(PS12-63) Coping Self Efficacy and Symptom Change in a Brief PTSD Treatment That Utilizes a Mobile App

Background

Digital health interventions are a growing area of research in PTSD treatment. Findings on efficacy show promising results, and as these interventions progress, it is vital to understand factors that impact treatment. Coping self-efficacy (CSE) is an important mediator in PTSD recovery, and research suggests it may be a factor in symptom reduction with digital health interventions. Understanding the mechanisms behind symptom reduction with digital health interventions provides important information for further development and dissemination.

Methods

The current study examined CSE as a mediator of treatment outcome in a randomized controlled trial of clinician supported use of PTSD Coach, an app with coping skills and psychoeducation for PTSD. We examined data from the intervention group who utilized the app (n=69). ANCOVA analyses were performed to assess if change in CSE over the course of the intervention mediated the relationship between app utilization (measured by total visits) and post-treatment symptoms (PTSD and depression), while controlling for baseline symptom scores. ANCOVA analyses were also performed to assess change in CSE scores between baseline and 8-week follow-up.

Results

CSE significantly increased from baseline to follow-up (B=.69, SE=.05, p< .001), and change in CSE was significantly associated with PTSD severity (B=-.13, SE=.06, p=.035) and depression severity (B=-.04, SE=.02, p=.032), with an increase in CSE predicting lower severity. However, CSE did not mediate the relationship between app use and symptom change and utilization was not significantly associated with a change in CSE.

Conclusions

These results highlight the importance of coping self-efficacy in digital health PTSD interventions, as increased CSE predicted lower depression and PTSD severity at follow-up. The lack of a mediating relationship may indicate that app visits are not closely related to change in CSE. Identifying other variables that impact CSE remains important in future research, as increasing CSE may lead to better treatment outcome. Potential CSE predictors to examine through future research include increased knowledge through use of the app (e.g. learned coping skills, knowledge about PTSD and treatment options) or the comfort of having a device for in-the-moment support. As CSE was an important factor in treatment outcome, it remains necessary to target this variable in PTSD digital intervention research.