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自我引导式正念指导移动应用程序对创伤后应激障碍退伍军人的临床益处:一项试点随机对照试验。

Clinical benefits of self-guided mindfulness coach mobile app use for veterans with posttraumatic stress disorder: A pilot randomized control trial.

作者信息

Wielgosz Joseph, Walser Robyn D, Kuhn Eric, Chang Andrew, Bantum Erin O, Pagano Ian, Jaworski Beth K, Taylor Katherine, Ramsey Kelly M, Owen Jason E

机构信息

Dissemination and Training Division, VA National Center for PTSD.

University of Hawaii Cancer Center, University of Hawai'i at Manoa.

出版信息

Psychol Trauma. 2025 Jul;17(5):1117-1126. doi: 10.1037/tra0001736. Epub 2024 Aug 26.

Abstract

OBJECTIVE

Mindfulness training can relieve posttraumatic stress disorder (PTSD) symptoms in military veterans and others but is inconsistently accessible. Self-guided mobile apps could improve access but their acceptability, feasibility, and benefits for veterans with PTSD have not been established. We conducted a pilot randomized trial of Mindfulness Coach (MC), a free, publicly available, trauma-informed mobile app tailored to veterans.

METHOD

U.S. veterans with PTSD ( = 173) were randomized to self-guided use of MC or waitlist control (WLC) with 8-week follow-up. Clinical outcomes were PTSD symptoms (PTSD Symptom Checklist-5), depression symptoms (Patient Health Questionnaire, nine item), and psychosocial functioning (Brief Inventory of Psychosocial Functioning). Primary analyses were intent-to-treat using linear mixed models with maximum likelihood estimation. App uptake, objective usage, and usability ratings measured acceptance and feasibility.

RESULTS

Participants varied in age, gender, and ethnoracial identity; most reported recent mental health care utilization. Although study attrition was high (68.4% overall) due to participant dropout (treatment: 43.0%; control: 43.7%) and technical study issues (23% overall), diagnostic tests showed no evidence of bias due to missingness. Study completers (MC: = 19; WLC: = 37) showed medium effects on PTSD symptoms ( = -9.31, = -0.69) and depression ( = -3.10, = -0.52). Higher-intensity users showed greater benefits. App engagement trended lower for women and minoritized subpopulations. No changes were observed in psychosocial functioning. Usability and helpfulness ratings were favorable.

CONCLUSIONS

Transdiagnostic clinical benefits indicate promise for MC as a public health resource for veterans with PTSD. Further study is warranted to confirm these benefits and ensure consistent engagement across subpopulations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

摘要

目的

正念训练可以缓解退伍军人及其他人群的创伤后应激障碍(PTSD)症状,但目前其普及程度并不一致。自助式移动应用程序可能会改善其可及性,但尚未确定此类应用程序对患有创伤后应激障碍的退伍军人的可接受性、可行性和益处。我们针对一款名为“正念教练”(MC)的免费、公开可用且考虑到创伤因素的移动应用程序进行了一项初步随机试验,该应用程序是专门为退伍军人量身定制的。

方法

173名患有创伤后应激障碍的美国退伍军人被随机分为两组,一组为自助使用MC,另一组为等待名单对照组(WLC),并进行为期8周的随访。临床结果包括创伤后应激障碍症状(创伤后应激障碍症状清单-5)、抑郁症状(患者健康问卷,9项)和心理社会功能(心理社会功能简要量表)。主要分析采用意向性分析,使用最大似然估计的线性混合模型。应用程序的采用情况、客观使用情况和可用性评分用于衡量接受度和可行性。

结果

参与者在年龄、性别和种族身份方面存在差异;大多数人报告最近接受过心理健康护理。尽管由于参与者退出(治疗组:43.0%;对照组:43.7%)和技术研究问题(总体23%)导致研究损耗率很高,但诊断测试表明没有因数据缺失而产生偏差的证据。研究完成者(MC组:n = 19;WLC组:n = 37)在创伤后应激障碍症状(β = -9.31,d = -0.69)和抑郁(β = -3.10,d = -0.52)方面显示出中等效果。使用强度较高的用户受益更大。女性和少数族裔亚群体的应用程序参与度较低。心理社会功能方面未观察到变化。可用性和有用性评分良好。

结论

跨诊断的临床益处表明,MC作为一种针对患有创伤后应激障碍的退伍军人的公共卫生资源具有前景。有必要进行进一步研究以确认这些益处,并确保各亚群体的持续参与。(PsycInfo数据库记录(c)2025美国心理学会,保留所有权利)

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