Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 22, 2021
Date Accepted: Jan 5, 2022
Efficacy, Benefits and Harms of a Self-Management App (PTSD Coach) in a Swedish, Trauma-Exposed Community Sample: Randomized Controlled Trial
ABSTRACT
Background:
Self-guided interventions may complement and overcome obstacles for in-person treatment options. The efficacy of app interventions that target PTSD is unclear and results from prior studies regarding PTSD Coach (an app for managing trauma-related distress) are inconsistent.
Objective:
We investigated whether PTSD Coach affected posttraumatic stress, depressive and somatic symptoms. Furthermore, we assessed perceived helpfulness, satisfaction, negative effects, response and remission related to PTSD Coach.
Methods:
Adults who had experienced potentially traumatic events in the past 2 years were randomized (1:1) to access to PTSD Coach (n=89) or waitlist (n=90). We assessed clinical characteristics at baseline (semi-structured interview and self-rating scales) and 3 months later (self-rating scales). We analyzed data with linear mixed-effects modeling, χ2 and Fisher’s exact test in R.
Results:
Intention-to-treat analyses indicate that access to PTSD Coach decreased posttraumatic stress and depressive symptoms, but not somatic symptoms. More participants who had access to PTSD Coach responded with clinically significant improvement and less instances of probable PTSD after 3 months compared to waitlist controls. Participants found PTSD Coach a little to moderately helpful and moderately satisfactory. Every other person reported at least one negative reaction related to using PTSD Coach (e.g. disappointment in the app or its results, arousal of stress or distressing memories).
Conclusions:
Using PTSD Coach may trigger symptoms among a minority of users; yet a majority of users perceives PTSD Coach as helpful and satisfactory. Access to PTSD Coach supports improvement of psychological trauma-related symptoms. We discuss implications for research and clinical practice. Clinical Trial: Clinical trials, NCT04094922, https://clinicaltrials.gov/ct2/show/NCT04094922?term=ptsd+coach&cond=ptsd&cntry=SE&draw=2&rank=1
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