157 participants were recruited from police and hospital sources and randomly assigned to one of three groups -- one group got assessment only, another got education (30 minutes), and a third received PD (one hour) followed by education. Initial interviews in the victims' homes were held within one month of the crime and followed up at 6 months and 11 months. 94% of the participants had experienced an actual or threatened physical assault from a non-family member. Post-traumatic stress was measured using post-traumatic Stress Disorder Symptom Scale PSS, Impact of Event Scale (IES) and Beck Depression Inventory (BDI). All three groups showed improvement over time, but there were no significant differences in recovery between the groups and no differences between groups in how helpful the participants perceived their interventions to be. Thus, "no evidence was found to support the efficacy of brief one-session interventions for preventing post-traumatic symptoms in individual victims of violent crime" (p. 793).
Hobbs, M., Mayou, R., Harrison, B., & Worlock, P. (1996). A randomized controlled trial of psychological debriefing for victims of road traffic accidents - the researchers wanted to know if a single debriefing could reduce post-traumatic psychopathology in road accident victims. Participants were victims of road accidents who had been admitted to the hospital. They were randomly placed in an intervention group or a control group and initially screened using a semi-structured interview. Participants completed the Impact of Events Scale and the Brief Symptom Inventory. They received psychological debriefing within 24-48 hours of the accident, which lasted about an hour. At four months they were reassessed. Although the intervention group had a higher mean injury severity score and longer hospital stays than the controls, no significant differences were found in their post-traumatic symptoms. "Neither group showed a significant reduction in specific post-traumatic symptoms, mood disorder, anxiety, the self-reported measures, interview ratings of intrusive thoughts or travel anxiety, or clinical diagnosis of posttraumatic stress disorder or phobic anxiety" (p. 1438). They found no evidence that debriefing had helped. The researchers speculate that the interventions may have been done too early and interfered with natural psychological defenses against fear and distress.
Mayou, R.A., Ehlers, a., & Hobbs, M. (2003). Psychological debriefing for road traffic accident victims: Three-year follow-up of a randomized controlled trial - Researchers wanted to follow up on an earlier study to see if psychological debriefing (PD) would prevent post-traumatic stress symptoms from developing in traffic accident victims with physical injuries. The researchers had found after 4 months no evidence that debriefing had helped and reported PD as an ineffective means to deal with auto accident victims. The present study was a 3-year follow up of the same participants. Patients were asked if road travel was now less enjoyable, to rate their pain, to rate physical problems, degree of interference with everyday functioning, financial problems and insurance problems. Changes in scores were analyzed over time. Results showed negative effects on patients. At three years, the intervention group showed significantly higher scores for anxiety, depression, obsessive-compulsive problems, and hostility. They enjoyed riding as a passenger less than those in the control group, and they reported more severe psychiatric symptoms and more severe pain. Patients in the intervention group did not recover physically as well as those in the control group and reported more impaired functioning in daily life. They also had more financial problems. The researchers conclude, "Psychological debriefing in hospital is not helpful and has adverse effects for those with initial post-traumatic symptoms" (p. 377).
Conlon, L., Fahy, T.J. & Conroy, R. (1998). PTSD in ambulant RTA victims: A randomized controlled trial of debriefing - the researchers wanted to find out if psychological debriefing would reduce or prevent PTSD in road traffic accident (RTA) victims. Forty patients, 19 men and 21 women, who presented themselves at the Accident & Emergency Department of a clinic following a traffic accident with minor injuries were randomly assigned to two groups, one an intervention group and one a control group. Baseline assessments were completed between 3 and 14 days following the accident. All participants completed the Impact of Events Scale (IES) and the Clinician-Administered PTSD Scale. A single 30-minute standard PD session followed. Follow-up took place about 99 days later when the same researcher interviewed and tested participants again. Initially, 75% of the participants were significantly distressed, but 3 months later, the number of distressed had dropped significantly to 35%, regardless of whether or not they received an intervention. At 3 months the incidence of PTSD was 19%, 22% were rated clinically as having a poor outcome, and 40% still had pain. During the follow-up period, 6 participants developed PTSD. Four were from the control group and two from the intervention group. This was not considered significant; in fact, "no significant differences between intervention and monitoring groups on any recorded variable reflect[ed] PTSD-related morbidity at follow-up" (p. 41). The researchers conclude the evidence fails to show any prophylactic benefit from PD in trauma victims.
Carlier, I.V.E., Voerman, a.E., & Gersons, B.P.R. (2000). The influence of occupational debriefing on post-traumatic stress symptomatology in traumatized police officers - the researchers wanted to test whether debriefing reduces the development of PTSD caused by work-related incidents. Because some researchers suggest that more than a one-time session of debriefing may be needed to obtain better outcomes in traumatized individuals, three successive debriefing sessions for police officers exposed to traumatic events were held at 24 hours, one month and 3 months post-trauma and included traumatic stress education. The study used a pre-test -- post-test control group design. A group of 86 debriefed officers, using a 7-stage semi-structured procedure, was compared to a non-debriefed internal group of 82 and an external control group of 75 officers exposed to trauma before debriefing and intervention were introduced in 1992. At 24 hours post-trauma, no significant differences were found between the intervention group and control groups. After one week, the group that received intervention reported significantly higher levels of re-experiencing, avoidance symptoms, and loss of recall. Six months post-trauma, no significant differences were found between the comparison groups. Individual debriefing did not result in reduction of stress-related symptoms. "All symptoms had strongly receded with the passage of time. No one in the sample qualified for the PTSD diagnosis at post-test" (p. 92). Those who received debriefing expressed a high degree of satisfaction with it -- 98%; however, no statistical correlation was found between satisfaction and the number of psychological symptoms reported.
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Carlier, I.V.E., Voerman, a.E. And Gersons, B.P.R. (2000). The influence of occupational debriefing on post-traumatic stress symptomatology in traumatized police officers. British Journal of Medical Psychology, 73, 87-98.
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