Stress management versus cognitive restructuring in trauma-affected refugees-A pragmatic randomised study

Area of Science:

• Psychiatry
• Psychology
• Trauma Studies

Background:

• Refugees resettling in new countries often experience trauma and develop post-traumatic stress disorder (PTSD).
• Effective psychotherapeutic interventions are crucial for managing PTSD symptoms and improving well-being in this vulnerable population.

Purpose of the Study:

• To compare the effectiveness of manualized stress management (SM) against cognitive restructuring (CR) for trauma-affected refugees with PTSD.
• To evaluate the impact of these interventions on PTSD symptom severity, depression, anxiety, quality of life, functioning, pain, and somatization.

Main Methods:

• A randomized trial involving 126 refugees diagnosed with PTSD.
• Participants received 16 sessions of either SM or CR psychotherapy, supplemented by 10 sessions of psychoeducation and pharmacological treatment with a medical doctor.
• Outcomes were assessed using the Harvard Trauma Questionnaire (primary), Hopkins Symptom Checklist-25, Hamilton Depression and Anxiety Ratings, WHO-5, Global Assessment of Functioning, Sheehan Disability Scale, Visual Analogue Scale, and Symptom Checklist.

Main Results:

• No statistically significant difference was observed between the SM and CR groups for the primary outcome of PTSD symptom severity.
• The stress management group demonstrated a statistically significant improvement in anxiety symptoms compared to the cognitive restructuring group (effect size 0.46).
• No significant group differences were found for depression, quality of life, functioning, pain, or somatization.

Conclusions:

• While both stress management and cognitive restructuring appear comparable for PTSD symptom severity in trauma-affected refugees, stress management shows a potential advantage in alleviating anxiety.
• Further research into specific stress management techniques may offer valuable therapeutic options for managing anxiety in this population.