title: Pilot study of Internet-based early intervention for combat-related mental distress.
abstract: This article evaluates an Internet-based early intervention combining online cognitive-behavioral therapy (CBT) with electronic peer-to-peer support intended to promote mental health and well-being among combat veterans. We conducted a phase 1 clinical trial of 50 Iraq and Afghanistan veterans using a pre and post single-arm design. We evaluated feasibility and changes in mental health symptoms (depression and posttraumatic stress disorder [PTSD]), functional status, and attitudes toward treatment seeking at baseline and weeks 4, 8, and 12. A diverse group of veterans was enrolled (26% ethnic minority, 90% male, 66% with income <$30,000/year, 88% with no prior treatment for depression). Participants completed a mean of 4 of 6 lessons (standard deviation = 2.54). From baseline to week 12, there were significant declines in the Center for Epidemiologic Studies-Depression scale score (effect size [ES] = 0.41) and PTSD Checklist-Military version score (ES = 0.53). There were significant improvements in willingness to accept diagnosis (ES = 1.08) and perceived social norms and stigma regarding friends (ES = 1.51). Although lack of a control group is a limitation, the Internet-based program combining CBT-based coping skills training and peer-to-peer support demonstrated potential feasibility and evidenced benefit in symptom remediation for depression and PTSD.
authors: RISE Consulting, 845 Bruce Ave, Flossmoor, IL 60422, USA. bvanvoor@uic.edu
authors: Benjamin W
authors: BW
authors: Van Voorhees
authors: Jackie
authors: J
authors: Gollan
authors: Joshua
authors: J
authors: Fogel
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D055826:Afghan Campaign 2001-; D015928:Cognitive Behavioral Therapy; D003130:Combat Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D018479:Early Intervention, Educational; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020407:Internet; D054542:Iraq War, 2003-2011; D008297:Male; D008603:Mental Health; D010342:Patient Acceptance of Health Care; D010379:Peer Group; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology*