National Centre for Disaster Psychiatry, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Psychiatry, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
J Med Internet Res. 2022 Mar 30;24(3):e31419. doi: 10.2196/31419.
Self-guided interventions may complement and overcome obstacles to in-person treatment options. The efficacy of app interventions targeting posttraumatic stress disorder (PTSD) is unclear, and results from previous studies on PTSD Coach-an app for managing trauma-related distress-are inconsistent.
This study investigates whether access to the Swedish version of the PTSD Coach affects posttraumatic stress, depressive, and somatic symptoms. In addition, we aim to assess the perceived helpfulness, satisfaction, negative effects, response, and remission related to PTSD Coach.
Adults who had experienced potentially traumatic events in the past 2 years were randomized (1:1) to have access to PTSD Coach (n=89) or be on the waitlist (n=90). We assessed clinical characteristics at baseline (semistructured interviews and self-rating scales) and after 3 months (self-rating scales). We analyzed the data in R software using linear mixed effects models, chi-square tests, and Fisher exact test.
Intention-to-treat analyses indicated that access to PTSD Coach decreased posttraumatic stress and depressive symptoms but not somatic symptoms. More participants who had access to PTSD Coach responded with clinically significant improvement and fewer instances of probable PTSD after 3 months compared with waitlist controls. Overall, participants found that PTSD Coach was slightly to moderately helpful and moderately satisfactory. Half of the intervention group (36/71, 51%) reported at least one negative reaction related to using PTSD Coach (eg, disappointment with the app or its results, arousal of stress, or distressing memories).
Using PTSD Coach may trigger symptoms among a few users; however, most of them perceived PTSD Coach as helpful and satisfactory. This study showed that having access to PTSD Coach helped improve psychological trauma-related symptoms. In addition, we have discussed implications for future research and clinical practice.
ClinicalTrials.gov NCT04094922; https://clinicaltrials.gov/ct2/show/NCT04094922.
自我指导干预措施可能补充并克服面对面治疗选择的障碍。针对创伤后应激障碍（PTSD）的应用程序干预措施的疗效尚不清楚，并且以前关于 PTSD Coach（一种用于管理创伤相关困扰的应用程序）的研究结果也不一致。
本研究旨在探讨是否可以使用瑞典语版本的 PTSD Coach 来改善创伤后应激、抑郁和躯体症状。此外，我们旨在评估与 PTSD Coach 相关的感知有用性、满意度、负性反应、应答和缓解率。
在过去 2 年内经历过创伤性事件的成年人被随机分配（1:1）接受 PTSD Coach（n=89）或候补名单（n=90）。我们在基线（半结构化访谈和自我评估量表）和 3 个月后（自我评估量表）评估临床特征。我们使用 R 软件中的线性混合效应模型、卡方检验和 Fisher 精确检验来分析数据。
意向性治疗分析表明，使用 PTSD Coach 可降低创伤后应激和抑郁症状，但不能降低躯体症状。与候补名单对照组相比，3 个月后更多接受 PTSD Coach 治疗的参与者表现出临床显著改善，出现可能的 PTSD 的情况更少。总体而言，参与者认为 PTSD Coach 稍微到中等程度有用且中等程度满意。干预组的一半（36/71，51%）报告了至少一次与使用 PTSD Coach 相关的负性反应（例如，对应用程序或其结果感到失望、唤醒压力或痛苦的记忆）。
使用 PTSD Coach 可能会引发少数用户的症状；然而，大多数人认为 PTSD Coach 是有用和满意的。本研究表明，获得 PTSD Coach 有助于改善与心理创伤相关的症状。此外，我们还讨论了对未来研究和临床实践的启示。
ClinicalTrials.gov NCT04094922；https://clinicaltrials.gov/ct2/show/NCT04094922。
