A Multidimensional Meta-Analysis of Psychotherapy for PTSD

Abstract

The majority of patients treated with psychotherapy for PTSD in randomized trials recover or improve, rendering these approaches some of the most effective psychosocial treatments devised to date. Several caveats, however, are important in applying these findings to patients treated in the community. Exclusion criteria and failure to address polysymptomatic presentations render generalizability to the population of PTSD patients indeterminate. The majority of patients posttreatment continue to have substantial residual symptoms, and follow-up data beyond very brief intervals have been largely absent. Future research intended to generalize to patients in practice should avoid exclusion criteria other than those a sensible clinician would impose in practice (e.g., schizophrenia), should avoid wait-list and other relatively inert control conditions, and should follow patients through at least 2 years.

A five-day inpatient EMDR treatment programme for PTSD: pilot study

“…Although the effect size in our pilot study was large at two weeks post-treatment, we note that the effect size was not as large as in other intensive treatments (e.g. Ehlers et al, 2014) and in regular, weekly trauma-focused treatment (Bradley et al, 2005). Identifying the optimal treatment format and duration is a subject for further study.…”

“…This effect should be placed in perspective, however, compared to previous meta-analyses of regular weekly treatments and other intensive treatment formats (e.g. Bradley et al, 2005; Ehlers et al, 2014; Hendriks et al, 2010). Bradley et al found that regular, weekly, trauma-focused treatment resulted in large effect sizes of 1.43.…”

“…However, several reviews and meta-analyses have shown that these treatments have large dropout and considerable non-response rates. In a review of treatment efficacy, Bradley, Greene, Russ, Dutra, and Westen (2005) report that the recovery rate of patients who entered treatment was only 56%, while 67% of treatment completers no longer met criteria for PTSD. For specific populations, such as military veterans, the recovery rate is even lower.…”

“…For specific populations, such as military veterans, the recovery rate is even lower. Only 40% of military veterans lose their PTSD diagnosis after receiving trauma-focused treatment (Bradley et al, 2005; Steenkamp, Litz, Hoge, & Marmar, 2015). Imel, Laska, Jakupcak, and Simpson (2013) found an average dropout of 18% among 44 studies, yet indicated that dropout rates varied quite dramatically across studies.…”

The role of automatic defensive responses in the development of posttraumatic stress symptoms in police recruits: protocol of a prospective study

“…Given the high incidence of (subsyndromal) PTSD symptoms in police officers (Carlier & Gersons, 1992) and insufficient response to currently available psychotherapies for PTSD (Bradley, Greene, Russ, Dutra, & Westen, 2005), revealing neurobiological mechanisms underlying the development and persistence of trauma-related psychopathology is highly relevant. The approach of our study has several noteworthy characteristics.…”