Accepted for/Published in: JMIR Mental Health
Date Submitted: Dec 13, 2020
Date Accepted: Jul 7, 2021
Date Submitted to PubMed: Sep 9, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Online Cognitive Behavioral Therapy for Posttraumatic Stress Disorder: A Single Arm Clinical Trial with Psychometric and Psychophysiological Outcomes
ABSTRACT
Background:
Background:
Posttraumatic Stress Disorder (PTSD) remains undertreated and the online delivery of cognitive behavioural therapy supplemented with mindfulness meditation and yoga can be a viable treatment that emphasizes self-directed practice.
Objective:
This study examined the effectiveness of an online cognitive behaviour therapy program combined with mindfulness and yoga methods (CBT-MY) designed for daily use.
Methods:
Method: This study was a registered clinical trial (www.clinicaltrials.gov ID: NCT03684473). Adults with PTSD symptoms (n = 22) enrolled in an 8-week single-arm trial. Each participant received online CBT-MY content and an hour of online counselling each week. Pre-post psychological outcomes were self-reported PTSD symptom severity, depression, anxiety, chronic pain, and mindfulness. Pre-post psychophysiological outcomes were measured using a lab protocol focused on pupillometry and heart rate variability (HRV). These outcomes were compared with a non-PTSD comparison group with no history of clinical mental health diagnoses (n = 46).
Results:
Results:
Pre-post analyses revealed substantial improvements in PTSD severity (d = 2.44), depression (d = 1.34), anxiety (d = 1.60), and mindfulness (d = 1.06). Linear multilevel mixed modelling revealed significant pre-post reductions in peak pupil diameter (PPD) at 8-week follow-up (ΔM = -.06, SE = .01, p = .000) but no significant changes in pre-post HRV (p = .87). Participants spent a mean of 12-minutes/day in self-directed mindfulness practice (M = 38.89 mins/week, SD = 28.16), guided yoga (M = 31.94 mins/week, SD = 28.24), and breath awareness techniques (M = 9.89 mins/week, SD = 11.87).
Conclusions:
Conclusion: Online CBT-MY program participation was associated with clinically significant symptom reductions in combination with significant PPD changes reflecting more normalized autonomic functioning. Future RCT research is needed to further examine the gains apparent in this single-arm study. Clinical Trial: This study was a registered clinical trial (www.clinicaltrials.gov ID: NCT03684473).
Citation
