Professorship Psychology and Digital Mental Health Care, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
Department of Child and Adolescent Psychiatry/ Psychotherapy, Ulm University, Ulm, Germany.
Eur J Psychotraumatol. 2024;15(1):2364469. doi: 10.1080/20008066.2024.2364469. Epub 2024 Jul 3.
Many youth with posttraumatic stress symptoms (PTSS) do not receive evidence-based care. Internet- and Mobile-Based Interventions (IMIs) comprising evidence-based trauma-focused components can address this gap, but research is scarce. Thus, we investigated the feasibility of a trauma-focused IMI for youth with PTSS. In a one-arm non-randomized prospective proof-of-concept study, 32 youths aged 15-21 years with clinically relevant PTSS (CATS ≥ 21) received access to a trauma-focused IMI with therapist guidance, comprising nine sessions on an eHealth platform accessible via web-browser. We used a feasibility framework assessing recruitment capability, sample characteristics, data collection, satisfaction, acceptability, study management abilities, safety aspects, and efficacy of the IMI in PTSS severity and related outcomes. Self-rated assessments took place pre-, mid-, post-intervention and at 3-month follow-up and clinician-rated assessments at baseline and post-intervention. The sample mainly consisted of young adult females with interpersonal trauma and high PTSS levels (CATS, = 31.63, = 7.64). The IMI sessions were found useful and comprehensible, whereas feasibility of trauma processing was perceived as difficult. Around one-third of participants (31%) completed the IMI's eight core sessions. The study completer analysis showed a significant reduction with large effects in self-rated PTSS at post-treatment [(21) = 4.27; < .001; = 0.88] and follow-up [(18) = 3.83; = .001; = 0.84], and clinician-rated PTSD severity at post-treatment [(21) = 4.52; < .001; = 0.93]. The intention-to-treat analysis indicated significant reductions for PTSS at post-treatment and follow-up with large effect sizes (= -0.97- -1.02). All participants experienced at least one negative effect, with the most common being the resurfacing of unpleasant memories (= 17/22, 77%). The study reached highly burdened young adults. The IMI was accepted in terms of usefulness and comprehensibility but many youths did not complete all sessions. Exploration of strategies to improve adherence in trauma-focused IMIs for youth is warranted, alongside the evaluation of the IMI's efficacy in a subsequent randomized controlled trial.
许多患有创伤后应激症状（PTSS）的年轻人并未接受基于证据的治疗。包含基于证据的创伤焦点成分的互联网和移动为基础的干预措施（IMIs）可以解决这一差距，但研究很少。因此，我们研究了针对创伤后应激症状的年轻人的创伤焦点 IMI 的可行性。在一项单臂非随机前瞻性概念验证研究中，32 名年龄在 15 至 21 岁之间的青少年接受了创伤焦点 IMI 的治疗，该 IMI 包含九节课程，在可通过网络浏览器访问的电子健康平台上进行，有治疗师的指导。我们使用了一个可行性框架来评估招募能力、样本特征、数据收集、满意度、可接受性、研究管理能力、安全性以及 IMI 在创伤后应激症状严重程度和相关结果中的疗效。自我评估在干预前、干预中和干预后 3 个月进行，临床医生评估在基线和干预后进行。该样本主要由年轻成年女性组成，她们遭受过人际创伤，且创伤后应激症状水平较高（CATS，=31.63，=7.64）。研究人员发现 IMI 课程很有用且易于理解，但是创伤处理的可行性被认为很困难。大约三分之一的参与者（31%）完成了 IMI 的八节核心课程。完成者分析显示，治疗后自我报告的创伤后应激症状显著减少，效果显著[（21）=4.27；<.001；=0.88]，且在随访中显著减少[（18）=3.83；<.001；=0.84]，以及治疗后临床医生评估的 PTSD 严重程度显著减少[（21）=4.52；<.001；=0.93]。意向治疗分析表明，治疗后和随访时的创伤后应激症状均显著减少，效果显著[=−0.97-−1.02]。所有参与者至少经历了一种不良影响，最常见的是不愉快的记忆重现[=17/22，77%]。该研究接触到了负担过重的年轻人。IMI 在有用性和可理解性方面得到了认可，但许多年轻人没有完成所有课程。需要探索改善针对年轻人的创伤焦点 IMI 依从性的策略，同时在随后的随机对照试验中评估 IMI 的疗效。
