***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose The aim of this r and omized controlled trial ( RCT ) was to test the effectiveness of a post-ICU recovery program compared to st and ard care during the first year after ICU discharge . Methods A pragmatic , non-blinded , multicenter , parallel-group RCT was conducted between December 2012 and December 2015 , at ten intensive care units ( ICUs ) in Denmark . We r and omly assigned 386 adult patients ( ≥18 years ) after receiving mechanical ventilation ( ≥48 h ) to st and ard care ( SC ) plus a nurse-led intensive care recovery program or st and ard care alone after ICU discharge ( 190 intervention , 196 SC ) . Primary outcome was health-related quality of life ( HRQOL ) at 12 months . Secondary outcomes were sense of coherence ( SOC ) , anxiety , depression , and post-traumatic stress disorder ( PTSD ) assessed at 3 and 12 months after ICU discharge including utilization of healthcare services at 12 months . Results At 12 months , we found no differences in HRQOL between groups ( mean difference in the Physical Component Summary score , 1.41 [ 95 % CI , −1.53 to 4.35 ; p = 0.35 ] ( n = 235 ) ; and in the Mental Component Summary score , 1.92 [ 95 % CI , −1.06 to 4.90 ; p = 0.11 ] ( n = 235 ) . No differences were found on self-reported SOC ( p = 0.63 ) , anxiety ( p = 0.68 ) , depression ( p = 0.67 ) , PTSD ( p = 0.27 ) , or the utilization of healthcare services including rehabilitation . We found a difference on anxiety , when a cut-off point ≥11 was applied , in per protocol analysis of complete cases at 3 months favoring the intervention ( 8.8 % vs. 16.2 % , p = 0.04 ) . Conclusions The tested recovery program was not superior to st and ard care during the first 12 months post-ICU.Trial registration The trial is registered at Clinical trials.gov , identification no. NCT01721239 Background : Writing assignments have shown promising results in treating traumatic symptomatology . Yet no studies have compared their efficacy to the current treatment of choice , cognitive behavior therapy ( CBT ) . The present study evaluated the efficacy of structured writing therapy ( SWT ) and CBT as compared to a waitlist control condition in treating acute stress disorder ( ASD ) and posttraumatic stress disorder ( PTSD ) . Methods : A r and omized controlled trial was conducted at an outpatient clinic . Participants ( n = 125 ) ( a ) satisfied DSM-IV criteria for ASD or PTSD , ( b ) were 16 years or older , ( c ) were sufficiently fluent in Dutch or English , ( d ) had no psychiatric problems except ASD or PTSD that would hinder participation or required alternative clinical care , and ( e ) received no concurrent psychotherapy .  Treatment consisted of five 1.5-hour sessions of CBT or SWT for participants with ASD or acute PTSD and ten 1.5-hour sessions for participants with chronic PTSD . Outcome measures included the Structured Clinical Interview for DSM-IV , Impact of Event Scale , Beck Depression Inventory , State-Trait Anxiety Inventory and the Dissociative Experiences Scale . Results : At posttest and follow-up , treatment was associated with improved diagnostic status and lower levels of intrusive symptoms , depression and state anxiety , while a trend was noted for the reduction of avoidance symptoms . Treatment did not result in lower levels of trait anxiety or dissociation . No differences in efficacy were detected between CBT and SWT . Conclusions : The present study confirmed the efficacy of CBT for ASD and PTSD and identified SWT as a promising alternative treatment OBJECTIVE : The current study evaluates a treatment intervention developed with the goal of reducing symptoms of posttraumatic stress , depression , and anxiety in parents of premature infants . METHODS : A total of 105 mothers of preterm infants ( 25–34 weeks ’ gestational age ; > 600 g ) were r and omized to receive a 6-session intervention developed to target parental trauma as well as facilitate infant redefinition ( n = 62 ) or to an active comparison group ( n = 43 ) . Mothers in the intervention group received a combination of trauma-focused treatments , including psychoeducation , cognitive restructuring , progressive muscle relaxation , and development of their trauma narrative . The intervention also incorporated material targeting infant redefinition , defined as the process of changing the mother ’s negative perceptions of her infant and the parenting experience . RESULTS : Mothers in the intervention group reported a greater reduction in both trauma symptoms ( Cohen ’s d = 0.41 , P = .023 ) and depression ( Cohen ’s d = 0.59 , P < .001 ) compared with the comparison group . Patients under both conditions improved significantly in terms of anxiety , with no differences between groups . Results of the moderator analysis showed that mothers with higher ratings of baseline NICU stress benefited more from the intervention compared with mothers who had lower ratings ( P = .036 ) . CONCLUSIONS : This short , highly manualized intervention for mothers of preterm infants statistically significantly reduced symptoms of trauma and depression . The intervention is feasible , can be delivered with fidelity , and has high ratings of maternal satisfaction . Given that improvements in mothers ’ distress may lead to improved infant outcomes , this intervention has the potential for a high public health impact Background Emergency room nurses were trained to provide a short-term psychological intervention in physically injured patients with Impact of Event Scale ( IES ) scores > 20 . The aims were to study the effects of the psychological intervention relative to usual care ( UC ) . Methods In a r and omized controlled trial , psychological distress , daily functioning and the personality traits optimism/pessimism were compared with patients who received the UC . The interventions were provided 1 - 3 months after discharge . Results The IES scores were significantly reduced in both groups at 3 months ( intervention : 41.1 - 28.6 , P < 0.001 vs. UC : 35.4 - 26.2 , P < 0.001 ) , but not significantly different between groups . Baseline IES score was a significant predictor of IES scores at 3 ( β = 0.4 , P < 0.05 ) and 12 months ( β = 0.3 , P < 0.05 ) , whereas overall daily functioning at 3 months predicted IES scores at 12 months ( β = -0.5 , P < 0.001 ) . Patients receiving intervention became significantly more optimistic during the year , and had an increase in overall daily functioning from 3 to 12 months ( P < 0.001 ) . Patients declining intervention were more pessimistic and had lower daily functioning . Patients who talked with nurses with more training in psychological processing had a larger reduction in IES symptoms at 3 months ( β = -0.3 , P = 0.081 ) . Conclusion The nurse-led intervention had a significant effect on optimism and overall daily functioning . Nurses may become a low-cost option to perform short-term psychological interventions with physically injured hospitalized patients Acute stress disorder ( ASD ) is a precursor of chronic posttraumatic stress disorder ( PTSD ) . Twenty-four participants with ASD following civilian trauma were given 5 sessions of either cognitive-behavioral therapy ( CBT ) or supportive counseling ( SC ) within 2 weeks of their trauma . Fewer participants in CBT ( 8 % ) than in SC ( 83 % ) met criteria for PTSD at posttreatment . There were also fewer cases of PTSD in the CBT condition ( 17 % ) than in the SC condition ( 67 % ) 6 months posttrauma . There were greater statistically and clinical ly significant reductions in intrusive , avoidance , and depressive symptomatology among the CBT participants than among the SC participants . This study represents the 1st demonstration of successful treatment of ASD with CBT and its efficacy in preventing chronic PTSD U.S. Army mortuary affairs ( MA ) soldiers experience stressors of deployment and exposure to the dead , increasing risk for post-traumatic stress and depression . This study examines Troop Education for Army Morale , a postdeployment early intervention based on Psychological First Aid . MA soldiers ( N = 126 ) were r and omized to intervention or comparison groups 1-month postdeployment . Intervention sessions were held at 2 , 3 , 4 , and 7 months . Assessment s of post-traumatic stress disorder ( PTSD ) , depression , and quality of life ( QOL ) were conducted at 1 , 2 , 3 , 4 , 7 , and 10 months for both groups . At baseline , 25.0 % of the total sample had probable PTSD ( 17-item PTSD Checklist M = 35.4 , SD = 16.9 ) and 23.6 % had probable depression ( 9-item Patient Health Question naire Depression Scale M = 7.8 , SD = 6.9 ) . Over 10 months , PTSD and depression symptoms decreased and QOL improved for the total sample . At study conclusion , intervention and comparison groups were not different . Intervention group males showed a transient symptom increase at 2 to 3 months . Males attended fewer intervention sessions than females . Lower attendance was associated with more symptoms and lower QOL . Higher attendance was associated with greater intervention benefits . Findings highlight the need for better underst and ing postdeployment interventions and facilitating attendance . Further intervention for MA soldiers is indicated Background Posttraumatic stress disorder ( PTSD ) develops in 10 - 20 % of injury patients . We developed a novel , self-guided Internet-based intervention ( called Trauma TIPS ) based on techniques from cognitive behavioral therapy ( CBT ) to prevent the onset of PTSD symptoms . Objective To determine whether Trauma TIPS is effective in preventing the onset of PTSD symptoms in injury patients . Methods Adult , level 1 trauma center patients were r and omly assigned to receive the fully automated Trauma TIPS Internet intervention ( n=151 ) or to receive no early intervention ( n=149 ) .  Trauma TIPS consisted of psychoeducation , in vivo exposure , and stress management techniques . Both groups were free to use care as usual ( non protocol ized talks with hospital staff ) . PTSD symptom severity was assessed at 1 , 3 , 6 , and 12 months post injury with a clinical interview ( Clinician-Administered PTSD Scale ) by blinded trained interviewers and self-report instrument ( Impact of Event Scale — Revised ) . Secondary outcomes were acute anxiety and arousal ( assessed online ) , self-reported depressive and anxiety symptoms ( Hospital Anxiety and Depression Scale ) , and mental health care utilization . Intervention usage was documented . Results The mean number of intervention logins was 1.7 , SD 2.5 , median 1 , interquartile range ( IQR ) 1 - 2 . Thirty-four patients in the intervention group did not log in ( 22.5 % ) , 63 ( 41.7 % ) logged in once , and 54 ( 35.8 % ) logged in multiple times ( mean 3.6 , SD 3.5 , median 3 , IQR 2 - 4 ) . On clinician-assessed and self-reported PTSD symptoms , both the intervention and control group showed a significant decrease over time ( P<.001 ) without significant differences in trend . PTSD at 12 months was diagnosed in 4.7 % of controls and 4.4 % of intervention group patients . There were no group differences on anxiety or depressive symptoms over time . Post hoc analyses using latent growth mixture modeling showed a significant decrease in PTSD symptoms in a subgroup of patients with severe initial symptoms ( n=20 ) ( P<.001 ) . Conclusions Our results do not support the efficacy of the Trauma TIPS Internet-based early intervention in the prevention of PTSD symptoms for an unselected population of injury patients . Moreover , uptake was relatively low since one-fifth of individuals did not log in to the intervention . Future research should therefore focus on innovative strategies to increase intervention usage , for example , adding gameplay , embedding it in a blended care context , and targeting high-risk individuals who are more likely to benefit from the intervention . Trial Registration International St and ard R and omized Controlled Trial Number ( IS RCT N ) : 57754429 ; http://www.controlled-trials.com/IS RCT N57754429 ( Archived by WebCite at http://webcitation.org/6FeJtJJyD ) Introduction Patients recovering from critical illness have been shown to be at risk of developing Post Traumatic Stress disorder ( PTSD ) . This study was to evaluate whether a prospect ively collected diary of a patient 's intensive care unit ( ICU ) stay when used during convalescence following critical illness will reduce the development of new onset PTSD . Methods Intensive care patients with an ICU stay of more than 72 hours were recruited to a r and omised controlled trial examining the effect of a diary outlining the details of the patients ICU stay on the development of acute PTSD . The intervention patients received their ICU diary at 1 month following critical care discharge and the final assessment of the development of acute PTSD was made at 3 months . Results 352 patients were r and omised to the study at 1 month . The incidence of new cases of 
    Output:
    
For individuals exposed to a trauma who were not pre-screened for traumatic stress symptoms there were no clinical ly important differences between any intervention and usual care .
For individuals reporting traumatic stress symptoms we found clinical ly important evidence of benefits for trauma-focused cognitive-behavioural therapy ( CBT-T ) , cognitive therapy without exposure and eye movement desensitization and reprocessing ( EMDR ) .
Differences were greatest for those diagnosed with acute stress disorder ( ASD ) and PTSD .
Conclusions : There is evidence for the effectiveness of several early psychological interventions for individuals with traumatic stress symptoms following trauma exposure , especially for those meeting the diagnostic threshold for ASD or PTSD .
Evidence is strongest for trauma-focused CBT