ГоловнаArchive of numbers2023Volume 31, issue 2 (115)Assessing predictors of stress in war survivors using a digital self-help tool
Title of the article Assessing predictors of stress in war survivors using a digital self-help tool
Authors Lahutina Sofiia
Frankova Iryna
Gryen Marius
Lozin Artem
In the section DIAGNOSTICS AND THERAPY OF MENTAL AND BEHAVIORAL DISORDERS
Year 2023 Issue Volume 31, issue 2 (115) Pages 29-36
Type of article Scientific article Index UDK 616.89:612.014 Index BBK -
Abstract

 Recent studies show the importance of timing of an intervention in the prevention of men- tal health disorders followed by exposure to traumatic experiences and lend further support to the concept of the “golden hours”. On the second day of the war escalation in Ukraine, a psychological first aid (PFA) digital intervention was launched. Chatbot ‘Friend’ provided psy- choeducation and self-help guidance on how to cope with war-related stress. A total of about 50,000 users interacted with the chatbot from March 2022 until the end of May 2022. The re- search aimed to identify the predictors of baseline levels of stress after exposure to traumatic experiences during the golden hours and the first 3 months of the war in the Ukrainian popula- tion. The inclusion criteria for this study were, age between 18 and 80 years; informed consent and agreement to further usage of personal data; and an indication of a stress level at the beginning of the chatbot conversation. The hypothesis test was conducted through a three- way Analysis of Variance. The final sample included 3740 participants (Mage = 29.00 years, SD age = 9.13 years). Approximately 67 % of the sample participants reported having children. A large majority of participants (93.2 %) reported being safe, and 70.5 % reported being lonely or isolated. Participants with children (p = .019), participants feeling not safe (p < .001), or iso- lated (p < .001) had higher pre-intervention stress levels. Parenthood, feelings of insecurity, and loneliness do predict the severity of perceived stress after exposure to traumatic experiences during the golden hours and the first 3 months of the war in the Ukrainian population. Especially those having children, feeling lonely and unsafe require active follow-up.
Key words digital interventions, post-traumatic stress disorder, stress predictors, stress, traumatic situation, social isolation, loneliness, parenting, sense of danger, psychological first aid, resilience, war, chatbot, mental health, exposure
Access to full text version of the article pdf download
Bibliography
1. Murthy RS, Lakshminarayana R. Mental health consequenc- es of war: a brief review of research findings. World Psychiatry. 2006 Feb;5(1):25-30. PMID: 16757987; PMCID: PMC1472271.
2. Karam EG, Salamoun MM, Mneimneh ZN, Fayyad JA, Karam AN, Hajjar R, Dimassi H, Nock MK, Kessler RC. War and first onset of suicidality: the role of mental disorders. Psychol Med. 2012 Oct;42(10):2109-18. doi: 10.1017/S0033291712000268. Epub 2012 Feb 28. PMID: 22370047; PMCID: PMC4100459.
3. Breslau N. Gender differences in trauma and posttraumatic stress disorder. J Gend Specif Med. 2002 Jan-Feb;5(1):34-40. PMID: 11859685.
4. Nesterko Y, Jäckle D, Friedrich M, Holzapfel L, Glaesmer H. Factors predicting symptoms of somatization, depression, anxiety, post-traumatic stress disorder, self-rated mental and physical health among recently arrived refugees in Germany. Confl Health. 2020 Jul 9;14:44. doi: 10.1186/s13031-020-00291-z. PMID: 32670398; PMCID: PMC7346670.
5. Kalucza S, Hammarström A, Nilsson, K. Mental health and parenthood — A longitudinal study of the relation- ship between self-reported mental health and parent- hood. Health Sociology Review. 2015;24(3), 283-296. doi: 10.1080/14461242.2015.1051079.
6. Reupert A, Price-Robertson R, Maybery D. Parenting as a focus of recovery: A systematic review of current practice. Psychiatr Rehabil J. 2017 Dec;40(4):361-370. doi: 10.1037/ prj0000240. Epub 2017 Feb 9. PMID: 28182474.
7. Xu Z, Zhang D, Xu D, Li X, Xie YJ, Sun W, Lee EK, Yip BH, Xiao S, Wong SY. Loneliness, depression, anxiety, and post- traumatic stress disorder among Chinese adults during COVID-19: A cross-sectional online survey. PLoS One. 2021 Oct 21;16(10):e0259012. doi: 10.1371/journal.pone.0259012. PMID: 34673812; PMCID: PMC8530321.
8. Lee C, Nguyen AJ, Russell T, Aules Y, Bolton P. Mental health and psychosocial problems among conflict-affected children in Kachin State, Myanmar: a qualitative study. Confl Health. 2018 Sep 19;12:39. doi: 10.1186/s13031-018-0175-8. PMID: 30250500; PMCID: PMC6145186.
9. World Health Organization, War Trauma Foundation & World Vision International. (2011). Psychological first aid: guide for field workers. World Health Organization. https://apps.who. int/iris/handle/10665/44615.
10. Shultz JM, Forbes D. Psychological First Aid: Rapid proliferation and the search for evidence. Disaster Health. 2013 Aug 2;2(1):3-12. doi: 10.4161/dish.26006. PMID: 28228996; PMCID: PMC5314921.
11. Hobfoll SE, Watson P, Bell CC, Bryant RA, Brymer MJ, Friedman MJ, Friedman M, Gersons BP, de Jong JT, Layne CM, Maguen S, Neria Y, Norwood AE, Pynoos RS, Reissman D, Ruzek JI, Shalev AY, Solomon Z, Steinberg AM, Ursano RJ. Five essential elements of immediate and mid-term mass trauma intervention: empirical evidence. Psychiatry. 2007 Winter;70(4):283-315; discus- sion 316-69. doi: 10.1521/psyc.2007.70.4.283. PMID: 18181708.
12. Ozer EJ, Best SR, Lipsey TL, Weiss DS. Predictors of post- traumatic stress disorder and symptoms in adults: a meta- analysis. Psychol Bull. 2003 Jan;129(1):52-73. doi: 10.1037/0033- 2909.129.1.52. PMID: 12555794.
13. Figueroa RA, Cortés PF, Marín H, Vergés A, Gillibrand R, Repetto P. The ABCDE psychological first aid intervention de- creases early PTSD symptoms but does not prevent it: results of a randomized-controlled trial. Eur J Psychotraumatol. 2022 Mar 1;13(1):2031829. doi: 10.1080/20008198.2022.2031829. PMID: 35251529; PMCID: PMC8890535.
14. Kerbage H, Bazzi O, El Hage W, Corruble E, Purper- Ouakil D. Early Interventions to Prevent Post-Traumatic Stress Disorder in Youth after Exposure to a Potentially Traumatic Event: A Scoping Review. Healthcare (Basel). 2022 Apr 28;10(5):818. doi: 10.3390/healthcare10050818. PMID: 35627955; PMCID: PMC9141228.
15. Carmi L, Fostick L, Burshtein S, Cwikel-Hamzany S, Zohar J. PTSD treatment in light of DSM-5 and the “golden hours” con- cept. CNS Spectrums. 2016. doi: 10.1017/S109285291600016X
16. Vermetten E, Frankova I, Carmi L, Chaban O, Zohar J. Trauma and Resilience in War Zones: The Role of Faith and Cultural Traditions: NATO Science for Peace and Security Series — E: Human and Societal Dynamics. Vol. 148. IOS Press, 2020. URI: https://www.iospress.com/catalog/books/risk-man- agement-of-terrorism-induced-stress.
17. Zohar J, Juven-Wetzler A, Sonnino R, Cwikel-Hamzany S, Balaban E, Cohen H. New insights into secondary preven- tion in post-traumatic stress disorder. Dialogues Clin Neurosci. 2011;13(3):301-9. doi: 10.31887/DCNS.2011.13.2/jzohar. PMID: 22033784; PMCID: PMC3182005.
18. Frankova I, Vermetten E, Shalev AY, Sijbrandij M, Holmes EA, Ursano R, Schmidt U, Zohar J. Digital psychologi- cal first aid for Ukraine. Lancet Psychiatry. 2022 Jul;9(7):e33. doi: 10.1016/S2215-0366(22)00147-X. Epub 2022 May 5. PMID: 35526557.
19. Everly GS, Jr, Lating JM. The Johns Hopkins Guide to Psychological First Aid. JHU Press. 2017 20. Yang E, Schamber E, Meyer RML, Gold JI. Happier Healers: Randomized Controlled Trial of Mobile Mindfulness for Stress Management. J Altern Complement Med. 2018 May;24(5):505-513. doi: 10.1089/acm.2015.0301. Epub 2018 Feb 8. PMID: 29420050.
21. Social Screening of Ukrainian Society during the Russian Invasion — eighth wave of the study: Analytical report. Gradus Research, 2023. Retrieved from https://gradus.app/docu- ments/353/Gradus_Report_-_War_Survey_w8_ENG.pdf.
22. Chudzicka-Czupała A, Hapon N, Chiang SK, Żywiołek- Szeja M, Karamushka L, Lee CT, Grabowski D, Paliga M, Rosenblat JD, Ho R, McIntyre RS, Chen YL. Depression, anxiety and post-traumatic stress during the 2022 Russo-Ukrainian war, a comparison between populations in Poland, Ukraine, and Taiwan. Sci Rep. 2023 Mar 3;13(1):3602. doi: 10.1038/s41598- 023-28729-3. PMID: 36869035; PMCID: PMC9982762.
23. Center for Substance Abuse Treatment (US). Trauma- Informed Care in Behavioral Health Services. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 57.) Chapter 3, Understanding the Impact of Trauma. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207191/.
24. Makwana N. Disaster and its impact on mental health: A narrative review. J Family Med Prim Care. 2019 Oct 31;8(10):3090- 3095. doi: 10.4103/jfmpc.jfmpc_893_19. PMID: 31742125; PMCID: PMC6857396.
25. Mushtaq R, Shoib S, Shah T, Mushtaq S. Relationship between loneliness, psychiatric disorders and physical health? A review on the psychological aspects of loneliness. J Clin Diagn Res. 2014 Sep;8(9):WE01-4. doi: 10.7860/JCDR/2014/10077.4828. Epub 2014 Sep 20. PMID: 25386507; PMCID: PMC4225959.
 26. Boscarino JA. Post-traumatic stress and associated disorders among Vietnam veterans: the significance of combat exposure and social support. J Trauma Stress. 1995 Apr;8(2):317- 36. doi: 10.1007/BF02109567. PMID: 7627446.
27. Ozbay F, Johnson DC, Dimoulas E, Morgan CA, Charney D, Southwick S. Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry (Edgmont). 2007 May;4(5):35-40. PMID: 20806028; PMCID: PMC2921311.
28. Mburia-Mwalili A, Wagner KD, Kwobah EK, Atwoli L, Aluda M, Simmons B, Lewis-Kulzer J, Goodrich S, Wools- Kaloustian K, Syvertsen JL. Social support and the effects of the COVID-19 pandemic among a cohort of people living with HIV (PLWH) in Western Kenya. PLOS Glob Public Health. 2023 Feb 28;3(2):e0000778. doi: 10.1371/journal.pgph.0000778. PMID: 36962963; PMCID: PMC10022114.