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Abstract Introduction Both exposure to a natural disaster and psychological symptoms may lead to decreases in social support. Few studies have examined ways to improve social support among victims of natural disasters. Aims The objective of the study was to assess emotional and tangible support following a 12‐session Internet‐based cognitive behavioral therapy (ICBT) targeting posttraumatic stress (PTS), insomnia, and depression symptoms and to examine the association between posttreatment symptoms and emotional and tangible support. Materials and Methods One hundred and seventy‐eight wildfire evacuees with significant PTS, depression and/or insomnia symptoms were given access to the ICBT. They completed questionnaires at pre‐ and posttreatment to measure social support and symptom severity. Results Results show that completion of the treatment led to an improvement in emotional support. Lower posttreatment PTS and insomnia symptoms were associated with higher posttreatment emotional support. Conclusion ICBT may contribute to enhance emotional support through symptom improvement and probably more so when social support is address directly in treatment.
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Introduction Studies have shown that, following psychotherapy for posttraumatic stress disorder (PTSD), symptoms and quality of life (QoL) may improve in many patients, but not always to the same extent. Dysfunctional core beliefs, such as personality beliefs (PB), are associated to psychopathology, including PTSD, and could be associated with the types of coping strategies deployed by an individual. Beliefs and coping strategies were also linked to psychotherapeutic outcomes. Objectives (1) To examine the associations between baseline PB as well as pre- and post-treatment coping strategies; (2) To investigate the mediation effects between PB and the changes in QoL, through changes in coping strategies in a cognitive-behavioral psychotherapy (CBT). Method Seventy-one adults with PTSD participating in a correlational/observational CBT study were assessed for PB before a CBT, as well as for coping strategies and QoL, before and after a CBT. Results PB were generally associated with post-treatment distancing coping. Moreover, changes in distancing coping mediated the relationships between avoidant or dependent PB and psychological QoL improvements. Conclusion This is the first study to show the relationships between PB and coping strategies in PTSD patients, and that higher avoidant or dependent PB predicts a lower reduction in the use of distancing coping through psychotherapy, which is associated with less improvement in psychological QoL. Future studies are needed to further define the role of these variables and target more precisely factors that may hamper the treatment effects of CBT for PTSD.
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This study aimed at evaluating the efficacy of an online CBT intervention with limited therapist contact targeting a range of posttraumatic symptoms among evacuees from the 2016 Fort McMurray wildfires. One hundred and thirty-six residents of Fort McMurray who reported either moderate PTSD symptoms (PCL-5 ≥ 23) or mild PTSD symptoms (PCL-5 ≥ 10) with moderate depression (PHQ-9 ≥ 10) or subthreshold insomnia symptoms (ISI ≥ 8) were randomized either to a treatment (n = 69) or a waitlist condition (n = 67). Participants were on average 45 years old, and mostly identified as White (82%) and as women (76%). Primary outcomes were PTSD, depression, and insomnia symptoms. Secondary outcomes were anxiety symptoms and disability. Significant Assessment Time × Treatment Condition interactions were observed on all outcomes, indicating that access to the treatment led to a decrease in posttraumatic stress (F[1,117.04] = 12.128, p = .001; d = .519, 95% CI = .142–.895), depression (F[1,118.29] = 9.978, p = .002; d = .519, 95% CI = .141–.898) insomnia (F[1,117.60] = 4.574, p = .035; d = .512, 95% CI = .132–.892), and anxiety (F[1,119.64] = 5.465, p = .021; d = .421, 95% CI = .044–.797) symptom severity and disability (F[1,111.55] = 7.015, p = .009; d = .582, 95% CI = .200–.963). Larger effect sizes (d = 0.823–1.075) were observed in participants who completed at least half of the treatment. The RESILIENT online treatment platform was successful to provide access to specialized evidence-based mental health care after a disaster.