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      Development of RESTORE: an online intervention to improve mental health symptoms associated with COVID-19-related traumatic and extreme stressors Translated title: Desarrollo de RESTORE (restaurar): una intervención en línea para mejorar los síntomas de salud mental asociados a los estresores traumáticos y extremos relacionados con COVID-19 Translated title: RESTORE 的开发:一项改善 COVID-19 相关创伤性和极端应激源相关的心理健康症状的在线干预

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          ABSTRACT

          Background

          Frontline healthcare workers, recovered COVID+ patients who had severe illness, and close others of COVID+ patients who have recovered or died are at risk for clinical levels of mental health symptoms in the context of the COVID-19 pandemic. RESTORE ( Recovering from Extreme Stressors Through Online Resources and E-health) was specifically designed for this context. RESTORE is a transdiagnostic guided online intervention adapted from evidence-based cognitive-behavioural therapies.

          Objectives

          RESTORE was designed to address depression, anxiety, and posttraumatic stress disorder symptoms associated with exposure to COVID-19-related traumatic and extreme stressors, and to overcome multiple barriers to accessing psychotherapies.

          Method

          This paper describes the intervention components and platform, as well as the principles used to develop RESTORE. Current research and future directions in developing and testing RESTORE are outlined.

          Results

          Preliminary data from an initial uncontrolled trial evaluating RESTORE in frontline healthcare workers is highly promising.

          Conclusion

          We believe RESTORE has great potential to provide accessible, evidence-based psychological intervention to those in great need.

          HIGHLIGHTS

          • RESTORE is a transdiagnostic online intervention adapted from evidence-based cognitive-behavioural therapies designed to address mental health symptoms related to exposure to COVID-19-related traumatic and extreme stressors, and to overcome barriers to accessing psychotherapy.

          Translated abstract

          Antecedentes: Los trabajadores de salud de primera línea, los pacientes de COVID positivo recuperados que tenían una enfermedad grave y las personas cercanas a los pacientes de COVID positivo que se han recuperado o fallecido están en riesgo de presentar niveles clínicos de síntomas de salud mental en el contexto de la pandemia de COVID-19. RESTORE (por sus siglas en inglés: Recovering from Extreme Stressors Through Online Resources and E-health: Recuperación de estresores extremos a través de recursos en línea y salud electrónica) fue diseñada específicamente para este contexto. RESTORE es una intervención en línea guiada transdiagnóstica adaptada de terapias cognitivo-conductuales basadas en la evidencia.

          Objetivos: RESTORE fue diseñado para abordar la depresión, la ansiedad y los síntomas del trastorno de estrés postraumático asociados con la exposición a factores estresantes traumáticos y extremos relacionados con COVID-19, y para superar múltiples barreras para acceder a psicoterapias.

          Método: Este artículo describe los componentes y la plataforma de la intervención, así como los principios utilizados para desarrollar RESTORE. Se describen las investigaciones actuales y las direcciones futuras para desarrollar y testear RESTORE.

          Resultados: Los datos preliminares de un ensayo inicial no controlado que evalúa RESTORE en trabajadores de salud de primera línea son muy prometedores.

          Conclusión: Creemos que RESTORE tiene un gran potencial para brindar una intervención psicológica accesible y basada en la evidencia a quienes más lo necesitan.

          Translated abstract

          背景: 在 COVID-19 疫情背景下, 一线医护人员, 重症 COVID+ 康复患者以及已康复或死亡的 COVID+ 患者的其他亲友都有出现临床心理健康症状的风险。 RESTORE (通过在线资源和电子健康从极端应激源中恢复) 专为这种情况而设计。 RESTORE 是一种改编自循证认知行为疗法的跨诊断指导的在线干预。

          目的: RESTORE 旨在致力于 COVID-19 相关创伤性和极端应激源暴露相关的抑郁, 焦虑和创伤后应激障碍症状, 并克服心理治疗可得性的多种障碍。

          方法: 本文介绍了干预组成和平台, 以及用于开发RESTORE的原则。概述了开发和测试 RESTORE 的当前研究和未来方向。

          结果: 来自评估一线医护人员 RESTORE 的初始非对照试验的初步数据大有前景。

          结论: 我们相信 RESTORE 有很大的潜力为急需帮助者提供易得, 询证的心理干预。

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          Most cited references28

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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            The PHQ-9: validity of a brief depression severity measure.

            While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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              Psychological Medicine, 45(1), 11-27
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                Author and article information

                Journal
                Eur J Psychotraumatol
                Eur J Psychotraumatol
                European Journal of Psychotraumatology
                Taylor & Francis
                2000-8198
                2000-8066
                1 November 2021
                2021
                1 November 2021
                : 12
                : 1
                : 1984049
                Affiliations
                [a ]Centre for Mental Health, University Health Network; , Toronto, ON, Canada
                [b ]Department of Psychiatry, University of Toronto; , Toronto, ON, Canada
                [c ]Department of Psychology, Ryerson University; , Toronto, ON, Canada
                [d ]Department of Psychiatry & Behavioral Sciences, Stanford University; , Stanford, CA, USA
                [e ]Remedy; , Toronto, ON, Canada
                [f ]Likeable IT Inc; ., Toronto, ON, Canada
                Author notes
                CONTACT Kathryn Trottier Kathryn.trottier@ 123456uhn.ca University Health Network; , 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada
                Author information
                https://orcid.org/0000-0001-7192-6140
                https://orcid.org/0000-0001-7961-2787
                Article
                1984049
                10.1080/20008198.2021.1984049
                8567930
                34745446
                e8db56b3-c16e-4f58-97a5-2f466bd71b16
                © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Figures: 0, Tables: 1, References: 30, Pages: 1
                Categories
                Research Article
                Short Communication

                Clinical Psychology & Psychiatry
                mental health,covid-19,online,intervention,transdiagnostic,restore,salud mental,en línea,intervención,transdiagnóstico,restaurar,心理健康,在线的,干预,跨诊断

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