Citation

Schulte C, Sachser C, Rosner R, Ebert DD, Zarski AC. Eur. J. Psychotraumatol. 2024; 15(1): e2364469.

Copyright

(Copyright © 2024, The Author(s), Publisher Co-action Publishing)

DOI

10.1080/20008066.2024.2364469

PMID

38957142

Abstract

BACKGROUND: Many youth with posttraumatic stress symptoms (PTSS) do not receive evidence-based care. Internet- and Mobile-Based Interventions (IMIs) comprising evidence-based trauma-focused components can address this gap, but research is scarce. Thus, we investigated the feasibility of a trauma-focused IMI for youth with PTSS.

METHODS: In a one-arm non-randomized prospective proof-of-concept study, 32 youths aged 15-21 years with clinically relevant PTSS (CATS ≥ 21) received access to a trauma-focused IMI with therapist guidance, comprising nine sessions on an eHealth platform accessible via web-browser. We used a feasibility framework assessing recruitment capability, sample characteristics, data collection, satisfaction, acceptability, study management abilities, safety aspects, and efficacy of the IMI in PTSS severity and related outcomes. Self-rated assessments took place pre-, mid-, post-intervention and at 3-month follow-up and clinician-rated assessments at baseline and post-intervention.

RESULTS: The sample mainly consisted of young adult females with interpersonal trauma and high PTSS levels (CATS, M = 31.63, SD = 7.64). The IMI sessions were found useful and comprehensible, whereas feasibility of trauma processing was perceived as difficult. Around one-third of participants (31%) completed the IMI's eight core sessions. The study completer analysis showed a significant reduction with large effects in self-rated PTSS at post-treatment [t(21) = 4.27; p < .001; d = 0.88] and follow-up [t(18) = 3.83; p = .001; d = 0.84], and clinician-rated PTSD severity at post-treatment [t(21) = 4.52; p < .001; d = 0.93]. The intention-to-treat analysis indicated significant reductions for PTSS at post-treatment and follow-up with large effect sizes (d = -0.97- -1.02). All participants experienced at least one negative effect, with the most common being the resurfacing of unpleasant memories (n = 17/22, 77%).

CONCLUSION: The study reached highly burdened young adults. The IMI was accepted in terms of usefulness and comprehensibility but many youths did not complete all sessions. Exploration of strategies to improve adherence in trauma-focused IMIs for youth is warranted, alongside the evaluation of the IMI's efficacy in a subsequent randomized controlled trial.

Language: en

Keywords

Humans; Female; Male; Trauma; Internet; Adolescent; Prospective Studies; Young Adult; posttraumatic stress disorder; Telemedicine; Mobile Applications; Internet-Based Intervention; *Stress Disorders, Post-Traumatic/therapy; *Feasibility Studies; adolescentes y adultos jóvenes; adolescents and young adults; exposición basada en la escritura; exposición por imágenes; imaginal exposure; internet- and mobile-based intervention; intervención en línea y por dispositivo móvil; Proof of Concept Study; terapia cognitiva conductual centrada en el trauma; trastorno de estrés postraumático; trauma-focused cognitive behaviour therapy; written-based exposure