Emotion regulation skills training as an adjunctive treatment to narrative exposure therapy for posttraumatic stress disorder (PTSD) in refugees: a pilot randomized controlled trial.
Angela Nickerson, Marylene Cloitre, Frank Neuner et al.
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In 30 seconds
This pilot randomized controlled trial compared Skills Training in Affective and Interpersonal Regulation for Refugees plus Narrative Exposure Therapy (STAIR-R + NET) with Supportive Problem-Solving plus NET in 71 refugees with PTSD. The primary outcome was clinician-assessed PTSD severity. There were no significant between-group differences at mid-treatment, post-treatment, or 3-month follow-up. Both groups improved by follow-up: clinician-assessed PTSD symptoms showed large within-group changes (STAIR-R + NET, g = -1.41; SPS + NET, g = -1.54, p < .001). Exploratory analyses suggested greater benefits from STAIR-R + NET among participants with high insecurity.
Key findings
- No significant between-group differences were found at mid-treatment, post-treatment, or 3-month follow-up.
- At 3-month follow-up, clinician-assessed PTSD symptoms improved in both groups (STAIR-R + NET, g = -1.41; SPS + NET, g = -1.54, p < .001).
- Among participants with high insecurity (n = 16), exploratory analyses favored STAIR-R + NET across self-reported PTSD, depression, emotion regulation, relationships, and quality of life.
Why it matters
The findings indicate that refugees in both treatment conditions experienced reduced PTSD symptoms, while adding emotion regulation skills training did not produce an overall advantage over supportive problem-solving when each was paired with NET. The exploratory results raise the possibility that environmental insecurity may be relevant to treatment response, underscoring the value of evaluating outcomes across differing circumstances.
What to keep in mind
This was a pilot trial, and the high-insecurity subgroup was small (n = 16); the authors state that the subgroup findings require replication.