛查,并评估了基于简短在线社交接触的视频干预在增加退役军人治疗意愿方面的效果。我们假设视频干预会比书面情景描述和对照组更能增加治疗意愿。

方法

172 名退役军人被随机分配到以下三组:(a)简短的基于视频的干预组;(b)书面情景描述干预组,或(c)非干预对照组。在 3 分钟的视频中,一位曾被诊断患有 PTSD 的退役军人描述了他因新冠而重新出现症状、他面临的治疗障碍,以及治疗如何帮助他应对的情况。评估在基线、干预后以及 14 天和 30 天随访时进行。

结果

共有 91 名(53%)退役军人报告了较高的临床症状水平,特别是那些自我报告新冠暴露的退役军人。简短的基于视频的干预措施显著增加了退役军人的治疗意愿。在视频组中,女性仅在干预后比基线时增加了治疗意愿,而男性则表现出更持续的效果,从基线到第 14 天。

结论

调查的退役军人报告了较高的症状水平。简短的视频干预增加了治疗意愿,可能是通过与视频主角的认同和情感共鸣。这种易于传播的基于视频的干预措施有可能增加寻求治疗的可能性。未来的研究应探讨更长期的可持续性和寻求帮助行为的变化。

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