基于网络的创伤后应激障碍早期干预研究:基于网络的创伤后应激障碍早期干卡塔尔世界杯8强波胆分析预研究随机对照试验%A Mouthaan,Joanne %A Sijbrandij,Marit %A de Vries,Giel-Jan %A Reitsma,Johannes B %A van de Schoot,Rens %A Goslings,J Carel %A Luitse,Jan SK %A Bakker,Fred C %A Gersons,Berthold PR %A Olff,Miranda %+焦虑障碍研究中心，精神创伤研究组，学术医学中心，Meibergdreef 5，阿姆斯特丹，3356 BE，荷兰，31 208913552，j.mouthaan@amc.uva.nl %K早期干预%K预防%K互联网%K创伤后应激障碍%K认知行为治疗%D 2013 %7 2013年8月13日原创论文%J J Med互联网研究%G英语%X背景:创伤后应激障碍(PTSD)在10-20%的损伤患者中发生。我们基于认知行为疗法(CBT)的技术，开发了一种新颖的、自我引导的基于互联网的干预(称为创伤TIPS)，以预防PTSD症状的发作。目的:探讨创伤TIPS是否能有效预防创伤后应激障碍症状的发生。方法:1级创伤中心成人患者随机分为两组，一组接受全自动创伤TIPS网络干预(151例)，另一组不接受早期干预(149例)。创伤TIPS包括心理教育、体内暴露和压力管理技术。两组都可以像往常一样自由使用护理(与医院工作人员进行非协议会谈)。在损伤后1、3、6和12个月，通过临床访谈(临床医师管理的PTSD量表)和自我报告工具(事件影响量表-修订版)评估PTSD症状严重程度。次要结局是急性焦虑和觉醒(在线评估)，自我报告的抑郁和焦虑症状(医院焦虑和抑郁量表)，以及精神卫生保健的利用。 Intervention usage was documented. Results: The 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<.001) without significant differences in trend. PTSD at 12 months was diagnosed in 4.7% of controls and 4.4% of intervention group patients. There were no group differences on anxiety or depressive symptoms over time. Post hoc analyses using latent growth mixture modeling showed a significant decrease in PTSD symptoms in a subgroup of patients with severe initial symptoms (n=20) (P<.001). Conclusions: Our results do not support the efficacy of the Trauma TIPS Internet-based early intervention in the prevention of PTSD symptoms for an unselected population of injury patients. Moreover, uptake was relatively low since one-fifth of individuals did not log in to the intervention. Future research should therefore focus on innovative strategies to increase intervention usage, for example, adding gameplay, embedding it in a blended care context, and targeting high-risk individuals who are more likely to benefit from the intervention. Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN): 57754429; http://www.controlled-trials.com/ISRCTN57754429 (Archived by WebCite at http://webcitation.org/6FeJtJJyD). %M 23942480 %R 10.2196/jmir.2460 %U //www.mybigtv.com/2013/8/e165/ %U https://doi.org/10.2196/jmir.2460 %U http://www.ncbi.nlm.nih.gov/pubmed/23942480