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Chinese My Trauma Recovery, a Web-based intervention for traumatized persons in two parallel samples: randomized controlled trial.

Wang Z, Wang J, Maercker A - J. Med. Internet Res. (2013)

Bottom Line: CMTR reduced post-traumatic symptoms significantly with high effect size after one month of treatment (F₁,₄₅=15.13, Cohen's d=0.81, P<.001) and the reduction was sustained over a 3-month follow-up (F₁,₄₅=17.29, Cohen's d=0.87, P<.001).Post-traumatic symptoms decreased significantly after treatment (F₁,₄₈=43.97, Cohen's d=1.34, P<.001) and during the follow-up period (F₁,₄₈=24.22, Cohen's d=0.99, P<.001).Additional outcome measures (post-traumatic cognitive changes, depression) indicated a range of positive effects, in particular in the urban sample (group×time interactions: F₁,₈₈=5.32-8.37, all Ps<.03), contributing to the positive evidence for self-help interventions.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Psychology, School of Philosophy, Wuhan University, Wuhan, China.

ABSTRACT

Background: Guided self-help interventions for PTSD (post-traumatic stress disorder) are a promising tool for the dissemination of contemporary psychological treatment.

Objective: This study investigated the efficacy of the Chinese version of the My Trauma Recovery (CMTR) website.

Methods: In an urban context, 90 survivors of different trauma types were recruited via Internet advertisements and allocated to a randomized controlled trial (RCT) with a waiting list control condition. In addition, in a rural context, 93 survivors mainly of the 2008 Sichuan earthquake were recruited in-person for a parallel RCT in which the website intervention was conducted in a counseling center and guided by volunteers. Assessment was completed online on a professional Chinese survey website. The primary outcome measure was the Post-traumatic Diagnostic Scale (PDS); secondary outcome measures were Symptom Checklist 90-Depression (SCL-D), Trauma Coping Self-Efficacy Scale (CSE), Post-traumatic Cognitive Changes (PCC), and Social Functioning Impairment (SFI) questionnaires adopted from the My Trauma Recovery website.

Results: For the urban sample, findings indicated a significant group×time interaction in post-traumatic symptom severity (F₁,₈₈=7.65, P=.007). CMTR reduced post-traumatic symptoms significantly with high effect size after one month of treatment (F₁,₄₅=15.13, Cohen's d=0.81, P<.001) and the reduction was sustained over a 3-month follow-up (F₁,₄₅=17.29, Cohen's d=0.87, P<.001). In the rural sample, the group×time interaction was also significant in post-traumatic symptom severity (F₁,₉₁=5.35, P=.02). Post-traumatic symptoms decreased significantly after treatment (F₁,₄₈=43.97, Cohen's d=1.34, P<.001) and during the follow-up period (F₁,₄₈=24.22, Cohen's d=0.99, P<.001). Additional outcome measures (post-traumatic cognitive changes, depression) indicated a range of positive effects, in particular in the urban sample (group×time interactions: F₁,₈₈=5.32-8.37, all Ps<.03), contributing to the positive evidence for self-help interventions. Differences in the effects in the two RCTs are exploratorily explained by sociodemographic, motivational, and setting feature differences between the two samples.

Conclusions: These findings give support for the short-term efficacy of CMTR in the two Chinese populations and contribute to the literature that self-help Web-based programs can be used to provide mental health help for traumatized persons.

Trial registration: Australia New Zealand Clinical Trials Registry (ANZCTR): ACTRN12611000951954; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611000951954 (Archived by WebCite at http://www.webcitation.org/6G7WyNODk).

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Example screenshot of the CMTR website.
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figure1: Example screenshot of the CMTR website.

Mentions: My Trauma Recovery (MTR) website is a self-help trauma intervention program based on social cognitive theory [17], which consists of six modules of social support, self-talk, relaxation, trauma triggers, unhelpful coping, and professional help [7,18]. It has been translated, as CMTR, by funding via a Swiss-Chinese collaboration between University of Zurich (A Maercker) and Beijing Normal University (J Wang). The translation work was done mainly by the first author, and the second author (and her master’s students) and the third author (and his doctoral students) were involved in the back-translation work. CMTR utilizes interactive components, such as pictures, audio segments, video segments, and self-tests, to offer educational information on trauma and provide trauma coping skills practice for its users. All pictures on the CMTR website were new ones with Chinese figures; in addition, a total of 27 audio segments on the website were newly created. Due to the high costs of video, five video segments were kept in English with Chinese subtitles added to these videos. The users are encouraged to take self-tests regularly on CMTR so that they will receive a series of updated charts on their post-traumatic distress, depression symptoms, social support perceptions, and coping self-efficacy levels. An example screenshot of the CMTR website is given in Figure 1.


Chinese My Trauma Recovery, a Web-based intervention for traumatized persons in two parallel samples: randomized controlled trial.

Wang Z, Wang J, Maercker A - J. Med. Internet Res. (2013)

Example screenshot of the CMTR website.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3815433&req=5

figure1: Example screenshot of the CMTR website.
Mentions: My Trauma Recovery (MTR) website is a self-help trauma intervention program based on social cognitive theory [17], which consists of six modules of social support, self-talk, relaxation, trauma triggers, unhelpful coping, and professional help [7,18]. It has been translated, as CMTR, by funding via a Swiss-Chinese collaboration between University of Zurich (A Maercker) and Beijing Normal University (J Wang). The translation work was done mainly by the first author, and the second author (and her master’s students) and the third author (and his doctoral students) were involved in the back-translation work. CMTR utilizes interactive components, such as pictures, audio segments, video segments, and self-tests, to offer educational information on trauma and provide trauma coping skills practice for its users. All pictures on the CMTR website were new ones with Chinese figures; in addition, a total of 27 audio segments on the website were newly created. Due to the high costs of video, five video segments were kept in English with Chinese subtitles added to these videos. The users are encouraged to take self-tests regularly on CMTR so that they will receive a series of updated charts on their post-traumatic distress, depression symptoms, social support perceptions, and coping self-efficacy levels. An example screenshot of the CMTR website is given in Figure 1.

Bottom Line: CMTR reduced post-traumatic symptoms significantly with high effect size after one month of treatment (F₁,₄₅=15.13, Cohen's d=0.81, P<.001) and the reduction was sustained over a 3-month follow-up (F₁,₄₅=17.29, Cohen's d=0.87, P<.001).Post-traumatic symptoms decreased significantly after treatment (F₁,₄₈=43.97, Cohen's d=1.34, P<.001) and during the follow-up period (F₁,₄₈=24.22, Cohen's d=0.99, P<.001).Additional outcome measures (post-traumatic cognitive changes, depression) indicated a range of positive effects, in particular in the urban sample (group×time interactions: F₁,₈₈=5.32-8.37, all Ps<.03), contributing to the positive evidence for self-help interventions.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Psychology, School of Philosophy, Wuhan University, Wuhan, China.

ABSTRACT

Background: Guided self-help interventions for PTSD (post-traumatic stress disorder) are a promising tool for the dissemination of contemporary psychological treatment.

Objective: This study investigated the efficacy of the Chinese version of the My Trauma Recovery (CMTR) website.

Methods: In an urban context, 90 survivors of different trauma types were recruited via Internet advertisements and allocated to a randomized controlled trial (RCT) with a waiting list control condition. In addition, in a rural context, 93 survivors mainly of the 2008 Sichuan earthquake were recruited in-person for a parallel RCT in which the website intervention was conducted in a counseling center and guided by volunteers. Assessment was completed online on a professional Chinese survey website. The primary outcome measure was the Post-traumatic Diagnostic Scale (PDS); secondary outcome measures were Symptom Checklist 90-Depression (SCL-D), Trauma Coping Self-Efficacy Scale (CSE), Post-traumatic Cognitive Changes (PCC), and Social Functioning Impairment (SFI) questionnaires adopted from the My Trauma Recovery website.

Results: For the urban sample, findings indicated a significant group×time interaction in post-traumatic symptom severity (F₁,₈₈=7.65, P=.007). CMTR reduced post-traumatic symptoms significantly with high effect size after one month of treatment (F₁,₄₅=15.13, Cohen's d=0.81, P<.001) and the reduction was sustained over a 3-month follow-up (F₁,₄₅=17.29, Cohen's d=0.87, P<.001). In the rural sample, the group×time interaction was also significant in post-traumatic symptom severity (F₁,₉₁=5.35, P=.02). Post-traumatic symptoms decreased significantly after treatment (F₁,₄₈=43.97, Cohen's d=1.34, P<.001) and during the follow-up period (F₁,₄₈=24.22, Cohen's d=0.99, P<.001). Additional outcome measures (post-traumatic cognitive changes, depression) indicated a range of positive effects, in particular in the urban sample (group×time interactions: F₁,₈₈=5.32-8.37, all Ps<.03), contributing to the positive evidence for self-help interventions. Differences in the effects in the two RCTs are exploratorily explained by sociodemographic, motivational, and setting feature differences between the two samples.

Conclusions: These findings give support for the short-term efficacy of CMTR in the two Chinese populations and contribute to the literature that self-help Web-based programs can be used to provide mental health help for traumatized persons.

Trial registration: Australia New Zealand Clinical Trials Registry (ANZCTR): ACTRN12611000951954; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611000951954 (Archived by WebCite at http://www.webcitation.org/6G7WyNODk).

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Related in: MedlinePlus