Post Traumatic Stress Disorder
Conditions
Brief summary
This study will examine the initial feasibility of a program called Islamic Trauma Healing by conducting a small feasibility study (N = 26) of Islamic Trauma Healing in Somalia on key targets of PTSD, depression, somatic symptoms, and quality of life. The hypothesis is that those in Islamic Trauma Healing will show a reduction of PTSD symptoms, depressive symptoms, and somatic symptoms and show improvement in quality of well-being. Feasibility will also be examined by examining at retention, satisfaction, and community feedback.
Detailed description
Islamic Trauma Healing is a lay-led, small-group intervention specifically targeting healing mental wounds of trauma within mosques. The six-session intervention combines empirically supported exposure-based and cognitive restructuring techniques with Islamic principles. A lay-led, group program promotes community building, acknowledges trauma's impact in the community, and facilitates wider implementation. The program is not referred to as therapy or treatment for mental illness. It incorporates community building (e.g., shared tea, supplication), integrated Islamic principles that utilize cognitive restructuring through discussion of prophet narratives (e.g., faith during hard times, Prophet Job \[Ayyub\]), and exposure therapy through individual prayer, talking to Allah about the trauma. Ultimately, the program will follow a self-sustaining train-the-trainer model, led by group leaders, empowering lay leaders to facilitate healing in their communities. Further, training time is dramatically reduced to two, 4-hour training sessions, focusing on teaching skills of group discussion leading rather than training as a lay therapist or mental health counselor. Preliminary data from a community sample and from initial men's and women's groups show a strong perceived need and match with the Islamic faith, with large effects obtained for pre- to post-group across measures (g = 0.76-3.22). Qualitative analysis identified the intervention as operating on potential mechanisms of connectedness to the community, faith integration, healing, and growth. The preliminary data point to the program being well-received and offering a promising model for delivery of a trauma-focused intervention to Muslim communities. The next steps are examining Islamic Trauma Healing in low and moderate-income Muslim countries, examining the feasibility of implementing this lay-led program.
Interventions
6 session behavioral intervention program designed to reduce PTSD and related symptomatology
Sponsors
Study design
Intervention model description
This is an active intervention feasibility study, using a pre-post clinical trial design; there is no randomization and no control intervention.
Eligibility
Inclusion criteria
* Experienced a DSM-5 trauma at least 12 weeks ago * Report current re-experiencing or avoidance symptoms * Islamic faith * 18-65 year of age
Exclusion criteria
* Immediate suicide risk, with intent or plan * Cannot understand consent/visible cognitive impairment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| PTSD Scale - Self-Report for DSM-5 (PDS-5; Foa et al., 2016) | Last 1 Week | PTSD symptoms will be measured using the PTSD Scale - Self-Report for DSM-5 (PDS-5; Foa et al., 2016). Twenty items comprise the PTSD severity scale, with scores ranging from 0 to 80 and higher scores indicating higher PTSD severity. A total score is calculated. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient Health Questionnaire-9 (PHQ-9; Kroenke, Spitzer, & Williams, 2001) | Last 1 Week | The PHQ-9 is a self-report measure of depression symptoms with each question rated from 0-3. Higher scores indicate greater depression severity, with scores ranging from 0 to 27. |
| Somatic Symptoms Scale-8 (SSS-8; Gierk et al., 2014) | Last 1 Week | The Somatic Symptoms Scale is an 8 item version of the PHQ-15; self-report assessment of somatic symptoms (e.g., stomach pain, headaches, dizziness). The current version scored items on the original PHQ-15 scale from 0 to 2, with a range from 0 to 16. |
| Quality of Well-being Index | Last 1 Week | The WHO-5 Wellbeing Index (WHO-5; Bech, Olsen, Kjoller, & Rasmussen, 2003) will be used to measure well-being. This five-item measure assesses emotional well-being on a 0-5 scale, with higher scores reflecting better well-being. Range of scores is from 0 to 25. |
Countries
Somalia
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| PTSD Lay-led Group Treatment Program The group will go through the Islamic Trauma Healing Program
Islamic Trauma Healing: 6 session behavioral intervention program designed to reduce PTSD and related symptomatology | 26 |
| Total | 26 |
Baseline characteristics
| Characteristic | PTSD Lay-led Group Treatment Program |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 0 Participants |
| Age, Categorical Between 18 and 65 years | 26 Participants |
| Depression Symptoms (PHQ-9) | 10.42 score on a scale STANDARD_DEVIATION 4.69 |
| PTSD Severity (PDS-5) | 30.88 score on a scale STANDARD_DEVIATION 13.76 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 26 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 0 Participants |
| Region of Enrollment Somalia | 26 participants |
| Sex: Female, Male Female | 14 Participants |
| Sex: Female, Male Male | 12 Participants |
| Somatic Symptoms (SSS-8) | 8.46 score on a scale STANDARD_DEVIATION 2.53 |
| Well-Being (WHO-5) | 10.00 score on a scale STANDARD_DEVIATION 6.62 |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 26 |
| other Total, other adverse events | 0 / 26 |
| serious Total, serious adverse events | 0 / 26 |
Outcome results
PTSD Scale - Self-Report for DSM-5 (PDS-5; Foa et al., 2016)
PTSD symptoms will be measured using the PTSD Scale - Self-Report for DSM-5 (PDS-5; Foa et al., 2016). Twenty items comprise the PTSD severity scale, with scores ranging from 0 to 80 and higher scores indicating higher PTSD severity. A total score is calculated.
Time frame: Last 1 Week
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| PTSD Lay-led Group Treatment Program | PTSD Scale - Self-Report for DSM-5 (PDS-5; Foa et al., 2016) | 8.08 score on a scale | Standard Deviation 5.74 |
Patient Health Questionnaire-9 (PHQ-9; Kroenke, Spitzer, & Williams, 2001)
The PHQ-9 is a self-report measure of depression symptoms with each question rated from 0-3. Higher scores indicate greater depression severity, with scores ranging from 0 to 27.
Time frame: Last 1 Week
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| PTSD Lay-led Group Treatment Program | Patient Health Questionnaire-9 (PHQ-9; Kroenke, Spitzer, & Williams, 2001) | 2.50 score on scale | Standard Deviation 1.5 |
Quality of Well-being Index
The WHO-5 Wellbeing Index (WHO-5; Bech, Olsen, Kjoller, & Rasmussen, 2003) will be used to measure well-being. This five-item measure assesses emotional well-being on a 0-5 scale, with higher scores reflecting better well-being. Range of scores is from 0 to 25.
Time frame: Last 1 Week
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| PTSD Lay-led Group Treatment Program | Quality of Well-being Index | 19.38 score on a scale | Standard Deviation 2.48 |
Somatic Symptoms Scale-8 (SSS-8; Gierk et al., 2014)
The Somatic Symptoms Scale is an 8 item version of the PHQ-15; self-report assessment of somatic symptoms (e.g., stomach pain, headaches, dizziness). The current version scored items on the original PHQ-15 scale from 0 to 2, with a range from 0 to 16.
Time frame: Last 1 Week
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| PTSD Lay-led Group Treatment Program | Somatic Symptoms Scale-8 (SSS-8; Gierk et al., 2014) | 2.38 score on a scale | Standard Deviation 1.58 |