dc.contributor.author
Stein, Jana
dc.contributor.author
Vöhringer, Max
dc.contributor.author
Wagner, Birgit
dc.contributor.author
Stammel, Nadine
dc.contributor.author
Nesterko, Yuriy
dc.contributor.author
Böttche, Maria
dc.contributor.author
Knaevelsrud, Christine
dc.date.accessioned
2023-12-14T10:47:09Z
dc.date.available
2023-12-14T10:47:09Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/41871
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-41592
dc.description.abstract
Background: Cognitive behavioral interventions delivered via the internet are demonstrably efficacious treatment options for posttraumatic stress disorder (PTSD) in underserved, Arabic-speaking populations. However, the role of specific treatment components remains unclear, particularly in conflict-affected areas of the Middle East and North Africa.
Objective: This study aims to evaluate 2 brief internet-based treatments in terms of efficacy, including change in PTSD symptom severity during treatment. Both treatments were developed in line with Interapy, an internet-based, therapist-assisted cognitive behavioral therapy protocol for PTSD and adapted to the specific research question. The first treatment comprised self-confrontation and social sharing (exposure treatment; 6 sessions); the second comprised cognitive restructuring and social sharing (cognitive restructuring treatment; 6 sessions). The 2 treatments were compared with each other and with a waitlist control group.
Methods: In total, 365 Arabic-speaking participants from the Middle East and North Africa (mean age 25.49, SD 6.68 y) with PTSD were allocated to cognitive restructuring treatment (n=118, 32.3%), exposure treatment (n=122, 33.4%), or a waitlist control group (n=125, 34.2%) between February 2021 and December 2022. PTSD symptom severity, posttraumatic maladaptive cognitions, anxiety, depressive and somatoform symptom severity, and quality of life were assessed via self-report at baseline and after treatment or waiting time. PTSD symptom severity was also measured throughout treatment or waiting time. Treatment satisfaction was assessed after treatment completion. Treatment use and satisfaction were compared between the 2 treatment conditions using appropriate statistical tests (eg, chi-square and Welch tests). Multiple imputation was performed to address missing data and evaluate treatment-associated changes. These changes were analyzed using multigroup change modeling in the completer and intention-to-treat samples.
Results: Overall, 200 (N=240, 83.3%) participants started any of the treatments, of whom 123 (61.5%) completed the treatment. Treatment condition was not significantly associated with the proportion of participants who started versus did not start treatment (P=.20) or with treatment completion versus treatment dropout (P=.71). High treatment satisfaction was reported, with no significant differences between the treatment conditions (P=.48). In both treatment conditions, PTSD, anxiety, depressive and somatoform symptom severity, and posttraumatic maladaptive cognitions decreased, and quality of life improved significantly from baseline to the posttreatment time point (P≤.001 in all cases). Compared with the baseline assessment, overall PTSD symptom severity decreased significantly after 4 sessions in both treatment conditions (P<.001). Moreover, both treatment conditions were significantly superior to the waitlist control group regarding overall PTSD symptom severity (P<.001) and most other comorbid mental health symptoms (P<.001 to P=.03). Differences between the 2 conditions in the magnitude of change for all outcome measures were nonsignificant.
en
dc.format.extent
27 Seiten
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
posttraumatic stress
en
dc.subject
posttraumatic stress disorder
en
dc.subject
North Africa
en
dc.subject
Arabic-speaking people
en
dc.subject.ddc
100 Philosophie und Psychologie::150 Psychologie::150 Psychologie
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Exposure Versus Cognitive Restructuring Techniques in Brief Internet-Based Cognitive Behavioral Treatment for Arabic-Speaking People With Posttraumatic Stress Disorder: Randomized Clinical Trial
dc.type
Wissenschaftlicher Artikel
dc.identifier.sepid
95785
dcterms.bibliographicCitation.articlenumber
e48689
dcterms.bibliographicCitation.doi
10.2196/48689
dcterms.bibliographicCitation.journaltitle
JMIR Mental Health
dcterms.bibliographicCitation.originalpublishername
JMIR Publications
dcterms.bibliographicCitation.originalpublisherplace
Toronto
dcterms.bibliographicCitation.volume
10
dcterms.bibliographicCitation.url
https://doi.org/10.2196/48689
refubium.affiliation
Erziehungswissenschaft und Psychologie
refubium.affiliation.other
Arbeitsbereich Klinisch-Psychologische Intervention
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refubium.funding
Publikationsfonds FU
refubium.note.author
Die Publikation wurde aus Open Access Publikationsgeldern der Freien Universität Berlin gefördert.
de
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.isPartOf.eissn
2368-7959