TY - JOUR
T1 - The efficacy and acceptability of psychological interventions for adult PTSD: A network and pairwise meta-analysis of randomized controlled trials
AU - Hoppen, Thole Hilko
AU - Jehn, Marvin
AU - Holling, Heinz
AU - Mutz, Julian
AU - Kip, Ahlke
AU - Morina, Nexhmedin
N1 - Funding Information:
Julian Mutz received studentship funding from the Biotechnology and Biological Sciences Research Council (ref: 2050702) and Eli Lilly and Company Limited. Julian Mutz is funded by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley National Health Service (NHS) Foundation Trust and King’s College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care
Publisher Copyright:
© 2023 American Psychological Association
PY - 2023/8/1
Y1 - 2023/8/1
N2 - Objective: A comprehensive quantitative summary of the efficacy and acceptability of psychological interventions (PIs) for adult posttraumatic stress disorder (PTSD) is lacking. Method: We conducted a systematic literature search to identify randomized controlled trials (RCTs) examining the efficacy and acceptability (allcause dropout) of psychological interventions (i.e., trauma-focused cognitive behavior therapy [TF-CBT], eye movement desensitization and reprocessing [EMDR], other trauma-focused interventions and non-traumafocused interventions). Results: One hundred fifty-seven RCTs were included comprising 11,565 patients. Most research (64% of RCTs) accumulated for TF-CBT. In network meta-analyses, all therapies were effective when compared to control conditions. Interventions did not differ significantly in their efficacy. Yet, TF-CBT yielded higher short- (g = 0.17, 95% CI [0.03–0.31], number of comparisons kes = 190), mid- (i.e., ≤5 months posttreatment, g = 0.23, 95% CI [0.06–0.40], kes = 73) and long-term efficacy (i.e., >5 months posttreatment, g = 0.20, 95% CI [0.04–0.35], kes = 41) than non-trauma-focused interventions. There was some evidence of network inconsistencies, and heterogeneity in outcomes was large. In pairwise meta-analysis, slightly more patients dropped out from TF-CBT than non-trauma-focused interventions (RR = 1.36; 95% CI [1.08–1.70], kes = 22). Other than that, interventions did not differ in their acceptability. Conclusions: Interventions with and without trauma focus are effective and acceptable in the treatment of PTSD. While TF-CBT yields the highest efficacy, slightly more patients discontinued TF-CBT than non-trauma-focused interventions. Altogether, the present results align with results of most previous quantitative reviews. Yet, results need to be interpreted with caution in light of some network inconsistencies and high heterogeneity in outcomes.
AB - Objective: A comprehensive quantitative summary of the efficacy and acceptability of psychological interventions (PIs) for adult posttraumatic stress disorder (PTSD) is lacking. Method: We conducted a systematic literature search to identify randomized controlled trials (RCTs) examining the efficacy and acceptability (allcause dropout) of psychological interventions (i.e., trauma-focused cognitive behavior therapy [TF-CBT], eye movement desensitization and reprocessing [EMDR], other trauma-focused interventions and non-traumafocused interventions). Results: One hundred fifty-seven RCTs were included comprising 11,565 patients. Most research (64% of RCTs) accumulated for TF-CBT. In network meta-analyses, all therapies were effective when compared to control conditions. Interventions did not differ significantly in their efficacy. Yet, TF-CBT yielded higher short- (g = 0.17, 95% CI [0.03–0.31], number of comparisons kes = 190), mid- (i.e., ≤5 months posttreatment, g = 0.23, 95% CI [0.06–0.40], kes = 73) and long-term efficacy (i.e., >5 months posttreatment, g = 0.20, 95% CI [0.04–0.35], kes = 41) than non-trauma-focused interventions. There was some evidence of network inconsistencies, and heterogeneity in outcomes was large. In pairwise meta-analysis, slightly more patients dropped out from TF-CBT than non-trauma-focused interventions (RR = 1.36; 95% CI [1.08–1.70], kes = 22). Other than that, interventions did not differ in their acceptability. Conclusions: Interventions with and without trauma focus are effective and acceptable in the treatment of PTSD. While TF-CBT yields the highest efficacy, slightly more patients discontinued TF-CBT than non-trauma-focused interventions. Altogether, the present results align with results of most previous quantitative reviews. Yet, results need to be interpreted with caution in light of some network inconsistencies and high heterogeneity in outcomes.
UR - http://www.scopus.com/inward/record.url?scp=85165223502&partnerID=8YFLogxK
U2 - 10.1037/ccp0000809
DO - 10.1037/ccp0000809
M3 - Article
SN - 0022-006X
VL - 91
SP - 445
EP - 461
JO - Journal of Consulting and Clinical Psychology
JF - Journal of Consulting and Clinical Psychology
IS - 8
ER -