Browsing by Author "Olff, Miranda"

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    Peritraumatic Dissociation Partially Mediates the Influence of Lifetime Trauma Exposure on Prospective PTSD Symptoms
    (2024) Figueroa Cabello, Rodrigo Andrés; Errázuriz Arellano, Paula Andrea; Hoeboer, Chris M.; Olff, Miranda
    Higher lifetime trauma exposure and increased peritraumatic dissociation (PD) are well-known predictors of Post-Traumatic Stress Disorder (PTSD) symptoms following new trauma (prospective PTSD symptoms). The interplay between those factors, however, is not well established. In this study, we aimed to assess whether PD mediates the influence of lifetime trauma exposure on prospective PTSD symptoms. A total of 387 adults visiting five emergency departments who had experienced a traumatic event within 72 hours completed baseline assessments on lifetime trauma exposure count and PD. PTSD symptoms were assessed 1 month later. Structural equation modeling was used to examine the mediation effect of PD in the relationship between lifetime trauma exposure count and 1-month PTSD symptoms. We found that PD mediated the association between lifetime trauma exposure count and 1-month PTSD symptoms, even after accounting for some confounders. However, the mediation was partial, accounting for 17.9% of the lifetime trauma exposure count's total effect. While this finding is significant, it also suggests that additional mechanisms beyond PD play a role in explaining the influence of higher lifetime trauma exposure on prospective PTSD symptoms. These findings provide valuable insights into the complex dynamics of PTSD development and call for further research to explore complementary factors and preventive strategies.
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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.