JMIR Publications

ABSTRACT

Background:

Post-traumatic stress disorder (PTSD) is a psychiatric disorder that can manifest after a traumatic event, in which the individual perceives a threat to his or her life, or that of others. Its estimated prevalence in the European population is 0.7–1.9%. According to the ‘dose-response’ model, individuals who are most exposed to traumatic events are most at risk of developing the disorder. Hence, it is unsurprising that studies have observed a higher prevalence among the military population, ranging from 10–18%, or even up to 45%. The overall goal of this project is to evaluate primary prevention actions that can strengthen the resilience of at-risk professionals, notably military personnel, in the short term, with the medium to long-term aim of preventing the occurrence of PTSD, and improving the patient’s prognosis.

Objective:

The project’s objectives are: (i) to design a primary prevention program for PTSD, tailored to the studied military population, and compatible with operational constraints; and (ii) to implement/ validate the PREPAR program in the short term with operational personnel belonging to the French Mountain Infantry Brigade (Brigade d’Infanterie de Montagne).

Methods:

This is a single-center, prospective, randomized, parallel-group controlled cohort study. The cohort of 116 participants is divided into two groups: the non-intervention (NI) group receives no training, and the intervention group (I) follows a dedicated prevention program. Each participant is evaluated four times (at inclusion, +4 months, +6 months, and +12 months). Members of the I group attend eight workshops, making up the prevention program, and two debriefing and practice reinforcement workshops. All visits and workshops are conducted at the Brigade’s premises. During each visit, participants complete several psychosocial questionnaires (which take 15–80 minutes to complete, depending on the visit). Samples (a 30 ml blood sample, and three 5 ml saliva samples) are collected on three occasions: at inclusion, +4 months, and +12 months. Emotional reactivity (electrocardiogram and electrodermal activity) is measured before, during and after the classic and the emotional Stroop task, using surface electrodes placed on the last phalanx of two fingers, and the thorax.

Results:

This a protocol paper, therefore there is no result presented

Conclusions:

The study adopts an integrative approach to the processes that play a role in the risk of developing PTSD. Our biopsychosocial perspective makes it possible to target levers related to factors specific to the individual (at physiological and psychological levels), and contextual and social factors (related to the professional environment). The following dimensions are addressed: (i) biophysiology (by studying the key markers of the neurobiological stress response, wear and tear, and vulnerability phenomena, and by reinforcing the flexibility of the autonomic nervous system), (ii) psychology (by facilitating and measuring the development of flexible coping strategies to deal with stress, and evaluating the moderating role of the individual’s sense of duty in the development of PTSD) and (iii) social (by facilitating community strategies aimed at reducing stigmatization and supporting the use of care by professionals in difficulty, in the institutional context). Clinical Trial: Trial Registration: ClinicalTrials.gov NCT05094531.