TY - JOUR
T1 - Stress management versus cognitive restructuring in trauma-affected refugees - A follow-up study on a pragmatic randomised trial
AU - Barhoma, Maria
AU - Sonne, Charlotte
AU - Lommen, Miriam J J
AU - Mortensen, Erik Lykke
AU - Carlsson, Jessica
N1 - Copyright © 2021. Published by Elsevier B.V.
PY - 2021/7/16
Y1 - 2021/7/16
N2 - BACKGROUND: There is a lack of research and consensus with respect to long-term effective treatments for trauma-affected refugees. The purpose of this follow-up study of a randomised clinical trial was to investigate the effectiveness of Stress Management (SM) versus Cognitive Restructuring (CR) in treating trauma-affected refugees, six and 18 months post-treatment, respectively.METHODS: From a total of 126 refugees with PTSD, the intention-to-treat sample in the original trial, 74 patients were present at the six-month follow-up (SM; n = 37, CR; n = 37) and 34 patients at the 18-month follow-up (SM; n = 14, CR; n = 20). During the trial, the patients had been offered a total of 16 psychotherapy sessions and 10 sessions with a medical doctor.RESULTS: Mixed regression analyses at six and 18-month follow-up showed a non-significant small reduction in PTSD symptoms at both follow-up points with no significant between-group differences between the two psychotherapeutic interventions. Statistically significant between-group treatment effects were, however, observed with the patients receiving SM having significantly reduced symptoms of somatisation measured by the Symptom Checklist (β = 0.40), depression (β = 0.29) and anxiety (β = 0.37) (measured by the Hamilton Depression and Anxiety ratings) at 18 months post-treatment compared to the CR group.LIMITATIONS: Limitations to the present study include the dropout rate at follow-up(s).CONCLUSIONS: The findings suggest that the consolidation of coping strategies including relaxation, attention-diversion and behavioural activation in SM appears to be more beneficial than CR in reducing long-term somatisation, depression and anxiety symptoms for this population.
AB - BACKGROUND: There is a lack of research and consensus with respect to long-term effective treatments for trauma-affected refugees. The purpose of this follow-up study of a randomised clinical trial was to investigate the effectiveness of Stress Management (SM) versus Cognitive Restructuring (CR) in treating trauma-affected refugees, six and 18 months post-treatment, respectively.METHODS: From a total of 126 refugees with PTSD, the intention-to-treat sample in the original trial, 74 patients were present at the six-month follow-up (SM; n = 37, CR; n = 37) and 34 patients at the 18-month follow-up (SM; n = 14, CR; n = 20). During the trial, the patients had been offered a total of 16 psychotherapy sessions and 10 sessions with a medical doctor.RESULTS: Mixed regression analyses at six and 18-month follow-up showed a non-significant small reduction in PTSD symptoms at both follow-up points with no significant between-group differences between the two psychotherapeutic interventions. Statistically significant between-group treatment effects were, however, observed with the patients receiving SM having significantly reduced symptoms of somatisation measured by the Symptom Checklist (β = 0.40), depression (β = 0.29) and anxiety (β = 0.37) (measured by the Hamilton Depression and Anxiety ratings) at 18 months post-treatment compared to the CR group.LIMITATIONS: Limitations to the present study include the dropout rate at follow-up(s).CONCLUSIONS: The findings suggest that the consolidation of coping strategies including relaxation, attention-diversion and behavioural activation in SM appears to be more beneficial than CR in reducing long-term somatisation, depression and anxiety symptoms for this population.
KW - Health Sciences
KW - Psychological intervention
KW - Transcultural Psychiatry
KW - Trauma and Stressor Related Disorders, including traumatic experience in childhood
KW - randomised controlled clinical trial
KW - Psychotherapy
KW - PTSD
KW - refugees
KW - Stress Management
KW - trauma
UR - http://www.scopus.com/inward/record.url?scp=85111337715&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2021.07.007
DO - 10.1016/j.jad.2021.07.007
M3 - Journal article
C2 - 34332363
SN - 0165-0327
VL - 294
SP - 628
EP - 637
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -