INVESTIGATING ASSOCIATIONS BETWEEN ENGAGEMENT QUALITY AND SYMPTOM IMPROVEMENT IN TRAUMA-FOCUSED DIGITAL THERAPIES

Abstract

Posttraumatic Stress Disorder (PTSD) remains undertreated despite the efficacy of evidence-based therapies like Prolonged Exposure (PE) and Written Exposure Therapy (WET), largely due to access barriers and high attrition rates. This study introduces a novel engagement quality rating scale and presents preliminary data from a digital trauma-focused intervention (RainFrog) delivered to 47 college students with elevated PTSD symptoms. A piecewise multilevel model revealed greater symptom reductions in participants who engaged in imaginal exposure (IE) modules compared to participants who dropped out early. Exploratory analyses suggested a positive correlation between engagement quality, as assessed via the novel scale, and symptom improvement. Findings highlight the importance of measuring engagement quality to optimize outcomes in digital PTSD treatments.