Department of Clinical Neuroscience, Division of Psychology, Nobels väg 9, Karolinska Institutet, 171 77 Stockholm, Sweden.
Department of Neuroscience, Psychiatry, National Centre for Disaster Psychiatry, 751 24 Uppsala, Sweden.
Psychol Med. 2023 Apr;53(5):1989-1998. doi: 10.1017/S0033291721003706. Epub 2021 Sep 14.
Exposure to trauma is common and can have a profoundly negative impact on mental health. Interventions based on trauma-focused cognitive behavioural therapy have shown promising results to facilitate recovery. The current trial evaluated whether a novel, scalable and digital early version of the intervention, Condensed Internet-Delivered Prolonged Exposure (CIPE), is effective in reducing post-traumatic stress symptoms.
A single-site randomised controlled trial with self-referred adults ( = 102) exposed to trauma within the last 2 months. The participants were randomised to 3 weeks of CIPE or a waiting list (WL) for 7 weeks. Assessments were conducted at baseline, week 1-3 (primary endpoint), week 4-7 (secondary endpoint) and at 6-month follow-up. The primary outcome measure was PTSD Checklist for DSM-5 (PCL-5).
The main analysis according to the intention-to-treat principle indicated statistically significant reductions in symptoms of post-traumatic stress in the CIPE group as compared to the WL group. The between-group effect size was moderate at week 3 (bootstrapped = 0.70; 95% CI 0.33-1.06) and large at week 7 (bootstrapped = 0.83; 95% CI 0.46-1.19). Results in the intervention group were maintained at the 6-month follow-up. No severe adverse events were found.
CIPE is a scalable intervention that may confer early benefits on post-traumatic stress symptoms in survivors of trauma. The next step is to compare this intervention to an active control group and also investigate its effects when implemented in regular care.
创伤暴露很常见,会对心理健康产生深远的负面影响。基于创伤焦点认知行为疗法的干预措施已显示出有希望的结果,以促进康复。本试验评估了一种新的、可扩展的数字早期干预措施——浓缩互联网延长暴露(CIPE),是否能有效减少创伤后应激症状。
一项单站点随机对照试验,纳入了最近 2 个月内暴露于创伤的自我报告成年人(n=102)。参与者被随机分配到 3 周的 CIPE 或 7 周的等待名单(WL)。评估在基线、第 1-3 周(主要终点)、第 4-7 周(次要终点)和 6 个月随访时进行。主要结局指标是 DSM-5 创伤后应激障碍检查表(PCL-5)。
根据意向治疗原则进行的主要分析表明,与 WL 组相比,CIPE 组的创伤后应激症状有统计学显著降低。在第 3 周时,组间效应大小为中等(bootstrapped = 0.70;95%CI 0.33-1.06),在第 7 周时为大(bootstrapped = 0.83;95%CI 0.46-1.19)。干预组的结果在 6 个月随访时仍保持。未发现严重不良事件。
CIPE 是一种可扩展的干预措施,可能对创伤幸存者的创伤后应激症状早期有益。下一步是将这种干预措施与一个积极的对照组进行比较,并研究其在常规护理中的效果。