Is only one cognitive technique also effective? Results from a randomized controlled trial of two different versions of an internet-based cognitive behavioural intervention for post-traumatic stress disorder in Arabic-speaking countries

Böttche, Maria; Wagner, Birgit; Vöhringer, Max; Heinrich, Manuel; Stein, Jana; Selmo, Pirko; Stammel, Nadine; Knaevelsrud, Christine

doi:10.1080/20008198.2021.1943870

Cited by 11 publications

(17 citation statements)

References 50 publications

(79 reference statements)

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“…Participants were treatment-seeking individuals who completed an online screening survey to take part in an internet-based treatment for either post-traumatic stress disorder (PTSD) or depression in the Arabic language (approved by the Ethics Committee of the University of Leipzig, Germany: 236-11-22082011). The study has a cross-sectional design and is part of an open-label dissemination study of the included treatments [e.g., ( 22 – 24 )]. The dissemination study is being implemented in the context of a program that has been ongoing since 2008 and is conducted by a German psychosocial center that offers psychosocial treatment for victims of torture and war.…”

Section: Methodsmentioning

confidence: 99%

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Prolonged grief disorder in Arabic-speaking treatment-seeking populations: Relationship with socio-demographic aspects, loss- and trauma-related characteristics, and mental health support

et al. 2022

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Section: Methodsmentioning

confidence: 99%

“…Furthermore, they had to have experienced one or more losses of family members or friends. As only screening data were analyzed, the inclusion and exclusion criteria for the dissemination study of the treatments were not yet applicable [for exclusion criteria of the intervention see ( 22 )].…”

Section: Methodsmentioning

confidence: 99%

Prolonged grief disorder in Arabic-speaking treatment-seeking populations: Relationship with socio-demographic aspects, loss- and trauma-related characteristics, and mental health support

et al. 2022

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“…A small pilot study of a comparable programme for N = 15 Dari or Farsi speaking youths showed high drop-out rates (23). In two larger scale studies, Knaevelsrud and colleagues (24,25) could show that a guided online program led to large changes in PTSD symptoms in patients in war and conflict zones. Although very encouraging, the focus of these trials was on PTSD, excluding other very prevalent problems such as anxiety, depression, and substance abuse.…”

Section: Introduction Background and Rationale {6a}mentioning

confidence: 99%

Internet based versus face-to-face transdiagnostic treatment for emotional disorders in Arabic- and Farsi-speaking refugees: Study protocol of a three-arm randomized controlled non-inferiority trial.

Boettcher

Heinrich

Boettche

et al. 2023

Preprint

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Background Refugee populations have an increased risk for mental disorders, such as depressive, anxiety, and posttraumatic stress disorders. Comorbidity is common. At the same time, refugees face multiple barriers to accessing mental health treatment. Only a minority of them receives adequate help. The planned trial evaluates a low-threshold, transdiagnostic Internet based treatment. The trial aims at establishing its efficacy and cost-effectiveness compared with face-to-face treatment and no treatment. Methods In a three-arm, multi-site randomized-controlled trial we will test the non-inferiority of the Internet based, cognitive-behavioral treatment to content-equivalent face-to-face treatment and its superiority to waitlist control. N = 499 treatment-seeking Arabic- or Farsi-speaking patients, meeting diagnostic criteria for a depressive, anxiety, and/or posttraumatic stress disorder will be randomized to one of three groups. The first group receives an Internet based treatment with weekly written guidance provided by Arabic- or Farsi-speaking professionals. The second group will receive weekly face-to-face treatment provided by German-speaking CBT therapists and facilitated by interpreters. The third group will wait for three months and then receive their treatment of choice. Both active treatments are based on the Common Elements Treatment Approach (CETA), are tailored to the individual patient, and take 6–16 weeks. Discussion The planned trial will result in an estimate of the (comparative) efficacy of two valuable treatment options for the most common mental disorders in refugees. Trial registration The trial was registered at GCTR, the German clinical trials register, as DRKS00024154 on 2021-02-01.

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“…Over the past two decades, cognitive–behavioural methods, including exposure-based and cognitive techniques for the treatment of PTSD, have been adapted for delivery in web-based settings (e.g. Böttche et al, 2021 ; Spence et al, 2014 ; Stein et al, 2023 ). Providing treatment to individuals experiencing mental health problems through the internet presents significant advantages, particularly for those with limited access to face-to-face treatment.…”

Section: Introductionmentioning

confidence: 99%

Changes in trauma appraisal during brief internet-based exposure and cognitive restructuring treatment for Arabic-speaking people with PTSD

Stein,

El-Haj-Mohamad,

Stammel

et al. 2024

European Journal of Psychotraumatology

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Background: Maladaptive trauma appraisal plays an important role in the development and maintenance of posttraumatic stress disorder (PTSD). While studies have demonstrated the effectiveness of exposure and cognitive treatments for PTSD symptomatology, the effect of such treatments on specific trauma appraisals is still not well understood. Objective: The study investigated the effect of an exposure and a cognitive restructuring internet-based treatment on specific trauma appraisals in Arabic-speaking participants with PTSD. Method: 334 participants received either an exposure ( n = ) or a cognitive restructuring ( n = ) internet-based treatment. PTSD symptom severity (PCL-5) and specific trauma appraisals (TAQ) were assessed at pre- and post-treatment. Changes in specific trauma appraisals within and between the two treatments were analyzed using multi-group change modelling. Associations between changes in PTSD symptom severity and changes in trauma appraisals were evaluated using Pearson product-moment correlation. For both treatments, participants with versus without reliable improvement were compared regarding changes in specific trauma appraisals using Welch tests. Analyses were performed on 100 multiple imputed datasets. Results: Both treatments yielded significant changes in shame, self-blame, fear, anger, and alienation (all p s < .001). Changes in betrayal were only significant in the cognitive restructuring treatment ( p < .001). There was no evidence of differences between treatments for any specific trauma appraisal. Changes in PTSD symptom severity were significantly associated with changes in trauma appraisals (all p s < .001). In both treatments, participants who experienced reliable improvement in PTSD symptom severity showed significantly larger pre- to post-treatment changes in specific trauma appraisals compared to those without reliable improvement. Again, differences in betrayal were only significant in the cognitive restructuring treatment. Conclusions: The findings indicate that both treatments are effective in reducing trauma appraisals in Arabic-speaking people with PTSD. Changes in trauma appraisal seem to be associated with changes in PTSD symptomatology. Trial registration: .

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Is only one cognitive technique also effective? Results from a randomized controlled trial of two different versions of an internet-based cognitive behavioural intervention for post-traumatic stress disorder in Arabic-speaking countries

Abstract: Knaevelsrud (2021) Is only one cognitive technique also effective? Results from a randomized controlled trial of two different versions of an internet-based cognitive behavioural intervention for post-traumatic stress disorder in Arabic-speaking countries,

Cited by 11 publications

References 50 publications

Prolonged grief disorder in Arabic-speaking treatment-seeking populations: Relationship with socio-demographic aspects, loss- and trauma-related characteristics, and mental health support

Prolonged grief disorder in Arabic-speaking treatment-seeking populations: Relationship with socio-demographic aspects, loss- and trauma-related characteristics, and mental health support

Internet based versus face-to-face transdiagnostic treatment for emotional disorders in Arabic- and Farsi-speaking refugees: Study protocol of a three-arm randomized controlled non-inferiority trial.

Changes in trauma appraisal during brief internet-based exposure and cognitive restructuring treatment for Arabic-speaking people with PTSD

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