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Stress management versus cognitive restructuring in trauma-affected refugees - A follow-up study on a pragmatic randomised trial

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@article{d09eb56a93d143e6ab27fbf6554afc70,
title = "Stress management versus cognitive restructuring in trauma-affected refugees - A follow-up study on a pragmatic randomised trial",
abstract = "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.",
keywords = "Health Sciences, Psychological intervention, Transcultural Psychiatry, Trauma and Stressor Related Disorders, including traumatic experience in childhood, randomised controlled clinical trial, Psychotherapy, PTSD, refugees, Stress Management, trauma",
author = "Maria Barhoma and Charlotte Sonne and Lommen, {Miriam J J} and Mortensen, {Erik Lykke} and Jessica Carlsson",
note = "Copyright {\textcopyright} 2021. Published by Elsevier B.V.",
year = "2021",
month = jul,
day = "16",
doi = "10.1016/j.jad.2021.07.007",
language = "English",
volume = "294",
pages = "628--637",
journal = "Journal of Affective Disorders",
issn = "0165-0327",
publisher = "Elsevier BV",

}

RIS

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

VL - 294

SP - 628

EP - 637

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

ER -

ID: 66997854