One size fits all? Towards individual prediction of treatment success for posttraumatic stress disorder in post-conflict settings (TRAUMA-FIT)

• Applicant: Dr. Sarah Wilker
• Subject Area: Personality Psychology, Clinical and Medical Psychology, Methodology
• Term: since 2024
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 554393807

In war-affected countries, posttraumatic stress disorder (PTSD) represents a major mental health problem. Accumulating evidence indicates, that next to the individual trauma history, relevant contextual factors of the social and societal environment, as well as ongoing stressors and adversity play a major role in PTSD development and its treatment after war and conflict. While trauma-focused psychotherapy is recommended as first-line treatment for PTSD, the individual treatment effects vary strongly, and a substantial number of individuals do not benefit from this type of treatment. This high treatment-effect heterogeneity for PTSD indicates that an individual allocation of treatments could lead to improved treatment outcomes. This is especially important in war-affected countries with limited resources for mental health care. Against this background, the present project aims to conduct a large precision mental health trial on effective treatment options for PTSD in the post-conflict region of Northern Uganda. A total number of N = 660 individuals will be randomized to the two arms of the trial: Narrative Exposure Therapy (NET), a trauma-focused short-term intervention, and Problem Management + (PM+), a present-centered intervention that aims to facilitate coping with current stress. Importantly, both treatments have been effectively implemented by local health workers in low-resource settings. Employing machine learning, the optimal treatment condition for each individual will be determined based on a set of individual predictors and relevant social and societal context factors. In the next step, the performance of the algorithm will be evaluated by comparing mean treatment effects and rates of clinically significant changes between individuals who received their optimal versus sub-optimal treatment condition. All in all, the project will provide knowledge on relevant predictors of treatment success in trauma-focused versus present-centered interventions for PTSD patients. Furthermore, knowledge regarding treatment personalization and optimal utilization of treatment resources in post-conflict settings will be generated.

• DFG Programme: Research Grants
• International Connection: Switzerland
• Partner Organisation: Schweizerischer Nationalfonds (SNF)
• Cooperation Partner: Privatdozent Dr. Naser Morina