OBJECTIVE In spite of the evidence that both symptom reduction and functional improvement are important for supporting recovery from trauma, psychotherapy process research has largely focused on mechanisms of symptom reduction. A better understanding of how change occurs in treatments that emphasize functional improvement rather than trauma processing is critical for optimizing effective, patient-centered care. METHOD This study involved secondary analysis of data collected in three multisite trials of a 10-module web-based version of Skills Training in Affective and Interpersonal Regulation, a skills-focused transdiagnostic intervention. The sample included 314 trauma-exposed veterans (38% male; 64% non-Hispanic White) who screened positive for elevated symptoms of posttraumatic stress disorder and/or depression. Latent change score modeling examined prospective relationships between changes from pre-to-mid and mid-to-post treatment in four potential mechanisms (emotion regulation, interpersonal problems, posttraumatic stress disorder symptoms, and depression symptoms) and the association of these changes with overall functional improvement (at posttreatment and follow-up). RESULTS Emotion regulation change during the first half of treatment predicted interpersonal and symptom improvements during the second half of treatment, but not vice versa. Changes in each potential mechanism were uniquely associated with functional improvement and together statistically accounted for 78% additional variance in functional improvement beyond what was associated with baseline functioning and covariates. CONCLUSIONS Results support emotion regulation as an early mechanism of transdiagnostic therapeutic change in web-based version of Skills Training in Affective and Interpersonal Regulation and highlight the relevance of all four potential mechanisms to functional improvement. The study contributes to an understanding of how change occurs in skills-focused interventions for trauma-exposed individuals. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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在基于网络的情感和人际调节技能训练 （webSTAIR） 版本中为创伤暴露的退伍军人更改与功能改进相关的过程。


目的 尽管有证据表明症状减轻和功能改善对于支持创伤恢复都很重要，但心理治疗过程研究主要集中在症状减轻的机制上。更好地了解强调功能改善而不是创伤处理的治疗如何发生变化，对于优化有效的、以患者为中心的护理至关重要。方法 本研究涉及对在情感和人际调节技能训练的 10 个模块的基于网络的技能训练的三个多中心试验中收集的数据进行二次分析，这是一种以技能为重点的跨诊断干预。样本包括 314 名遭受创伤的退伍军人（38% 为男性;64% 为非西班牙裔白人），他们对创伤后应激障碍和/或抑郁症的症状升高筛查呈阳性。潜在变化评分模型检查了四种潜在机制 （情绪调节、人际关系问题、创伤后应激障碍症状和抑郁症状） 治疗前到中期和中到治疗后变化之间的前瞻性关系，以及这些变化与整体功能改善的关联 （在治疗后和随访中）。结果 治疗前半期的情绪调节变化可预测治疗后半期的人际关系和症状改善，反之则不然。每种潜在机制的变化都与功能改善独特相关，并且在统计上共同占功能改善超出基线功能和协变量相关差异的 78% 的额外方差。 结论 结果支持情绪调节是情感和人际调节技能训练中基于网络的跨诊断治疗变化的早期机制，并强调了所有四种潜在机制与功能改善的相关性。该研究有助于了解针对创伤暴露个体的以技能为重点的干预措施中如何发生变化。（PsycInfo 数据库记录 （c） 2024 APA，保留所有权利）。