Internet-Based Early Intervention to Prevent Posttraumatic Stress Disorder in Injury Patients: Randomized Controlled Trial

Autor: Mouthaan, Joanne, Sijbrandij, Marit, de Vries, Giel-Jan, Reitsma, Johannes B, van de Schoot, Rens, Goslings, J Carel, Luitse, Jan SK, Bakker, Fred C, Gersons, Berthold PR, Olff, Miranda
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Zdroj: Journal of Medical Internet Research, Vol 15, Iss 8, p e165 (2013)
Druh dokumentu: article
ISSN: 1438-8871
47333944
DOI: 10.2196/jmir.2460
Popis: BackgroundPosttraumatic stress disorder (PTSD) develops in 10-20% of injury patients. We developed a novel, self-guided Internet-based intervention (called Trauma TIPS) based on techniques from cognitive behavioral therapy (CBT) to prevent the onset of PTSD symptoms. ObjectiveTo determine whether Trauma TIPS is effective in preventing the onset of PTSD symptoms in injury patients. MethodsAdult, level 1 trauma center patients were randomly assigned to receive the fully automated Trauma TIPS Internet intervention (n=151) or to receive no early intervention (n=149). Trauma TIPS consisted of psychoeducation, in vivo exposure, and stress management techniques. Both groups were free to use care as usual (nonprotocolized talks with hospital staff). PTSD symptom severity was assessed at 1, 3, 6, and 12 months post injury with a clinical interview (Clinician-Administered PTSD Scale) by blinded trained interviewers and self-report instrument (Impact of Event Scale—Revised). Secondary outcomes were acute anxiety and arousal (assessed online), self-reported depressive and anxiety symptoms (Hospital Anxiety and Depression Scale), and mental health care utilization. Intervention usage was documented. ResultsThe mean number of intervention logins was 1.7, SD 2.5, median 1, interquartile range (IQR) 1-2. Thirty-four patients in the intervention group did not log in (22.5%), 63 (41.7%) logged in once, and 54 (35.8%) logged in multiple times (mean 3.6, SD 3.5, median 3, IQR 2-4). On clinician-assessed and self-reported PTSD symptoms, both the intervention and control group showed a significant decrease over time (P
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