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

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.

 

HIGHLIGHTS

  • 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.
Reference: 
Rodrigo Andrés Figueroa, Paula Francisca Cortés, Carolina Miller, Humberto Marín, Rodrigo Gillibrand, Chris Maria Hoeboer & Miranda Olff | 2024
In: European Journal of Psychotraumatology ; ISSN: 2000-8066 | 15 | 1 | july | 2364443
https://doi.org/10.1080/20008066.2024.2364443
Keywords: 
Depressive Disorders, Emergency Personnel, Hospitals, Middle Aged, Posttraumatic Stress Disorder, Prevention, Psychotherapy, Psychotrauma, PTSD (en), Randomized Clinical Trial, Statistical Analysis, Survivors, Treatment
Affiliation author(s):