Steinberg Joshua S, Sun Jingxuan, Venturo-Conerly Katherine E, Sood Gauri, Mair Patrick, Davydenko Oksana, Porzak Robert, Ougrin Dennis, Weisz John R
Department of Psychology, Harvard University, Cambridge, Massachusetts, US.
Department of Psychology, Political Science, and Sociocultural Technologies, Sumy State University, Sumy, Ukraine.
Npj Ment Health Res. 2025 May 16;4(1):20. doi: 10.1038/s44184-025-00134-w.
Ukraine's war-exposed youth face a myriad of barriers to receiving mental health services, perhaps most notably a dearth of mental health professionals. Experts recommend evaluating digital mental health interventions (DMHIs), which require minimal clinician support. Based on the content of empirically supported treatments for war-exposed youth (e.g., Teaching Recovery Techniques), one strategy that might be useful is self-calming (e.g., paced breathing, progressive muscle relaxation). In this pre-registered randomized controlled trial (ClinicalTrials.gov Record: NCT06217705 ; first submitted January 12, 2024), we assessed the acceptability, utility, and clinical efficacy of one such DMHI (Project Calm) relative to a usual schoolwork control among a sample of Ukrainian students in grades 4-11. We analyzed outcomes for the full sample and subsamples with elevated symptoms at baseline. Although Calm was perceived favorably, there were no significant between-group differences in the full sample (N = 626); differences in subsample analyses demonstrated that while internalizing, externalizing, and trauma symptoms held steady for the Calm group, control participants' symptoms reduced. We generated potential explanations for these results (e.g., interference with youths' natural coping skills or fear extinction) through a focus group with school staff. Given that we found no evidence that calming skills taught via DMHI are effective for Ukrainian youth, we suggest that researchers test other strategies delivered by DMHI and that calming skills continue to be taught in provider-guided formats.
乌克兰经历战争的青少年在获得心理健康服务方面面临着众多障碍，其中最显著的可能是心理健康专业人员的匮乏。专家建议评估数字心理健康干预措施（DMHI），这类措施所需的临床医生支持最少。根据针对经历战争的青少年的实证支持治疗内容（例如，教授恢复技巧），一种可能有用的策略是自我平静（例如，有节奏的呼吸、渐进性肌肉松弛）。在这项预先注册的随机对照试验（ClinicalTrials.gov记录：NCT06217705；首次提交于2024年1月12日）中，我们评估了一种此类DMHI（平静项目）相对于常规学业控制措施在4至11年级乌克兰学生样本中的可接受性、效用和临床疗效。我们分析了全样本以及基线时症状加重的子样本的结果。尽管平静项目受到好评，但全样本（N = 626）中组间没有显著差异；子样本分析中的差异表明，虽然平静项目组的内化、外化和创伤症状保持稳定，但对照组参与者的症状有所减轻。我们通过与学校工作人员的焦点小组对这些结果产生了潜在的解释（例如，干扰青少年的自然应对技能或恐惧消退）。鉴于我们没有发现证据表明通过DMHI教授的平静技能对乌克兰青少年有效，我们建议研究人员测试DMHI提供的其他策略，并且平静技能应继续以提供者指导的形式教授。
