Efficacy of mobile application interventions for the treatment of post-traumatic stress disorder: A systematic review

Abstract

Background Many adults with post-traumatic stress disorder (PTSD) are unable to access healthcare services for treatment due to logistical, social, and attitudinal barriers. Interventions delivered via mobile applications (apps) may help overcome these barriers. Objective The aim of this study is to systematically evaluate the most recent evidence from trials investigating the efficacy of mobile apps for treating PTSD. Methods PubMed, Web of Science, Embase, PsycINFO, and Medline were searched in February 2018. Randomised controlled trials (RCTs) were included if they quantitatively evaluated the efficacy of a mobile app for treating PTSD as part of the primary aim. Findings were presented in a narrative synthesis. Results In the five identified RCTs, the use of app-based interventions appeared to be associated with reductions in PTSD symptoms. However, the strength of evidence for this association appeared to be inconsistent, and there was little evidence that those using the apps experienced greater reductions in PTSD symptoms than those in control conditions. Nonetheless, there was some evidence that app-based interventions are both a feasible and acceptable treatment pathway option. Conclusions Included studies were often limited by small sample sizes, brief intervention, and follow-up periods, and self-reported measures of PTSD. Evidence for the efficacy of mobile interventions for treating PTSD was inconclusive, but promising. Healthcare professionals should exercise caution in recommending app-based interventions until the potentially adverse effects of app use are better understood and larger-scale studies have taken place.

‘Help for trauma from the app stores?’ A systematic review and standardised rating of apps for Post-Traumatic Stress Disorder (PTSD)

“…The median of the user ratings (maximum five stars) was 4.3 (M = 4.2, SD = 0.7) (last updated on 15 May 2019). One app ('PTSD coach') was evaluated in several studies, including an RCT (Kuhn et al, 2017(Kuhn et al, , 2018Miner et al, 2016;Possemato et al, 2016;Wickersham, Petrides, Williamson, & Leightley, 2019). The 'CBT-I coach' app was evaluated in a feasibility pilot RCT (Koffel et al, 2018).…”

Efficacy of Self-Management Smartphone-Based Apps for Post-traumatic Stress Disorder Symptoms: A Systematic Review and Meta-Analysis

“…It is discernable that this field of research is underpowered and conclusions about the benefits of smartphone-based applications cannot be drawn on single trials alone. A recent study (Wickersham et al, 2019) reviewed the efficacy of mobile interventions, both self-managed and with clinician support, for the treatment of PTSD symptoms in randomized controlled trials (RCTs) and found inconclusive yet promising results, with a decrease of symptoms in app-based treatments, but not compared to control groups. To evaluate the efficacy of self-managed apps alone, further granulation and metaanalysis of individual studies is needed.…”

Digital-Based Interventions for Complex Post-Traumatic Stress Disorder: Protocol for a Systematic Literature Review

“…In contrast, eight systematic reviews and meta-analyses investigating DBIs for non-complex PTSD have been published since 2016 (Kuester et al, 2016;Lewis et al, 2019;Sijbrandij et al, 2016;Simblett et al, 2017;Simon et al, 2019;Turgoose et al, 2018;Wickersham et al, 2019;Young & Campbell, 2018), with a ninth currently under development (Steubl et al, 2019). Across these reviews, the literature supports the effectiveness of internet-based CBT (i-CBT) for reducing symptoms of PTSD, showing superiority to TAU/waitlist conditions, and equal effectiveness to in-person CBT (Knaevelsrud & Maercker, 2007;Kuester et al, 2016;Lewis et al, 2018;Lewis et al, 2019;Sijbrandij et al, 2016;Simblett et al, 2017;Young & Campbell, 2018).…”