{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:07:43Z","timestamp":1790784463867,"version":"4.1.0"},"reference-count":48,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Three-quarters of sexual assault (SA) survivors meet criteria for posttraumatic stress disorder (PTSD) 1 month after SA, and PTSD is highly comorbid with substance use disorders. Intervening early is critical to preventing the onset or escalation of these conditions.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess the preliminary effectiveness of Skills Training in Affective Recovery (STAR), a brief video, and TextSTAR, a 3-week daily text message program on reducing posttraumatic stress and substance misuse symptoms among SA survivors during an SA medical forensic examination.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This pilot sequential, multiple-assignment randomized clinical trial recruited women from 4 US SA medical forensic examination programs from March 12 to November 3, 2025, who had experienced past 7-day SA. Participants were randomized to the video program or treatment as usual (TAU; no video) at the SA medical forensic examination and reassessed at 1 week; nonresponders\u2014those above the threshold for acute stress or opioid misuse\u2014were randomized to the text program or no text program. Participants completed weekly follow-up surveys for 1 month. Data analysis was conducted from December 2025 to April 2026.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n The study\u2019s video program is a 17-minute video that educates and encourages social support, positive coping including mindfulness, and self-exposure to feared but safe stimuli. The study\u2019s text program is a 3-week daily text message program that emphasizes social support, positive coping, and exposure.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n \n Primary outcome of acute or posttraumatic stress was measured at 1 and 4 weeks via the\n Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders<\/jats:italic>\n (Fifth Edition). Primary outcome of drug use was measured at 1 and 4 weeks with the Tobacco, Alcohol, Prescription Medication, and Other Substance Use Part 1. Exploratory outcome of pain was measured at 1 and 4 weeks with the Brief Pain Inventory.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Fifty women (mean [SD] age, 28.9 [10.1] years) were enrolled in the study. Those randomized to the study\u2019s video program had lower odds of acute stress (odds ratio, 0.13; 95% CI, 0.02-0.78). Those randomized to the video program also had lower pain at 1 week (mean [SD] score, 2.1 [2.2]) compared with those assigned to TAU (mean [SD] score, 3.6 [2.6]). Linear regression revealed that the video (mean [SE] estimate, \u22120.25 [0.14];\n z<\/jats:italic>\n =\u2009\u22121.73;\n P<\/jats:italic>\n \u2009=\u2009.08) and text (mean [SE] estimate, \u22120.41 [0.14];\n z<\/jats:italic>\n =\u2009\u22122.95;\n P<\/jats:italic>\n \u2009=\u2009.003) programs were negatively associated with week 4 pain scores.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this preliminary randomized clinical study for recent SA survivors, the video program was associated with immediate reductions in acute stress and pain; the text program was associated with reductions in week 4 pain. These results suggest that the study\u2019s video and text programs were easy-to-administer interventions that can be used in the short-term clinical setting where survivors receive care in the immediate aftermath of SA.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT06456190<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.36353","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T15:30:44Z","timestamp":1790782244000},"page":"e2636353","source":"Crossref","is-referenced-by-count":0,"title":["Skills Training in Affective Recovery Video and Text Programs for Recent Sexual Assault Survivors"],"prefix":"10.1001","volume":"9","author":[{"given":"Kate","family":"Walsh","sequence":"first","affiliation":[{"name":"Department of Psychology and Gender and Women\u2019s Studies, University of Wisconsin, Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia A.","family":"Stappenbeck","sequence":"additional","affiliation":[{"name":"Department of Psychology, Georgia State University, Atlanta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Acierno","sequence":"additional","affiliation":[{"name":"Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, UTHealth Houston, Houston, Texas"},{"name":"Department of Veterans Affairs Healthcare System, Charleston, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Marie","family":"Schipani-McLaughlin","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. 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