The ABCDE psychological first aid intervention decreases early PTSD symptoms but does not prevent it: results of a randomized-controlled trial

Figures & data

Table 1. Participant characteristics

Characteristic		PFA-ABCDE (N = 109)		PE (N = 112)
Age (years) mean (S.D.)		50.0	(14.9)	47.3	(17.6)
Education (years) mean (S.D.)		11.0	(4.1)	11.2	(4.5)
Depressive symptoms (BDI-II total score) mean (S.D.)		17.1	(11.0)	17.7	(12.8)
Gender n (%)
	Male	42	(38.5)	49	(43.8)
	Female	67	(61.5)	63	(56.3)
Civil status^a n (%)
	Married or civil union	56	(53.3)	44	(40.7)
	Widowed	5	(4.8)	12	(11.1)
	Separated	10	(9.5)	13	(12.0)
	Divorced	5	(4.8)	3	(2.8)
	Single	29	(27.6)	36	(33.3)
Type of trauma n (%)
	Motor vehicle accident	7	(6.4)	14	(12.5)
	Other accidents	17	(15.6)	21	(18.8)
	Severe and sudden medical condition	38	(34.9)	39	(34.8)
	Witness	6	(5.5)	5	(4.5)
	Close relative	29	(26.6)	20	(17.9)
	Sexual offence	0	(0.0)	0	(0.0)
	Assault	0	(0.0)	0	(0.0)
	Other trauma	12	(11.0)	13	(11.6)

PFA-ABCDE, Psychological First Aid ABCDE protocol; PE, psychoeducation; BDI-II, 21-items Beck Depression Inventory.

^aCount is less than expected because in 8 participants

(< 4%) civil status information was unavailable.

Table 2. Proportion of participants with PTSD secondary to the index trauma one month after the intervention

PFA-ABCDE (N = 109)			PE (N = 112)			Unadjusted model^a				Adjusted model^a,b
Total analysed n (%)	PTSD (+) in those analysed n (%)		Total analysed n (%)	PTSD (+) in those analysed n (%)		OR	(95% CI)	p		OR	(95% CI)	p
76 (69.7)	23 (30.3)		75 (67.0)	18 (24.0)		1.37	(0.67–2.83)	0.388		1.39	(0.63–3.07)	0.408

PFA-ABCDE, Psychological First Aid ABCDE protocol; PE, psychoeducation; OR, odds ratio; CI, confidence interval.

^aLost to follow-up individuals not included in the analysis.

^bAdjusted for baseline depressive symptoms, assessment method (face-to-face versus telephone), and age.

Table 3. Distress relief, PTSD self-reported symptoms, and depressive self-reported symptoms after the intervention

Outcome	Time to follow-up	PFA-ABCDE (N = 109)					PE (N = 112)					Unadjusted model^a				Adjusted models^a,b,c
		Total followed n (%)		Mean (S.D.) in those followed			Total followed n (%)		Mean (S.D.) in those followed			Man difference	Cohen’s d effect size	p		Mean difference	Cohen’s d effect size	p
Distress relief (0–10 AVS) mean (S.D.)	Immediate after intervention	97	(89.0)	9.06	(1.59)		104	(92.86)	8.55	(1.87)		0.51	0.30	.038*		0.51	0.30	.038*
PTSD symptoms (PCL-S total score) mean (S.D.)	1 month	31	(28.4)	36.26	(17.78)		34	(30.36)	43.62	(16.84)		−7.36	0.42	.092		−7.23	0.42	.033*^d
	6 months	48	(44.0)	33.73	(15.47)		43	(38.39)	33.19	(11.67)		0.54	0.04	.852		0.05	0.00	.986
Depressive symptoms (BDI-II total score) mean (S.D.)	1 month	31	(28.4)	14.71	(11.08)		34	(30.36)	15.53	(10.88)		−0.82	0.07	.765		−0.63	0.06	.713

PFA, Psychological First Aid ABCDE protocol; PE, psychoeducation; AVS, analogue visual scale; PCL-S, Posttraumatic Checklist specific version; BDI-ii, 21-items Beck Depression Inventory.

^aLost to follow-up individuals not included in the analysis.

^bAll models adjusted for baseline depressive symptoms.

^cPTSD symptoms 6-months after the intervention also adjusted for age and education due to evidence of selective attrition of older and less educated participants in the control group.

^dRemain significant (p = .044) after multiple missing data imputations.

* p < .05.

Figure 1. Flowchart of participants through the study.

Data availability statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to information that could compromise the privacy of research participants.