Meta-analysis showed the effectiveness of psychotherapy for PTSD regardless of the number of traumas
A meta-analysis of 137 randomized trials found that psychological interventions are highly effective for post-traumatic stress disorder (PTSD) regardless of the number of traumatic events. As reported in The Lancet Psychiatry, cognitive-behavioral therapy had the most significant effect.
It is believed that about four percent of people worldwide suffer from PTSD. In this disorder, a person constantly relives intrusive traumatic memories that are accompanied by avoidance and negative changes in cognitive abilities and mood. In this case, exposure to multiple traumatic events is associated with a higher prevalence and severity of PTSD and greater difficulty with psychological recovery. Although many treatment regimens for PTSD have been developed that include pharmacotherapy and psychotherapy, the separate efficacy of psychological interventions is not fully known.
Previous meta-analyses of randomized controlled trials suggest that psychotherapeutic treatments for PTSD have large effects compared to passive control conditions and medium effects compared to active control conditions. However, no meta-analyses have investigated whether the effectiveness of psychological treatments for PTSD depends on the number of traumatic events.
A team of researchers led by Thole Hoppen from the University of Münster conducted a systematic review and meta-analysis of 137 randomized controlled trials that examined the effectiveness of psychotherapy in people with PTSD and varying numbers of traumatic events with a total sample of 10,684 participants with baseline data and 9,477 with post-treatment data. The mean age across all studies was 40.2 years, ranging from 18 years to 65.4. Most of the accumulated evidence involved participants from high-income countries. In about three of the four studies, the interventions were individualized and face-to-face.
The average number of sessions was 11 with an average session duration of 91 minutes. At the treatment endpoint, psychological interventions were highly effective for PTSD compared with passive control conditions in studies with a single trauma (Hedges' g 1.04) and in studies with multiple traumas (Hedges' g 1.13). Heterogeneity between studies was not significant.
Compared with active control conditions, at the treatment endpoint, psychotherapy had a moderate effect for both single (Hedges' g 0.78) and multiple injuries (Hedges' g 0.44). Adjustment for statistical covariates did not significantly affect the results. Trauma-focused cognitive-behavioral therapy showed the greatest efficacy on the treatment endpoint compared to non-trauma-focused interventions in studies with multiple traumas.
This study demonstrates that psychotherapy is effective for PTSD regardless of the number of prior traumatic events. In addition, the results of the meta-analysis demonstrate the high efficacy of cognitive-behavioral therapy in the correction of PTSD.