None listed
Conditions
Brief summary
Adolescents in low- and middle-income countries (LMICs), such as Iraq, experience concerning levels of psychological distress, including posttraumatic stress disorder (PTSD), depression, and anxiety. These symptoms severely affect an adolescent’s life, including long-lasting cognitive, emotional, social and academic/vocational problems. Addressing psychological concerns in the critical developmental period of adolescence is imperative. However, very few adolescents in Iraq receive evidence-based interventions, due to high costs, limited mental health services and a shortage of skilled professionals. The needs of adolescents in LMICs (such as adolescents in Iraq) have not received sufficient attention in psychology/psychiatry research. In order to meet these identified needs, our MEmory Training for Recovery-Adolescent (METRA) research emerged; METRA is a low-intensity, accessible and scalable evidence-based intervention aimed to reduce psychological distress. Our aim is to investigate the efficacy of METRA in improving psychological symptoms (posttraumatic stress disorder, depression) in adolescents living in Iraq. We predict that METRA will improve symptoms of psychological distress (PTSD and depression) in adolescents living in Iraq and will be an acceptable and feasible intervention.
Interventions
METRA: Module 1: Memory specificity training is a manualized training delivered over five 60-minute face-to-face sessions (3-5 times per week based on local security situations) to groups of 6-8 adolescents. It is delivered by a group facilitator. Session 1 provides psycho-education about mental health and memory. Participants practice recalling memories in response to positive and neutral cues, with support from the group facilitator. Session 2 follows the same format with further practice focusing on recalling memories in response to positive and neutral cues. In Session 3, practice in response to negative cues is introduced. Session 4 involves further exercises. Session 5 includes further practice and a summary. Module 1 focuses on everyday remembering. Module 2: Writing for Recovery is a written exposure training that involves 5 face-to-face sessions (delivered 3-5 times per week based on local security situations). It is delivered by the same group facilitator that delivered Module 1 and is delivered immediately following Module 1 (i.e., week following last session of Module 1). In the first session, the purpose of Module 2 is outlined. Then the facilitator simply reads the instructions and the participant completes the writing task; writing about their trauma including thoughts and feelings. After 30 minutes, the facilitator instructs the participants to stop writing. This writing task is repeated in the following four sessions. Each session takes 45-60 minutes. Adherence will be monitored using session attendance checklists.
Sponsors
Study design
Eligibility
Inclusion criteria
Iraqi adolescents aged 10-19 years with elevated psychological distress. This age range aligns with our pilot work and definitions of ‘adolescent’. As in our pilot studies, elevated psychological distress is defined as greater or equal to 25 on the Child Revised Impact of Event Scale-13 and/or >12 on the Mood and Feeling Questionnaire.
Exclusion criteria
Exclusion Criteria: a) high levels of suicidality, b) unmanaged psychosis/manic episodes in past month, and c) presence of head trauma/organic brain damage.