Chinese My Trauma Recovery, A Web-Based Intervention for Traumatized Persons in Two Parallel Samples: Randomized Controlled Trial

Department of Psychology, School of Philosophy, Wuhan University, Wuhan, China.
Journal of Medical Internet Research (Impact Factor: 3.43). 09/2013; 15(9):e213. DOI: 10.2196/jmir.2690
Source: PubMed


Guided self-help interventions for PTSD (post-traumatic stress disorder) are a promising tool for the dissemination of contemporary psychological treatment.
This study investigated the efficacy of the Chinese version of the My Trauma Recovery (CMTR) website.
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.
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.
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.
Australia New Zealand Clinical Trials Registry (ANZCTR): ACTRN12611000951954; (Archived by WebCite at

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Available from: Andreas Maercker, Jun 16, 2014
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    • "Study 1 (Wang et al. 2013) "
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    ABSTRACT: Low and middle income countries (LMICs) are facing an increase of the impact of mental health problems while confronted with limited resources and limited access to mental health care, known as the ‘mental health gap’. One strategy to reduce the mental health gap would be to utilize the internet to provide more widely-distributed and low cost mental health care. We undertook this systematic review to investigate the effectiveness and efficacy of online interventions in LMICs. Methods. We systematically searched the data-bases PubMed, PsycINFO, JMIR, and additional sources. MeSH terms, Thesaurus, and free text keywords were used. We included all randomized controlled trials (RCTs) of online interventions in LMICs. Results. We found only three articles reported results of RCTs on online interventions for mental health conditions in LMICs, but none of these interventions was compared with an active control condition. Also, the mental health conditions were diverse across the three studies. Conclusions. There is a dearth of studies examining the effect of online interventions in LMICs, so we cannot draw a firm conclusion on its effectiveness. However, given the effectiveness of online interventions in high income countries and sharp increase of internet access in LMICs, online interventions may offer a potential to help reduce the ‘mental health gap’. More studies are urgently needed in LMICs.
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    Verhaltenstherapie 02/2014; 24(1):6-14. DOI:10.1159/000358472 · 0.48 Impact Factor
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    ABSTRACT: Objective: To construct a cognitive model to explain the relationship between social support and negative outcomes of trauma event. In this model, mediation effect was tested to explore the role of cognitive change in the correlation between social support and negative outcomes of trauma event. Methods: A total of 173 participants who experienced trauma event were recruited to complete a series of questionnaires. The social support was assessed by the Social Acknowledgement as a Victim or Survivor Questionnaire (SAQ). The cognitive change was assessed by the Posttraumatic Cognitive Changes (PCC). And the negative outcome of trauma event was assessed by Posttraumatic Diagnostic Scale (PDS), Symptom Checklist 90-Depression (SCL-D) and Social Functioning Impairment (SFI). Results: There were significant correlations among SAQ, PCC, PDS, SCL-D and SFI. Structural equation modeling showed that the model fit the data well (χ2/df=2.052, GFI=0.982, TLI=0.974, CFI=0.989, NFI=0.980, RMSEA=0.078). The indirect effect of cognitive change accounted for 60.4% of the total effect in the model. Further mediation analyses found that cognitive change acted as partial mediator in correlation between social support and depression (accounted for 55.8%), also as partial mediator in correlation between social support and functioning impairment (accounted for 45.7%), and as total mediator in correlation between social support and PTSD symptoms (accounted for 79.0%). Conclusion: Cognitive change is an important factor of social support’s influences on the recovery of PTSD. And the longitudinal design with large sample should be used and more comprehensive model of PTSD should be constructed in the future research.
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