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
Creators: name: Figueroa, Rodrigo Andrés
name: Cortés, Paula Francisca
name: Miller, Carolina
name: Marín, Humberto
name: Gillibrand, Rodrigo
name: Hoeboer, Chris Maria
name: Olff, Miranda
Publisher: name: Taylor & Francis
Year: 2024
Subjects: subject: Medicine
subject: Neuroscience
subject: Physiology
subject: FOS: Biological sciences
subject: Biotechnology
subject: Sociology
subject: FOS: Sociology
subject: Biological Sciences not elsewhere classified
subject: Science Policy
subject: Mental Health
subject: Infectious Diseases
subject: FOS: Health sciences

description: <b>Background:</b> Despite its popularity, evidence of the effectiveness of Psychological First Aid (PFA) is scarce. <b>Objective:</b> To assess whether PFA, compared to psychoeducation (PsyEd), an attention placebo control, reduces PTSD and depressive symptoms three months post-intervention. <b>Methods:</b> In two emergency departments, 166 recent-trauma adult survivors were randomised to a single session of PFA (<i>n </i>= 78) (active listening, breathing retraining, categorisation of needs, assisted referral to social networks, and PsyEd) or stand-alone PsyEd (<i>n</i> = 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. <b>Results:</b> 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 (<i>p</i> = .148) or depressive symptoms (<i>p</i> = .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, <i>p</i> = .003), interpersonal conflicts (OR = 0.27, <i>p</i> = .014), and having used psychotropics (OR = 0.23, <i>p</i> = .013) or sick leave (OR = 0.11, <i>p</i> = .047). <b>Conclusions:</b> 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. 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. 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.