Cognitive Behavioral Treatment for Acute Posttrauma Distress: A Randomized, Controlled Proof-of-Concept Study Among Hospitalized Adults With Burns
| Autor: | Neda F Gould, Shawn T. Mason, Stephen M. Milner, Amanda Gehrke, James A. Fauerbach, Julie Caffrey |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male 030506 rehabilitation medicine.medical_specialty Adolescent medicine.medical_treatment Physical Therapy Sports Therapy and Rehabilitation behavioral disciplines and activities law.invention Stress Disorders Post-Traumatic Young Adult 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law mental disorders Humans Medicine Depressive Disorder Major Trauma Severity Indices Rehabilitation business.industry Burn center Middle Aged Resilience Psychological medicine.disease humanities Acute Stress Disorder Hospitalization Psychotherapy Cognitive behavioral therapy Distress Supportive psychotherapy Physical therapy Major depressive disorder Female Burns 0305 other medical science business 030217 neurology & neurosurgery |
| Zdroj: | Archives of Physical Medicine and Rehabilitation. 101:S16-S25 |
| ISSN: | 0003-9993 |
| DOI: | 10.1016/j.apmr.2018.11.027 |
| Popis: | Objective (1) To evaluate the feasibility of conducting a randomized controlled trial (RCT) of the Safety, Meaning, Activation and Resilience Training (SMART) intervention vs nondirective supportive psychotherapy (NDSP) in an acutely hospitalized adult survivor of burn injury sample; and (2) to assess the preliminary effect of SMART on acute stress disorder (ASD), posttraumatic stress disorder (PTSD), and major depressive disorder (MDD) symptom reduction as secondary prevention. Design Proof-of-concept, parallel group RCT design. Setting Regional burn center. Participants Acutely injured, hospitalized adult survivors of burn injury (N=50) were randomly assigned to SMART (n=28) or nondirective supportive psychotherapy (n=22). Due to dropout and missing data, final sample size was 40, SMART (n=21) and nondirective supportive psychotherapy (n=19). Interventions SMART is a manualized, 4-session cognitive behavioral therapy-based psychological intervention targeting ASD, PTSD, and MDD symptoms. NDSP is a manualized, 4-session protocol. Main Outcome Measures Davidson Trauma Scale ([DTS]; diagnostic proxy for ASD and PTSD; clinical cutoff=40, with higher score=higher severity) and the Patient Health Questionnaire-9 ([PHQ-9]; diagnostic proxy for MDD; clinical cutoff=10, with higher score=higher severity) at pretreatment, immediate posttreatment, and 1 month posttreatment. Results At baseline, median DTS scores and PHQ-9 scores were above clinical cutoffs and did not differ across groups. At 1 week and 1 month posttreatment, median DTS and PHQ-9 scores were beneath clinical cutoffs in the SMART group; scores remained above clinical cutoffs in the NDSP group at these time points. Conclusions It is feasible to conduct an RCT of SMART in hospitalized adult survivors of burn injury. SMART has the potential to yield clinically significant outcomes. Additional studies are needed to replicate and extend these findings. |
| Databáze: | OpenAIRE |
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