Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-17T11:26:12.679Z Has data issue: false hasContentIssue false
  • English
  • Français

A Randomized Controlled Trial of the Effectiveness of Brief-CBT for Patients with Symptoms of Posttraumatic Stress Following a Motor Vehicle Crash

Published online by Cambridge University Press:  02 November 2012

Kitty K. Wu ,
Frendi W. Li  and
Valda W. Cho
Kitty K. Wu*
Affiliation:
Kwai Chung Hospital, Hong Kong, China
Frendi W. Li
Affiliation:
University of Hong Kong, China
Valda W. Cho
Affiliation:
Caritas Medical Centre, Hong Kong, China
*
Reprint requests to Kitty K. Wu, Clinical Psychology Service, Kwai Chung Hospital, 3-15 Kwai Chung Hospital Road, New Territories, Hong Kong, China. E-mail: wukyk@ha.org.hk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Motor vehicle crashes (MVCs) are leading contributors to the global burden of disease. Patients attending accident and emergency (A&E) after an MVC may develop symptoms of posttraumatic stress disorder (PTSD). There is evidence that brief cognitive behavioural therapy (B-CBT) can be effective in treating PTSD; however, there are few studies of the use of B-CBT to treat PTSD in MVC survivors. Aims: This study examined the effects of B-CBT and a self-help program on the severity of psychological symptoms in MVC survivors at risk of developing PTSD. Method: Sixty participants who attended A&E after a MVC were screened for PTSD symptoms and randomized to a 4-weekly session B-CBT or a 4-week self-help program (SHP) booklet treatment conditions. Psychological assessments were completed at baseline (1-month post-MVC) and posttreatment (3- and 6-month follow-ups) by utilizing Impact of Event Scale-Revised (IES-R) and Hospital Anxiety and Depression Scale (HADS). Results: There were significant improvements in the measures of anxiety, depression, and PTSD symptoms over time. Participants treated with B-CBT showed greater reductions in anxiety at 3-month and 6-month follow-ups, and in depression at 6-month follow-up. A comparison of effect size favoured B-CBT for the reduction of anxiety and depression symptoms measured by HADS. A high level of pretreatment anxiety and depression were predictive of negative outcome at 6-month follow-up in the SHP condition. There was no differential effect on PTSD symptoms measured by IES-R. Conclusions: This trial supports the efficacy of providing B-CBT as a preventive strategy to improve psychological symptoms after an MVC.

Keywords

Road traffic accidentanxietydepressionexposureself-help interventiontreatment outcome
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 42 , Issue 1 , January 2014 , pp. 31 - 47
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adler, A. B., Litz, B. T., Castro, C. A., Suvak, M., Thomas, J. L., Burrell, L., et al. (2008). A group randomized trial of critical incident stress debriefing provided to US peacekeepers. Journal of Traumatic Stress, 21, 253–263.CrossRefGoogle ScholarPubMed
Bisson, J. I., Shepherd, J. P., Joy, D., Probert, R. and Newcombe, R. G. (2004). Early cognitive-behavioural therapy for post-traumatic stress symptoms after physical injury: randomised controlled trial. British Journal of Psychiatry, 184, 63–69.Google Scholar
Blanchard, E. B. and Veazey, C. H. (2001). Mental disorders resulting from road traffic accidents. Current Opinion in Psychiatry, 14, 143–147.Google Scholar
Bryant, R. A., Mastrodomenico, J., Felmingham, K. L., Hopwood, S., Kenny, L., Kandris, E., et al. (2008). Treatment of acute stress disorder: a randomized controlled trial. Archive of General Psychiatry, 65, 659–667.Google Scholar
Bryant, R. A., Moulds, M. L., Nixon, R. D. V., Mastrodomenico, J., Felmingham, K. and Hopwood, S. (2006). Hypnotherapy and cognitive behaviour therapy of acute stress disorder: a 3-year follow-up. Behaviour Research and Therapy, 44, 1331–1335.CrossRefGoogle ScholarPubMed
Bugg, A., Turpin, G., Mason, S. and Scholes, C. (2009). A randomised controlled trial of the effectiveness of writing as a self-help intervention for traumatic injury patients at risk of developing post-traumatic stress disorder. Behavior Research and Therapy, 47, 6–12.Google Scholar
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
Devilly, G. J. (2004). The Effect Size Generator for Windows: version 2.3 (computer programme) (version 2.3). Swinburne University, Australia: Centre for Neuropsychology.Google Scholar
Ehlers, A., Clark, D. M., Hackmann, A., McManus, F., Fennell, M., Herbert, C., et al. (2003). A randomized controlled trial of cognitive therapy, a self-help booklet and repeated assessments as early interventions for postraumatic stress disorder. Archives of General Psychiatry, 60, 1024–1032.CrossRefGoogle Scholar
Foa, E. B., Keane, T. M., Friedman, M. J. and Cohen, J. A. (Eds.). (2009). Effective Treatments for PTSD: practice guidelines from the International Society for Traumatic Stress Studies (2nd ed.). New York: Guilford Press.Google Scholar
Foa, E. B., Zoellner, L. A. and Feeny, N. C. (2006). An evaluation of three brief programmes for facilitating recovery. Journal of Traumatic Stress, 19, 29–43.CrossRefGoogle ScholarPubMed
Friendly, M. (2004). Power analysis for ANOVA designs. Retrieved April 7; 2011, from http://www.math.yorku.ca/scs/online/power.Google Scholar
Hedges, L. V. (1982). Estimation of effect size from a series of independent experiments. Psychological Bulletin, 97, 490–499.Google Scholar
Leung, C. M., Ho, S., Kan, C. S., Hung, C. H. and Chen, C. N. (1993). Evaluation of the Chinese version of the Hospital Anxiety and Depression Scale. International Journal of Psychosomatics, 40, 29–34.Google Scholar
Mayou, A., Black, J. and Bryant, B. (2000). Unconsciousness, amnesia and psychiatric symptoms following road traffic accident injury. British Journal of Psychiatry, 177, 540–545.Google Scholar
Resick, P. A., Galovski, T. E., Uhlmansick, M. O., Scher, C. D., Clum, G. A. and Young-Xu, Y. (2008). A randomized clinical trial to dismantle components of cognitive processing therapy for posttraumatic stress disorder in female victims of interpersonal violence. Journal of Consulting and Clinical Psychology, 76, 243–258.Google Scholar
Roberts, N. P., Kitchiner, N. J., Kenardy, J. and Bisson, J. I. (2009). Systematic review and meta-analysis of multiple-session early interventions following traumatic events. American Journal of Psychiatry, 166, 293–301.CrossRefGoogle ScholarPubMed
Roberts, N. P., Kitchiner, N. J., Kenardy, J. and Bisson, J. I. (2010). Early psychological interventions to treat acute traumatic stress symptoms (Publication no. 10.1002/14651858.CD007944.pub2). (CD007944). Retrieved 5 January 2011.Google Scholar
Rose, S., Bisson, J., Churchill, R. and Wessely, S. (2002). Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database of Systematic Reviews, 2. Art. no. CD000560. DOI: 10.1002/14651858.CD000560.Google Scholar
Scholes, C., Turpin, G. and Mason, S. (2007). A randomised controlled trial to assess the effectiveness of providing self-help information to people with symptoms of acute stress disorder following a traumatic injury. Behaviour Research and Therapy, 45, 2527–2536.Google Scholar
Scott, M. J. and Stradling, , , S. G. (1997). Client compliance with exposure treatments for posttraumatic stress disorder. Journal of Traumatic Stress, 10, 523–526.Google Scholar
Turpin, G., Downs, M. and Mason, S. (2005). Effectiveness of providing self-help information following acute traumatic injury: randomised controlled trial. British Journal of Psychiatry, 187, 76–82.Google Scholar
Weiss, D. S. and Marmar, C. R. (1997). The Impact of Event Scale-Revised. In Wilson, J. P. and Keane, T. M. (Eds.), Assessing Psychological Trauma and PTSD (pp. 399–411): New York: Guilford Press.Google Scholar
Williams, M. and Poijula, , , S. (2002). The PTSD Workbook: simple, effective techniques for overcoming traumatic stress symptoms. Oakland, CA: New Harbinger Publications.Google Scholar
World Health Organization (2004). World Report on Road Traffic Injury Prevention. Geneva: World Health Organization.Google Scholar
Wu, K. K. (2011). Trauma assessments tools validated in Hong Kong. In Wu, K. K., Tang, C. S. and Leung, E. Y. (Eds.), Healing Trauma: a professional guide. Hong Kong: Hong Kong University Press.Google Scholar
Wu, K. K. and Cheung, M. W. (2006). Posttraumatic stress after motor vehicle accident: a six-month follow-up study utilizing latent growth models analysis. Journal of Traumatic Stress, 19, 923–936.Google Scholar
Submit a response

Comments

No Comments have been published for this article.