The Development and Refinement of Web-based Interventions to Reduce Distress among Survivors of Interpersonal Violence

Abstract

Many college students have a history of interpersonal violence (IPV) and are thus at risk of greater mental health problems and dropout. The present two studies evaluated the efficacy of web-based stress management programs targeting present control in promoting well-being among students with and without a history of IPV. In the first study, a previously-developed Present Control Intervention (Hintz, Frazier, & Meredith, 2015) was evaluated. Psychology students from a large Midwestern university were randomly assigned in a 2:1 ratio to the web-based stress management intervention (n = 329) or the waitlist comparison group (n = 171). In the second study, the efficacy of two new versions of the intervention was evaluated relative to the original intervention. Students (N = 314) were randomly assigned to one of three conditions: the original Present Control Intervention, an Enhanced Present Control Intervention based on Solie (2013), or a Present Control and Mindfulness Intervention. In both studies, IPV history was assessed preintervention, and self-report measures of four outcomes (perceived stress; symptoms of depression, anxiety, and stress) were completed online pre and postintervention. Worry was also examined as an outcome in the second study. The first study assessed two proposed mediators of intervention efficacy (present control and rumination), which were measured online pre and postintervention. In the first study, the intervention group reported less distress than the comparison group at posttest but effects were larger in the IPV group (mean d = .44) than in the No IPV group (mean d = .10). Increases in present control mediated intervention effects in both the IPV and No IPV groups; decreases in rumination mediated intervention effects in the IPV group only. In the second study, analyses of covariance assessed whether there were differences in efficacy across the three conditions or interactions between intervention condition and IPV status suggesting that the IPV and No IPV groups responded differently to the three interventions. There were significant Condition by IPV interactions for distress symptoms and worry. Paired t-tests suggested that the two new versions of the intervention were more effective than the original intervention and that the Enhanced Present Control Intervention decreased symptoms the most among students with an IPV history (mean within-group d = -.48). These studies provide evidence that web-based universal prevention stress management programs may be a cost-effective way to teach skills to students with an IPV history