Testing a Smartphone-Based Intervention Targeting Anxiety Sensitivity Among Women Presenting for Emergency Care After Sexual Assault: Pilot Randomized Controlled Trial
Clinical Snapshot
PICO Framework
| P — Population | Women with high anxiety sensitivity presenting for emergency care after sexual assault |
| I — Intervention | Smartphone-based anxiety sensitivity intervention |
| C — Comparator | Control condition (details not fully specified in abstract) |
| O — Outcomes | Anxiety sensitivity reduction, PTSD symptom reduction, intervention acceptability, feasibility measures |
Bottom Line
This pilot RCT examined a smartphone-based anxiety sensitivity intervention for women sexual assault survivors in emergency care. While the study demonstrated feasibility of recruitment and retention, methodological limitations prevent strong conclusions about efficacy. The finding that 81-89% of participants met criteria for probable PTSD highlights the critical need for early intervention in this population. Both intervention and control groups showed statistically significant symptom reductions at six months, though the unexpectedly large control effect complicates interpretation. Intervention acceptability was moderate (59% completion rate), comparable to traditional therapy. The smartphone delivery model offers potential advantages for accessibility and scalability in trauma care. However, the pilot nature, small sample size, poorly characterized control condition, and lack of effect size data limit clinical application. Larger definitive trials with better-controlled comparisons are needed before recommending implementation in clinical practice.
Key Findings
P Value: Statistically significant at 6 months (specific values not provided)
Effect Size: Not reported in abstract
Primary Outcome: Anxiety sensitivity and PTSD symptom reduction
Nnt Or Sensitivity: Not calculable from available data
Confidence Interval: Not reported
Clinical Application
Moderate - recruitment and retention feasible but intervention completion remains challenging Relevant to Australian emergency departments and sexual assault services; could complement existing CASA (Centres Against Sexual Assault) programs and align with trauma-informed care principles Women sexual assault survivors presenting to emergency departments with high anxiety sensitivity
Abstract
BACKGROUND: Anxiety sensitivity (AS), defined as the fear of anxious arousal, is a promising therapeutic target for reducing posttraumatic stress disorder (PTSD) symptom development after trauma exposure. Initial research suggests that smartphone-based AS interventions may be acceptable to sexual assault survivors at risk for PTSD symptoms and effective for symptom reduction, but only small one-arm proof-of-concept studies have been conducted. OBJECTIVE: The goal of this study was to extend prior proof-of-concept work by conducting a pilot randomized controlled trial. The aims were to evaluate intervention efficacy, AS and PTSD symptom change, the acceptability and credibility of a control intervention, and the feasibility of a larger randomized controlled trial. METHODS: A total of 60 women with high AS presenting for emergency care after sexual assault were recruited and randomized to either the AS intervention or a control condition, and they were followed up with for over 6 months via remote self-report questionnaires. RESULTS: The findings indicated that the study population is at risk and in need of intervention: 88.8% (40/45) and 80.6% (29/36) of women sexual assault survivors in the sample met the criteria for probable PTSD at 7 weeks and 6 months post assault, respectively. Most (16/27, 59.3%) individuals receiving the AS intervention who completed it rated it as acceptable (eg, 18/21, 85.7% reported that the treatment was helpful). Early within-group reductions were not statistically significant, but by month 6, statistically significant reductions in AS and PTSD symptoms were observed in both conditions. Recruitment and retention data supported the feasibility of the study design, although some suggestions were noted for future research (eg, improving intervention and ecological momentary assessment compliance). CONCLUSIONS: This pilot study replicated the proof of concept and acceptability of a novel smartphone-based intervention targeting AS delivered to women sexual assault survivors presenting to emergency care. Intervention completion was in line with or better than traditional therapy but remained a challenge. Our selected control condition demonstrated a larger effect than expected, and we were unable to track its initiation or completion, causing difficulty in drawing conclusions. Overall, the results highlight the need for additional research.
References
- 1.Short, N. A., Deguzman-Lucero, R., Weese, R., Chisam, N., Black, J., Serrano, K., & McLean, S. (2026). Testing a smartphone-based intervention targeting anxiety sensitivity among women presenting for emergency care after sexual assault: Pilot randomized controlled trial. JMIR Formative Research. https://doi.org/10.2196/86612
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