This R34 pilot intervention application seeks funds to evaluate the feasibility and potential effectiveness of a novel intervention aimed at preventing the development of posttraumatic stress disorder in adult survivors of serious physical injury. The intervention, which involves written self-disclosure, is derived from basic social psychological laboratory research, and will be translated for use as an applied tool in the context of post- trauma hospitalization aftercare. The planned evaluation will recruit patients drawn from a large trauma center that provides services to a predominantly Hispanic and low SES community. The scientific literature suggests that this community may have particular need for novel interventions directed at preventing the development of trauma-related psychopathology. Study participants (N = 106) at risk for developing PTSD would be recruited during hospitalization for treatment of physical injury, and randomly assigned to participate in one of two writing conditions: written emotional disclosure (N = 53) or a control condition in which participants write about mundane topics (N = 53). The overarching objective of the planned research is to collect information needed to determine the feasibility and potential merit of mounting a full-scale study of writing interventions as strategies to prevent the development of PTSD in physical trauma survivors.
The specific aims of this study are: (1) to evaluate the feasibility, tolerability, acceptability, and safety of the writing interventions;(2) to provide a preliminary evaluation as to whether the writing intervention possesses promise as strategy for preventing the development of PTSD in physical trauma survivors;(3) to assess the importance of age, education, reading level, and acculturation as possible moderators of the impact of the intervention on mental health outcomes;and (4) to examine possible mechanisms by which the writing interventions may exert their impact on mental health outcomes. If the results of this pilot study and the subsequent full-scale intervention prove successful, then trauma center service providers would have a versatile, low cost, and easily accessible tool to offer to physical injury survivors at risk for trauma-related psychopathology. This tool may be particularly useful for economically- disadvantaged Hispanic survivors who may choose not to avail themselves of formal mental health services. Knowledge derived from this randomized controlled trial regarding possible moderators and mediators of treatment efficacy can contribute to the development of more efficacious interventions.

Public Health Relevance

This study will evaluate the feasibility and potential effectiveness of a self-administrable and short writing intervention aimed at preventing the development of posttraumatic stress disorder in adult survivors of serious physical injury. Survivors of serious injury are at risk for PTSD in the weeks and months following injury, yet few seek mental health services. The writing interventions are not intended to replace proven approaches to treating or preventing mental health problems but their low cost and easy accessibility may address documented barriers to receiving more formal mental health services.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Planning Grant (R34)
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Interventions Committee for Adult Disorders (ITVA)
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Tuma, Farris K
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Rand Corporation
Santa Monica
United States
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