Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr 8:13:826633.
doi: 10.3389/fpsyt.2022.826633. eCollection 2022.

Investigating the Feasibility, Acceptability and Efficacy of Using Modified-Written Exposure Therapy in the Aftermath of a Terrorist Attack on Symptoms of Posttraumatic Stress Disorder Among Afghan Adolescent Girls

Sayed Jafar Ahmadi  1 , Zeinab Musavi  2 , Nasratullah Samim  2 , Masooma Sadeqi  2 , Laura Jobson  3
Affiliations

Investigating the Feasibility, Acceptability and Efficacy of Using Modified-Written Exposure Therapy in the Aftermath of a Terrorist Attack on Symptoms of Posttraumatic Stress Disorder Among Afghan Adolescent Girls

Sayed Jafar Ahmadi et al. Front Psychiatry. .

Abstract

Background: The aim of this study was to assess the efficacy, acceptability and feasibility of using modified written exposure therapy (m-WET) to treat symptoms of posttraumatic stress disorder (PTSD) in Afghan adolescent girls in the aftermath of a terrorist attack.

Methods: 120 Afghan (Hazara) adolescent girls who had been exposed to the Sayed al-Shuhada school terrorist attack were randomly assigned to the m-WET (n = 40), trauma-focused cognitive behavior therapy (TF-CBT) (n = 40), or control groups (n = 40). m-WET involved five consecutive daily group sessions where participants simply wrote about the terrorist attack including thoughts and feelings. TF-CBT was an intensive five-session group intervention. The control group had no additional contact. The trial was undertaken at a local non-government organization in Kabul. The primary analysis was comparing PTSD symptoms (Child Revised Impact of Event Scale-13) in the three groups at post-intervention and three-month follow-up.

Results: Overall, participant and facilitator satisfaction with m-WET was high. Acceptability of m-WET was relatively high, with 15% drop-out in the m-WET group and all m-WET sessions were attended. While the groups did not differ significantly in PTSD symptoms at baseline, the m-WET group had significantly lower levels of PTSD symptoms compared to the control group at post-intervention and follow-up. There was no significant difference between the m-WET and TF-CBT groups.

Conclusion: The findings suggest m-WET may be promising intervention for the treatment of PTSD among adolescent girls in humanitarian settings. Further research in the area is warranted.

Keywords: Afghan adolescents; cognitive behavior therapy; posttraumatic stress disorder; writing for recovery; written exposure therapy.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
CONSORT flow diagram.
FIGURE 2
FIGURE 2
Scatterplots for the Baseline and Post-Intervention Posttraumatic Stress Disorder (PTSD) symptoms for the written exposure group (A), cognitive behavior therapy group (B) and control group (C).
FIGURE 3
FIGURE 3
Depicting posttraumatic stress (PTSD) symptom severity at baseline, post-intervention and 3-month follow-up for the modified- Written Exposure Therapy (m-WET), trauma-focused-cognitive behavior therapy (TF-CBT), and control groups.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Saleem SM, Shoib S, Dazhamyar AR, Chandradasa M. Afghanistan: decades of collective trauma, ongoing humanitarian crises, Taliban rulers, and mental health of the displaced population. Asian J Psychiatry. (2021) 65:102854. 10.1016/j.ajp.2021.102854 - DOI - PubMed
    1. Panter-Brick C, Eggerman M, Gonzalez V, Safdar S. Violence, suffering, and mental health in Afghanistan: a school-based survey. Lancet (London, England). (2009) 374:807–16. 10.1016/S0140-6736(09)61080-1 - DOI - PMC - PubMed
    1. Panter-Brick C, Goodman A, Tol W, Eggerman M. Mental health and childhood adversities: a longitudinal study in Kabul, Afghanistan. J Am Acad Child Adolesc Psychiatry. (2011) 50:349–63. 10.1016/j.jaac.2010.12.001 - DOI - PMC - PubMed
    1. United Nations Office for the Coordination of Humanitarian Affairs. 2018 Afghanistan Humanitarian Needs Overview. New York, NY: United Nations Office for the Coordination of Humanitarian Affairs; (2018).
    1. Alemi Q, Stempel C, Koga PM, Montgomery S, Smith V, Sandhu G, et al. Risk and protective factors associated with the mental health of young adults in Kabul, Afghanistan. BMC Psychiatry. (2018) 18:71. 10.1186/s12888-018-1648-4 - DOI - PMC - PubMed