Serfaty Marc, Satchell Jessica, Lee Teresa, Laycock Gloria, Brewin Chris, Buszewicz Marta, Leavey Gerard, Drennan Vari M, Vickerstaff Victoria, Cooke Jonathan, Kessel Anthony
University College London, London, UK
Priory Hospital North London, London, UK.
BMJ Open. 2025 Jul 25;15(7):e095184. doi: 10.1136/bmjopen-2024-095184.
Older crime victims may be particularly vulnerable to psychological distress.
To compare the clinical effectiveness of a Victim Improvement Package (VIP) to treatment as usual (TAU) for reducing continued crime-associated distress.
A three-step parallel-group single-blind randomised controlled trial.
Police-reported victims of community crime aged 65 and over were recruited from 12 local authority areas in a major urban city in England, UK.
Selection criteria-inclusion: victims of community crime aged 65 years or more, with significant Generalised Anxiety Disorder (GAD-2) and Patient Health Questionnaire (PHQ-2) distress associated with the crime.
type of crime, diagnosis, receipt of cognitive-behavioural therapy (CBT) in the last 6 months; an inability to participate in CBT; cognitive impairment. Participants were typical of our local authority population; 71% were female, 69% white, with the majority of crimes associated with burglary (35%) and theft (26%). 67% (88/131) of the randomised participants were included in the primary analysis.
TAU was compared with TAU plus up to 10 sessions of a cognitively-behaviourally informed VIP, delivered by a mental health charity over 12 weeks.
Timings are in relation to the crime; baseline (3 months), post-VIP intervention (6 months) and follow-up (9 months). The primary outcome was a composite of the Beck Anxiety and Beck Depression Inventories. The primary endpoint was 6 months.
24% (4255/17 611) of reported crime victims were screened, 35% (1505/4255) were distressed. Of 60% (877/1505) rescreened at 3 months, 49% (427/877) remained distressed. Out of our target of 226, 131 participants were randomised; 65 to VIP and 66 to TAU alone. 68% (89/131) completed the primary outcome (post-intervention). The VIP showed no overall benefit; mean VIP -0.41 (SD 0.89) vs mean TAU -0.19 (SD 1.11); standardised mean difference -0.039; 95% CI (-0.39, 0.31), although stratified analyses suggested an effect in burglary victims (n=27, standardised mean difference -0.61; 95% CI (-1.22, -0.002), p=0.049).
Community crime had long-lasting impacts. The police are ideally placed to screen for distress, present in 35% of victims, but only 58% of participants were recruited and the cognitive-behavioural therapy was not delivered competently. Further research on victim care and improving the delivery and quality of therapy is required.
All procedures were approved by the University College London (UCL) Research Ethics Committee on 17 March 2016 (6960/001). International Standard Randomised Controlled Trial Number is ISRCTN16929670: https://doi.org/10.1186/ISRCTN16929670.
老年犯罪受害者可能特别容易受到心理困扰。
比较受害者改善套餐（VIP）与常规治疗（TAU）在减轻与犯罪相关的持续困扰方面的临床效果。
一项三步平行组单盲随机对照试验。
从英国英格兰一个主要城市的12个地方当局辖区招募警方报告的65岁及以上社区犯罪受害者。
选择标准——纳入标准：65岁或以上的社区犯罪受害者，患有严重的广泛性焦虑症（GAD - 2）且因犯罪而出现患者健康问卷（PHQ - 2）困扰。
犯罪类型、诊断、过去6个月内接受过认知行为疗法（CBT）；无法参与CBT；认知障碍。参与者具有当地当局人群的典型特征；71%为女性，69%为白人，大多数犯罪与入室盗窃（35%）和盗窃（26%）有关。随机分组的参与者中有67%（88/131）纳入了主要分析。
将TAU与TAU加最多10次由心理健康慈善机构在12周内提供的认知行为导向的VIP进行比较。
时间点与犯罪相关；基线（3个月）、VIP干预后（6个月）和随访（9个月）。主要结局是贝克焦虑量表和贝克抑郁量表的综合结果。主要终点是6个月。
在报告的犯罪受害者中，24%（4255/17611）接受了筛查，35%（1505/4255）感到困扰。在3个月时重新筛查的60%（877/1505）中，49%（427/877）仍然感到困扰。在我们设定的226名目标参与者中，131名被随机分组；65名接受VIP，66名仅接受TAU。68%（89/131）完成了主要结局（干预后）。VIP没有显示出总体益处；VIP组平均得分 -0.41（标准差0.89），TAU组平均得分 -0.19（标准差1.11）；标准化平均差 -0.039；95%置信区间（-0.39，0.31），尽管分层分析表明对入室盗窃受害者有效果（n = 27，标准化平均差 -0.61；95%置信区间（-1.22，-0.002），p = 0.049）。
社区犯罪有长期影响。警方最适合筛查困扰情况，35%的受害者存在困扰，但只有58%的参与者被招募，并且认知行为疗法实施得并不理想。需要对受害者护理以及改善治疗的提供和质量进行进一步研究。
所有程序于2016年3月17日获得伦敦大学学院（UCL）研究伦理委员会批准（6960/001）。国际标准随机对照试验编号为ISRCTN16929670：https://doi.org/10.1186/ISRCTN16929670 。
