PTSD Coach Online-Arabic: A Randomized Controlled Pilot Trial to Examine Feasibility, Acceptability, and Preliminary Effectiveness.

The Egyptian Revolution of 2011 resulted in high-level exposure to sociopolitical violence, placing a large burden on the mental health care system that cannot be effectively met given the small number of available providers in Egypt. We conducted a nonblinded, randomized controlled pilot trial of an online, self-directed tool for managing posttraumatic stress symptoms (PTSS). The study aimed to evaluate the feasibility, acceptability, and preliminary effectiveness of the PTSD Coach Online-Arabic. Trauma-exposed Egyptian adults with clinically significant PTSS (N = 87; intervention group: n = 41) completed assessments at baseline, weekly over the treatment period, posttest, and 3-month follow-up. Of participants who completed weekly surveys, 88.9% used the program; 22.0% of participants reported regular, weekly use. Most tools received good likeability and perceived benefit scores, but lower perceived benefit scores on three tools suggest that some content may require additional adaptation. Intent-to-treat analyses using multilevel modeling with multiple imputation to account for missing data were conducted. Effect sizes for PTSS were below the cutoff for small effects at posttest, d = -0.14, but demonstrated a small positive effect at 3-months, d = -0.25. There was a small positive effect of treatment on anxiety at posttest, d = -0.37, and a medium effect at 3-month follow-up, d = -0.49. Treatment effects for depressed mood were below the cutoff for small effects at posttest and 3-months, ds = -0.14 and -0.18. These findings suggest that the PTSD Coach Online-Arabic may be a promising supplemental resource for support in this setting.

User experiences of a culturally adapted web-based intervention for posttraumatic stress disorder in Egypt: A qualitative study.

The following study describes the usability and the acceptability of an online intervention for the treatment of posttraumatic stress disorder (PTSD), PTSD Coach Online that was culturally adapted and translated into local Egyptian dialect. The adapted intervention was piloted in a randomized control trial with 87 Egyptians meeting clinical criteria for a diagnosis of PTSD. Of the 41 participants who participated in the treatment condition, 15 participants (10 females, 5 males) were randomly selected to take part in a semistructured interview to explore their user experience. Favorable feedback centered on the program's ease of access, user-friendly tools, and cultural appropriateness. Participants also described benefits including increased awareness of PTSD, symptom reduction, and increased willingness to seek psychological support online or in person. In contrast, participants highlighted some drawbacks of the online program, particularly the need for further support or some kind of "human" interaction as well as feelings that the information was not sufficiently personalized and that activities could have been more interesting. The findings suggest that while the PTSD Coach Online-Arabic is unlikely to be an effective stand-alone support, approximately half of the sample indicated that the availability of online tools is important for accessibility of mental health care, particularly for those concerned with stigma. As such, it may be an important supplemental offering for other forms of ongoing care and support. Future research may consider integrated approaches to care that were highlighted as being of particular interest to participants. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Trauma, resilience, and distress in post-revolution Egypt.

OBJECTIVE: Trauma represents a persistent threat to health and wellbeing. Yet, little research has examined links between trauma, psychopathology, and resilience in the Middle East and North Africa region outside of refugee settings, especially in Egypt. Existing studies in Egypt rarely examine trauma exposure from a polyvictimization lens, assess multiple forms of trauma-related psychopathology, or focus on dimensional symptom assessment. The current study aimed to address these gaps by (a) reporting on the diverse range of trauma exposure types, including direct, witnessed, and indirect exposure in a trauma-exposed sample; and (b) examining the associations between trauma exposure, psychopathology, and resilience. METHOD: Participants (N = 87) were drawn from the baseline survey of a randomized clinical trial for online treatment of posttraumatic stress and reported on demographics, trauma exposure, resilience, and psychopathology. RESULTS: Men reported more direct and witnessed exposure to sociopolitical violence than women, but there were no gender differences in sexual violence or total trauma exposure. Multivariate regression models examining the effect of trauma and resilience on psychopathology, controlling for age and gender, indicated that all models explained significant variance for posttraumatic stress and anxiety (F(87, 7)PTSS = 2.64, p = .022, R² = 16.5%; F(87, 7)Anx = 6.04, p < .001, R² = 31.2%) but not depression. Direct trauma exposure was associated with higher severity levels of posttraumatic stress and anxiety (ßPTSS = 1.11, p = .005; ßAnx = 1.04, p = .001). Resilience was only associated with lower levels of anxiety (ßAnx = -.22, p < .001). CONCLUSIONS: These findings suggest the high need for evidence-based care in Egypt for trauma-related psychopathology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).