Predicting Change in Posttraumatic Distress Through Change in Coping Self-Efficacy After Using the My Trauma Recovery eHealth Intervention: Laboratory Investigation.

Abstract

BackgroundTechnology offers a unique platform for delivering trauma interventions (ie, eHealth) to support trauma-exposed populations. It is important to evaluate mechanisms of therapeutic change in reducing posttraumatic distress in eHealth for trauma survivors.ObjectiveThis study evaluated a proactive, scalable, and individually responsive eHealth intervention for trauma survivors called My Trauma Recovery. My Trauma Recovery is an eHealth intervention aiming to support trauma survivors and consisting of 6 modules: relaxation, triggers, self-talk, professional help, unhelpful coping, and social support. It was designed to enhance trauma coping self-efficacy (CSE). We tested 3 hypotheses. First, My Trauma Recovery would decrease posttraumatic stress symptoms (PTSS). Second, My Trauma Recovery would increase CSE. And last, changes in CSE would be negatively correlated with changes in PTSS.MethodsA total of 92 individuals exposed to trauma (78/92, 85% females, mean age 34.80 years) participated. Our study was part of a larger investigation and consisted of 3 sessions 1 week apart. Participants completed the baseline online survey assessing PTSS and CSE. Each session included completing assigned modules followed by the online survey assessing CSE. PTSS was remeasured at the end of the last module.ResultsPTSS significantly declined from T1 to T9 (F1,90=23.63, P<.001, η2p=.21) supporting the clinical utility of My Trauma Recovery. Significant increases in CSE for sessions 1 and 2 (F8,83=7.51, P<.001) were found. No significant change in CSE was found during session 3 (N=92). The residualized scores between PTSS T1 and T9 and between CSE T1 and T9 were calculated. The PTSS residualized score and the CSE residualized score were significantly correlated, r=–.26, P=.01. Results for each analysis with a probable PTSD subsample were consistent.ConclusionsThe findings of our study show that participants working through My Trauma Recovery report clinically lower PTSS after 3 weeks. The results also demonstrate that CSE is an important self-appraisal factor that increased during sessions 1 and 2. These improvements are correlated with reductions in PTSS. Thus, changes in CSE may be an important mechanism for reductions in PTSS when working on a self-help trauma recovery website and may be an important target for eHealth interventions for trauma. These findings have important implications for trauma eHealth interventions.