Recruiting participants (18+) for an internet based study about the treatment of Adverse Childhood Experiences

[xlevy]

Hello,

I am currently recruiting participants (18+) for a study about adults who previously experienced Adverse Childhood Experiences (such as abuse, neglect or assault). You will be asked questions about your childhood experiences, about your physical and mental health as well as any psychological treatments you have sought.

Some questions are of a sensitive nature and it may not be immediately clear why we are asking them. However, it is important for our research that you answer them fully and honestly.

All participants will remain anonymous and any question can be skipped. The study has been approved by the Newman University Ethics board and is being supervised by Dr Stuart Ross.

The aim of this study is to identify if there is an existing psychological treatment to help those who have had Adverse Childhood Experiences as this has been linked to poor physical and mental health.

If you have any questions please feel free to contact me at levy401@newman.ac.uk

https://www.esurveycreator.co.uk/s/Adve ... xperiences

Thank you!

[miriam]

I was a bit sceptical about the sensitive topics and whether it was ethical to recruit when limited real learning would be gained from a study that might reopen trauma for participants, but having done it I think this is quite an interesting study.

Please think a little bit more about your language in the recruitment post, explanation of study and debriefing text:

1) Above you say "if there is an existing psychological treatment to help those who have had Adverse Childhood Experiences as this has been linked to poor physical and mental health" this is quite simplistic (see below) and it would better reflect the evidence to say "which are common negative experiences that have been linked to elevated risks of poor physical and mental health". This theme also needs to be addressed in the information and consent section. See my blog about the misrepresentation of risk in discussion about ACEs in which I have to remind people who should know better about outcome multipliers that elevated risk is not inevitability (otherwise I'm doomed by my weight, asthma or blood pressure as each can increase the risk of adverse health outcomes or premature morbidity).
2) The title "Investigating a treatment for Adverse Childhood Experiences" suggests there would be a single universal treatment modality when all the evidence suggests that when it comes to therapy it is the quality of the relationship and the therapist's ability to really hear and connect with your experience that makes the difference, not the content or modality. I'd suggest you remove the "a".
3) "The purpose of this study is to identify a treatment that works for the majority of people who have had these experiences" again sounds like Lily the Pink. You are actually exploring the efficacy and availability of different treatment options for people who have had these experiences, which are incredibly common - more so than most people think.
4) "any psychological treatments (including medication) you have sought" isn't quite right either. Medication isn't a psychological treatment, and there is a difference between seeking and accessing/using services. I think you mean "any psychological treatments or medication related to your mental state you have tried / used".
5) "(if you have never experienced a panic attack please leave the following questions blank)" would make more sense as "(if you have never experienced a panic attack please leave the rest of the questions on this page blank)
6) You ask about alcohol but not substance misuse, this seemed a significant omission
7) "any of the disorders discussed" in debrief makes no sense, as you've not mentioned any diagnostic labels

This also needed a bit of checking before you set it live. There are a few obvious mistakes in the survey layout:

1) missing page break before asking about treatments. The explanation "For the following section you will be asked about the types of treatment you have accessed. This includes counselling, medication and self help" should be at the top of a new page
2) missing question after "Have you ever accessed Self help?" - you don't give a yes/no radio button option, and the box is presumably meant for people to enter information about what self-help materials or techniques they have tried, but no explanation is given
3) life coaching "do you have any other comments about this treatment?" is a yes/no button, not a text box
4) "Have you ever accessed another type of treatment not mentioned in the questionnaire or you cannot remember the type of treatment you accessed? Please specify" needs to be a yes/no radio button followed by a text box for "please specify"

[Spatch]

Miriam, I think a career as a DClin research tutor would have suited you.

While I agree with your comments, its definitely evokes some of my inner rebel.

"Investigating a treatment for Adverse Childhood Experiences" suggests there would be a single universal treatment modality when all the evidence suggests that when it comes to therapy it is the quality of the relationship and the therapist's ability to really hear and connect with your experience that makes the difference, not the content or moda

While this is the conclusion of Roth and Fonagy clearly what the evidence tends to suggest across all therapies at the moment, could there ever be in the future a possible single treatment modality that trumps everything? (Personally, I'd like to think so, and ideally I would also quite like to invent it).

Medication isn't a psychological treatment

Currently no one considers medication as a psychological intervention, but perhaps we should. There are clear psychological factors in drug prescribing such as placebo effect, patient beliefs around drug efficacy and the importance of bedside manner in terms of medication adherence. Then there are issues around addiction, tolerance of side effects and similar. Perhaps we should strike at the heart of the medical model and start demand people see prescription as much as a "psychological contract" as it is imbibing pills.

[xlevy]

Hello!

Thank you for replying to my post, I have made some edits to my study!

1. It is quite simplistic to state that ACEs have been linked to poor mental and physical health. ACEs have been found to increase an individual’s risk of developing a number of mental and physical health conditions. Brown et al. (2009) found that individuals who experienced 6 or more ACEs died on average almost 20 years earlier than the control group who did not experience ACEs. This is due to a multitude of health, social and economic factors however there is a graded response between number of ACEs experienced and higher levels of poor physical and mental health. It is not an inevitability, just an increased risk!
2. This is a good point! Ideally a single treatment would work for everyone but there are so many factors that impact the efficacy of treatment and so I have changed the title to “Investigting treatments for Adverse Childhood Experiences”.
3. I have now changed this to “The purpose of this study is to identify which treatment is most effective for the majority of people who have had these experiences (which is in part determined by the availability and efficacy of different treatment options)”.
4. I understand your point and the point that Spatch has made above. As with psychological intervention there are many factors that impact the efficacy of psychotropic medication. To make this easier for the general public to understand I have changed the wording to “...any psychological treatments or medication relating to your mental health or mental state that you have tried/used”.
5. I have edited the format of the panic attack section to make this easier for people who have not experienced panic attacks.
6. This is a significant omission. I have used the Patient Health Questionnaire in this study and it omits any mention of substances. I will include substance misuse in my future studies as substance misuse has been found to be common in those who experience ACEs.
7. I have changed this section to “If you believe you have experienced or witnessed any of the items discussed in this study...” to better account for this!

Thank you for pointing out the layout issues, I have edited it now!

[miriam]

Well done xlevy. Do come back and tell us the results of your research