Browsing by Author "Gillibrand, Rodrigo"

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    The ABCDE psychological first aid intervention decreases early PTSD symptoms but does not prevent it: results of a randomized-controlled trial
    (TAYLOR & FRANCIS LTD, 2022) Figueroa, Rodrigo Andres; Cortes, Paula Francisca; Marin, Humberto; Verges, Alvaro; Gillibrand, Rodrigo; Repetto, Paula
    Background Early Psychological First Aid (PFA) has been widely recommended for preventing posttraumatic stress disorder (PTSD). However, its lack of empirical evidence of safety and effectiveness has been criticized. Objectives To assess the effectiveness of PFA-ABCDE, an original PFA protocol, for preventing PTSD one month after the intervention and decreasing PTSD symptoms at one and six months of follow up. Methods We assessed the eligibility of 1,140 adult survivors of recent trauma (<= 72 hours) consulting five emergency departments in Chile. Two hundred twenty-one were randomized to receive either PFA-ABCDE (active listening, breathing retraining, categorization of needs, referral to ancillary services, and psychoeducation) or only psychoeducation. We used the Composite International Diagnostic Interview (CIDI) to assess PTSD diagnosis. The Posttraumatic Checklist (PCL), the Beck Depression Inventory-II (BDI-II), and a 0-10 points analogue visual scale were used to assess PTSD symptoms, depressive symptoms, and immediate distress relief after the intervention. Results We found no difference between the experimental and control groups in the frequency of PTSD one month after the intervention (PFA-ABCDE = 23/76 [30.3%], psychoeducation = 18/75 [24.0%], adjusted odds ratio = 1.39, 95% confidence interval = 0.63-3.07, p = .408). Immediately after the intervention, participants who received PFA-ABCDE reported greater distress relief (PFA-ABCDE mean = 9.06, psychoeducation mean = 8.55, Cohen's d = 0.30, p = .038). Fewer PTSD symptoms were reported by those who received PFA-ABCDE one month after the intervention (PFA-ABCDE mean = 36.26, psychoeducation mean = 43.62, Cohen's d = 0.42, p = .033). We found no difference in depressive symptoms at one-month follow up (p = .713) nor in PTSD symptoms six months after the intervention (p = .986). Conclusions PFA-ABCDE does not prevent PTSD diagnosis, but it provides immediate distress relief and decreases PTSD symptoms in the short term.
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    The effect of a single session of psychological first aid in the emergency department on PTSD and depressive symptoms three months post-intervention: results of a randomised controlled trial
    (2024) Figueroa Cabello, Rodrigo; Cortés, Paula Francisca; Miller, Carolina; Marín Uribe, Humberto; Gillibrand, Rodrigo; Hoeboer, Chris María; Olff, Miranda
    Background: Despite its popularity, evidence of the effectiveness of Psychological First Aid (PFA) is scarce.Objective: To assess whether PFA, compared to psychoeducation (PsyEd), an attention placebo control, reduces PTSD and depressive symptoms three months post-intervention.Methods: In two emergency departments, 166 recent-trauma adult survivors were randomised to a single session of PFA (n = 78) (active listening, breathing retraining, categorisation of needs, assisted referral to social networks, and PsyEd) or stand-alone PsyEd (n = 88). PTSD and depressive symptoms were assessed at baseline (T0), one (T1), and three months post-intervention (T2) with the PTSD Checklist (PCL-C at T0 and PCL-S at T1/T2) and the Beck Depression Inventory-II (BDI-II). Self-reported side effects, post-trauma increased alcohol/substance consumption and interpersonal conflicts, and use of psychotropics, psychotherapy, sick leave, and complementary/alternative medicine were also explored.Results: 86 participants (51.81% of those randomised) dropped out at T2. A significant proportion of participants in the PsyEd group also received PFA components (i.e. contamination). From T0 to T2, we did not find a significant advantage of PFA in reducing PTSD (p = .148) or depressive symptoms (p = .201). However, we found a significant dose-response effect between the number of delivered components, session duration, and PTSD symptom reduction. No significant difference in self-reported adverse effects was found. At T2, a smaller proportion of participants assigned to PFA reported increased consumption of alcohol/substances (OR = 0.09, p = .003), interpersonal conflicts (OR = 0.27, p = .014), and having used psychotropics (OR = 0.23, p = .013) or sick leave (OR = 0.11, p = .047).Conclusions: Three months post-intervention, we did not find evidence that PFA outperforms PsyEd in reducing PTSD or depressive symptoms. Contamination may have affected our results. PFA, nonetheless, appears to be promising in modifying some post-trauma behaviours. Further research is needed., Psychological First Aid (PFA) is widely recommended early after trauma.We assessed PFA's effectiveness for decreasing PTSD symptoms and other problems 3 months post-trauma.We didn't find definitive evidence of PFA's effectiveness. Still, it seems to be a safe intervention., Antecedentes: A pesar de su popularidad, la evidencia sobre la efectividad de los Primeros Auxilios Psicol & oacute;gicos (PAP) es escasa.Objetivo: Evaluar si los PAP, en comparaci & oacute;n con la psicoeducaci & oacute;n (PsiEd), un control de placebo atencional, reducen los s & iacute;ntomas de PTSD y depresi & oacute;n tres meses despu & eacute;s de la intervenci & oacute;n.M & eacute;todo: En dos servicios de urgencia, 166 adultos sobrevivientes de traumas recientes fueron asignados aleatoriamente a una sola sesi & oacute;n de PAP (n = 78) (escucha activa, ejercicios de respiraci & oacute;n, categorizaci & oacute;n de necesidades, derivaci & oacute;n asistida a redes sociales y PsiEd) o a PsiEd sola (n = 88). Los s & iacute;ntomas de PTSD y depresi & oacute;n fueron evaluados al inicio (T0), uno (T1) y tres meses despu & eacute;s de la intervenci & oacute;n (T2) con el PTSD Checklist (PCL-C en T0 y PCL-S en T1/T2) y el Inventario de Depresi & oacute;n de Beck-II (BDI-II). Tambi & eacute;n se explor & oacute; el autoreporte de efectos adversos, consumo de alcohol/sustancias, conflictos interpersonales, y uso de psicotr & oacute;picos, psicoterapia, licencia por enfermedad y medicina complementaria/alternativa.Resultados: 86 participantes (51,81% de los aleatorizados) abandonaron en T2. Una proporci & oacute;n significativa de participantes en el grupo PsiEd tambi & eacute;n recibi & oacute; componentes de PAP (es decir, hubo contaminaci & oacute;n). De T0 a T2, no encontramos una ventaja significativa de PAP en la reducci & oacute;n de s & iacute;ntomas de PTSD (p = .148) o depresi & oacute;n (p = .201). Sin embargo, encontramos un efecto dosis-respuesta significativo entre el n & uacute;mero de componentes entregados o la duraci & oacute;n de la sesi & oacute;n y la reducci & oacute;n de s & iacute;ntomas de PTSD. No encontramos diferencias significativas en efectos adversos. En T2, una proporci & oacute;n menor de participantes asignados a PAP report & oacute; un aumento en el consumo de alcohol/sustancias (OR = 0.09, p = .003), conflictos interpersonales (OR = 0.27, p = .014), y uso de psicotr & oacute;picos (OR = 0.23, p = .013) o licencia por enfermedad (OR = 0.11, p = .047).Conclusiones: Tres meses despu & eacute;s de la intervenci & oacute;n, no encontramos evidencia de que los PAP superen a PsiEd en la reducci & oacute;n de s & iacute;ntomas de PTSD o depresi & oacute;n. La contaminaci & oacute;n pudo haber afectado nuestros resultados. Sin embargo, los PAP parecen ser prometedores en la modificaci & oacute;n de algunos comportamientos postraum & aacute;ticos. Se necesita m & aacute;s investigaci & oacute;n.