Sayad Jafar Ahmadi, PhD

Credit: Linkedin

Specific memory training for adolescent patients with psychiatric disorders might be more beneficial in alleviating psychiatric symptoms in depression and anxiety compared to a treatment as usual regimen.¹

A team, led by Sayad Jafar Ahmadi, PhD, Bard College, identified the efficacy of Memory Training for Recovery-Adolescent(METRA) intervention for improving psychiatric symptoms of adolescent females in Afghanistan.

A Need for Interventions

There is a need for psychiatric interventions in the adolescent population worldwide, particularly in Afghanistan due to the ongoing humanitarian crisis.

“The Afghan humanitarian crisis is one of the world’s most complex and severe humanitarian emergencies,” the authors wrote. “The long history of armed conflict, poverty, and social injustice has impacted the mental health of Afghan youths, particularly girls.”

In the randomized, clinical trial, the investigators examined 125 pediatric patients aged 11-19 years with heightened psychiatric distress living in Kabul, Afghanistan. They also conducted a parallel-group trial comparing METRA with treatment as usual.

The mean age of the patient population was 15.96 years.

There was a 3 month follow-up.

A Different Therapy

In the METRA group (n = 80), each participant received a 10-session group-intervention with 2 modules. The first module involved memory specificity and the second module involved trauma writing over 2 weeks. The treatment as usual (n = 45) group received 10 group adolescent health sessions over 2 weeks.

The investigators sought primary outcome measures of self-reported posttraumatic stress disorder (PTSD) and depression symptoms following the intervention. They also looked at various secondary outcomes, including self-reported measures of anxiety, Afghan-cultural distress symptoms, and psychiatric difficulties.

The investigators assessed the data at baseline, after modules 1 and 2, and 3 months after treatment.

The Comparison

The results from the intention-to-treat principal, the METRA group had a 17.64 decrease (95% confidence interval [CI], -20.38 to -14.91 points) in PTSD symptoms, as well as a 6.73 point decrease in depressive symptoms (95% CI, -8.50 to -4.95 points). The decreases were larger than what was found in the treatment as usual group.

Here, the results show a 3.34 point decrease in PTSD symptoms (95% CI, -6.05 to -0.62 points) and a 0.66-point increase in depressive symptoms (95% CI, -0.70 to 2.01 points). The group x time interactions were significant (all P <.001).

Participants in the METRA group also had significantly greater reductions in the secondary outcomes, including anxiety, Afghan-cultural distress symptoms, and psychiatric difficulties compared to the treatment as usual group.

The improvements were all maintained at the follow-up.

Finally, 22.5% (n = 18) of the METRA group dropped out, compared to 8.9% (n = 4) of the treatment as usual group.

“In this randomized clinical trial, those in the METRA group had significantly greater improvements in psychiatric symptoms relative to those in the TAU group,” the authors wrote. “METRA appeared to be a feasible and effective intervention for adolescents in humanitarian contexts.”

References:

Ahmadi SJ, Jobson L, Musavi Z, et al. Effect of the Memory Training for Recovery–Adolescent Intervention vs Treatment as Usual on Psychiatric Symptoms Among Adolescent Girls in Afghanistan: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(3):e236086. doi:10.1001/jamanetworkopen.2023.6086