Effectiveness of an Online Psychoeducation Program for Improving Coping in People With a High Level of Dissociative Symptoms: A Pilot Randomized Waitlist-controlled Trial

Study Overview
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Brief Summary
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Subject Population Our study's target population is people with pathological dissociation in the community. Research Design A pilot randomized waitlist-controlled trial will investigate the effects of an online psychoeducation program on coping, symptom management, and self-efficacy of people with pathological dissociation immediately (posttest-1) and 2-month (posttest-2) post-intervention. Supplementary semi-structured interviews will be conducted for process evaluation. The analysis and reporting of the trial will strictly follow the CONSORT guidelines. Instrument The primary outcome of our study is the coping ability of individuals with pathological dissociation, which will be assessed by the Brief Coping Orientation to Problems Experienced Inventory (Brief-COPE). The secondary outcome measures are dissociative symptoms, emotional regulation, and self-efficacy, which would be assessed by the Dissociative Experiences Scale-Taxon (DES-T), the Emotion Regulation Questionnaire (ERQ), and the General Self-Efficacy Scale (GSES) accordingly. Procedure The online psychoeducation program is developed based on an integrative theoretical framework that integrates the Stress and Coping model, Cognitive-Behavioural Theory, Bandura's self-efﬁcacy theory, and findings of our previous feasibility studies on this psychoeducational program. Participants will be recruited via posting on social media and online forums. A 16-session online psychoeducation program will be delivered to the participants in eight weeks.

Official Title
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Effectiveness of an Online Psychoeducation Program for Improving Coping in People With a High Level of Dissociative Symptoms: A Pilot Randomized Waitlist-controlled Trial

Conditions
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Dissociation

Intervention / Treatment
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* Behavioral: Online psychoeducational program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: agree to give informed consent and participate aged 18 or above self-reported symptoms or experiences of pathological dissociation screened positive on the Chinese version of the DES-T (i.e., DES-T score 25 or above) at a baseline screening able to understand and communicate in Chinese-Cantonese have access to the internet. Exclusion Criteria: Individuals who have a reading disorder, cognitive impairment, dementia, or intellectual disabilities Individuals who are participating in any research studies Individuals who had participated in our previous feasibility study of the same intervention

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 64 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Online psychoeducational program<br>The intervention group will receive an online psychoeducational program for 8 weeks. The psychoeducation package consists of 16 different sets of reading materials and post-session writing/reflection exercises, which will be delivered to the participants twice a week. The program is designed to be a brief, trauma-informed, dissociation-focused education package that aims to enable users to better understand and cope with their post-traumatic and dissociative reactions and related life challenges. There are specific psychoeducation elements in each session, such as: (1) safety issues planning, (2) understanding the impacts of trauma and stress, (3) understanding the concept of dissociation and integration of the personality, (4) identifying and coping with the post-traumatic and dissociative symptoms, (5) identifying trauma-related cognitive distortions. | Behavioral: Online psychoeducational program<br>* The intervention group will receive an online psychoeducational program for 8 weeks. The psychoeducation package consists of 16 different sets of reading materials and post-session writing/reflection exercises, which will be delivered to the participants twice a week.<br>|
| Other: Waitlist control<br>The waitlist control group will receive an online psychoeducational program for 8 weeks a week after the completion of the two-month follow-up in the intervention group. The psychoeducation package is identical to the program in the intervention group. | Behavioral: Online psychoeducational program<br>* The intervention group will receive an online psychoeducational program for 8 weeks. The psychoeducation package consists of 16 different sets of reading materials and post-session writing/reflection exercises, which will be delivered to the participants twice a week.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Brief Coping Orientation to Problems Experienced Inventory (Brief-COPE) | Change in participants' coping strategies, as assessed using the Brief-COPE. This measure has 28 items and is a commonly used self-report measure of coping strategies. The Chinese version of the Brief-COPE had excellent internal consistency, test-retest reliability and content validity. Higher scores indicate more significant use of that specific coping strategy. | Immediately and two months after completion of the intervention in the experimental group | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dissociative Experiences Scale-Taxon (DES-T) | Change in participants' pathological dissociative experiences, as assessed using the DES-T. This measure has 8 items and can be used to screen for pathological dissociative experiences. The Chinese version of the DES-T demonstrated good construct validity and good discriminant validity between participants with and without clinically diagnosed dissociative disorders, with a cut-off score of 25. Higher scores indicate more frequent dissociative symptoms. | Immediately and two months after completion of the intervention in the experimental group |