Special Article

A Randomized Controlled Trial of Brief Skills Training in Affective and Interpersonal Regulation (STAIR) for Veterans in Primary Care

Shaili Jain

VA Palo Alto Health Care System, National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA

Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, California, USA

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Kile Ortigo,

Kile Ortigo

VA Palo Alto Health Care System, National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA

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Julia Gimeno,

Julia Gimeno

VA Palo Alto Health Care System, National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA

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Denine A. Baldor,

Denine A. Baldor

Integrated Care Team, VA Palo Alto Health Care System, Palo Alto, California, USA

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Brandon J. Weiss,

Brandon J. Weiss

VA Palo Alto Health Care System, National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA

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Marylène Cloitre,

Corresponding Author

Marylène Cloitre

marylene.cloitre@va.gov

VA Palo Alto Health Care System, National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA

Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, California, USA

Correspondence concerning this article should be addressed to Marylène Cloitre. National Center for PTSD Training and Dissemination Division, 495 Willow Road, Menlo Park, CA, 94025. E-mail: marylene.cloitre@va.gov

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Shaili Jain,

Shaili Jain

VA Palo Alto Health Care System, National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA

Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, California, USA

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Kile Ortigo,

Kile Ortigo

VA Palo Alto Health Care System, National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA

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Julia Gimeno,

Julia Gimeno

VA Palo Alto Health Care System, National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA

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Denine A. Baldor,

Denine A. Baldor

Integrated Care Team, VA Palo Alto Health Care System, Palo Alto, California, USA

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Brandon J. Weiss,

Brandon J. Weiss

VA Palo Alto Health Care System, National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA

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Marylène Cloitre,

Corresponding Author

Marylène Cloitre

marylene.cloitre@va.gov

VA Palo Alto Health Care System, National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA

Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, California, USA

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First published: 07 June 2020

https://doi.org/10.1002/jts.22523

Citations: 26

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Abstract

This randomized controlled trial assessed the efficacy of a five-session version of Skills Training in Affective and Interpersonal Regulation (STAIR) among veterans obtaining treatment in primary care. Veterans who screened positive for either posttraumatic stress disorder (PTSD) or depression (N = 26) were enrolled and randomized into either five-session STAIR or treatment as usual (TAU). Assessments of PTSD symptoms (PTSD Checklist for DSM-5; PCL-5), depression (Beck Depression Inventory–II; BDI-II), emotion regulation (Difficulties in Emotion Regulation Scale; DERS), and social engagement difficulties (World Health Organization Disability Assessment 2.0; WHODAS-2) were assessed at pretreatment, posttreatment, and 3-month follow-up assessments. Participants assigned to the five-session STAIR condition reported significant improvements on all measures, whereas those assigned to TAU showed no change. Group × Treatment interactions were significant for all outcomes, and effect sizes for the interactions ranged from moderate to large, Hedge's gs = 0.81 for the PCL-5, 1.15 for the BDI-II, 0.75 for the DERS, and 0.81 for the WHODAS-2. The results indicate that five-session STAIR, a brief, skills-focused treatment, may be effective in reducing a range of symptoms and in improving social functioning among veterans treated in primary care settings.

Resumen

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET)

Un Ensayo Controlado Aleatorizado de Entrenamiento Breve de Habilidades en Regulación Interpersonal y Afectiva (STAIR en su sigla en inglés) para Veteranos en Atención Primaria

ENTRENAMIENTO DE HABILIDADES EN ATENCION PRIMARIA: STAIR BREVE

Este ensayo controlado aleatorizado evaluó la eficacia de una versión de cinco sesiones del Entrenamiento de Habilidades en Regulación Interpersonal y Afectiva (STAIR en su sigla en inglés) entre veteranos que recibiendo tratamiento en atención primaria. Los veteranos que dieron positivo ya sea por trastorno de estrés postraumático (TEPT) o depresión (N = 26) se inscribieron y fueron asignados aleatoriamente a STAIR de cinco sesiones o a tratamiento usual (TAU en su sigla en inglés). Las evaluaciones de los síntomas de TEPT (Lista de Chequeo para TEPT del DSM-5, PCL-5 en su sigla en inglés), depresión (Inventario de Depresión de Beck-II, BDI-II en su sigla en inglés), regulación emocional (Escala de Dificultades en la Regulación Emocional, DERS en su sigla en inglés), dificultades en vinculación social (Evaluación de Discapacidad de la Organización Mundial de la Salud 2.0, WHODAS-2 en su sigla en inglés) se realizaron antes del tratamiento, después del tratamiento, y a los 3 meses de seguimiento. Los participantes en la condición de STAIR de cinco sesiones reportaron mejoras significativas en todas las medidas, mientras que quienes estaban en la condición TAU no mostraron cambios. Las interacciones Grupo x Tratamiento fueron significativas para todos los resultados, y los tamaños de los efectos para las interacciones fluctuaron entre moderados y grandes, con tamaños de los efectos g de Hedge de 0.81 para PCL-5, 1.15 para BDI-II, 0.75 para DERS, y 0.81 para WHODAS-2. Los resultados indican que STAIR de cinco sesiones, un tratamiento breve centrado en las habilidades, podría ser efectivo en reducir un rango de síntomas y en mejorar el funcionamiento social entre los veteranos tratados en contextos de atención primaria.

Palabras clave: Intervenciones basadas en la evidencia, MANOVA, trauma por causas humanas, resultados del tratamiento, funcionamiento y calidad de vida, militares (activos y veteranos)

抽象

Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS)

簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯

A Randomized Controlled Trial of Brief Skills Training in Affective and Interpersonal Regulation (STAIR) for Veterans in Primary Care

Traditional Chinese

標題: 對留院治療的退役軍人使用簡短的情感和人際調節技巧訓練(STAIR)的隨機對照試驗

撮要: 本隨機對照試驗評估情感和人際調節技巧訓練(STAIR)五節段版本, 用於留院治療的退役軍人的功效。我們招募被篩檢出患創傷後壓力症(PTSD)或抑鬱症的人組成樣本(N = 26), 然後隨機分派他們去接受五節段的STAIR或一般治療(TAU)。我們在樣本接受治療前、後, 及完成治療三個月後, 評估其PTSD症狀)PTSD評估表DSM-5版; PCL-5(、抑鬱症)貝克抑鬱量表II; BDI-II(、情感調節)情緒調節困難量表; DERS(, 和社交障礙)世界衛生組織身心障礙評估量表2.0; WHODAS-2(。接受STAIR的樣本在所有測量中都有顯著改善, 接受TAU的樣本則無改善。在所有測量結果中, 組別x治療的交互作用都顯著, 其效應量為中至大)Hedge's g 效應量:PCL-5的為0.81, BDI-II的為1.15, DERS的為0.75, WHODAS-2的為0.81(。結果反映, 五節段版本的STAIR作為簡短的聚焦技巧療法, 用於留院治療的退役軍人, 可能可有效減輕其一系列的症狀及改善其社會功能運作。

Simplified Chinese

标题: 对留院治疗的退役军人使用简短的情感和人际调节技巧训练(STAIR)的随机对照试验

撮要: 本随机对照试验评估情感和人际调节技巧训练(STAIR)五节段版本, 用于留院治疗的退役军人的功效。我们招募被筛检出患创伤后压力症(PTSD)或抑郁症的人组成样本(N = 26), 然后随机分派他们去接受五节段的STAIR或一般治疗(TAU)。我们在样本接受治疗前、后, 及完成治疗三个月后, 评估其PTSD症状)PTSD评估表DSM-5版; PCL-5(、抑郁症)贝克抑郁量表II; BDI-II(、情感调节)情绪调节困难量表; DERS(, 和社交障碍)世界卫生组织身心障碍评估量表2.0; WHODAS-2(。接受STAIR的样本在所有测量中都有显著改善, 接受TAU的样本则无改善。在所有测量结果中, 组别x治疗的交互作用都显著, 其效应量为中至大)Hedge's g 效应量:PCL-5的为0.81, BDI-II的为1.15, DERS的为0.75, WHODAS-2的为0.81(。结果反映, 五节段版本的STAIR作为简短的聚焦技巧疗法, 用于留院治疗的退役军人, 可能可有效减轻其一系列的症状及改善其社会功能运作。

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Volume33, Issue4

August 2020

Pages 401-409

A Randomized Controlled Trial of Brief Skills Training in Affective and Interpersonal Regulation (STAIR) for Veterans in Primary Care

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A Randomized Controlled Trial of Brief Skills Training in Affective and Interpersonal Regulation (STAIR) for Veterans in Primary Care

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