Pilot study of Internet-based early intervention for combat-related mental distress

J Rehabil Res Dev. 2012;49(8):1175-90. doi: 10.1682/jrrd.2011.05.0095.

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.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Afghan Campaign 2001-
  • Cognitive Behavioral Therapy*
  • Combat Disorders / diagnosis
  • Combat Disorders / psychology
  • Combat Disorders / therapy*
  • Depression / diagnosis
  • Depression / psychology
  • Depression / therapy*
  • Early Intervention, Educational
  • Feasibility Studies
  • Female
  • Humans
  • Internet
  • Iraq War, 2003-2011
  • Male
  • Mental Health
  • Patient Acceptance of Health Care
  • Peer Group
  • Pilot Projects
  • Psychiatric Status Rating Scales
  • Socioeconomic Factors
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / psychology
  • Stress Disorders, Post-Traumatic / therapy*
  • Surveys and Questionnaires
  • Treatment Outcome
  • Veterans / psychology*