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Cited by 218Posttraumatic Stress Disorder ResearchPsychotherapy Techniques and ApplicationsMigration, Health and Trauma

Multiple session early psychological interventions for the prevention of post-traumatic stress disorder

Open access
Roberts, Neil P, Kitchiner, Neil J, Kenardy, Justin, Bisson, Jonathan I·2009·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd006869.pub2PMC PMC6699654
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Abstract

BACKGROUND: The prevention of long-term psychological distress following traumatic events is a major concern. Systematic reviews have suggested that individual psychological debriefing is not an effective intervention at preventing post-traumatic stress disorder (PTSD). Over the past 20 years, other forms of intervention have been developed with the aim of preventing PTSD. OBJECTIVES: To examine the efficacy of psychological interventions aimed at preventing PTSD in individuals exposed to a traumatic event but not identified as experiencing any specific psychological difficulties, in comparison with control conditions (e.g. usual care, waiting list and no treatment) and other psychological interventions. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO and ProQuest's Published International Literature On Traumatic Stress (PILOTS) database to 3 March 2018. An earlier search of CENTRAL and the Ovid databases was conducted via the Cochrane Common Mental Disorders Controlled Trial Register (CCMD-CTR) (all years to May 2016). We handsearched reference lists of relevant guidelines, systematic reviews and included study reports. Identified studies were shared with key experts in the field.We conducted an update search (15 March 2019) and placed any new trials in the 'awaiting classification' section. These will be incorporated into the next version of this review, as appropriate. SELECTION CRITERIA: We searched for randomised controlled trials of any multiple session (two or more sessions) early psychological intervention or treatment designed to prevent symptoms of PTSD. We excluded single session individual/group psychological interventions. Comparator interventions included waiting list/usual care and active control condition. We included studies of adults who experienced a traumatic event which met the criterion A1 according to the Diagnostic and Statistical Manual (DSM-IV) for PTSD. DATA COLLECTION AND ANALYSIS: We entered data into Review Manager 5 software. We analysed categorical outcomes as risk ratios (RRs), and continuous outcomes as mean differences (MD) or standardised mean differences (SMDs), with 95% confidence intervals (CI). We pooled data with a fixed-effect meta-analysis, except where there was heterogeneity, in which case we used a random-effects model. Two review authors independently assessed the included studies for risk of bias and discussed any conflicts with a third review author. MAIN RESULTS: = 0%; studies = 2; participants = 414) or quality of life (MD -0.03, 95% CI -0.06 to 0.00; studies = 1; participants = 239).None of the included studies reported on adverse events or use of health-related resources. AUTHORS' CONCLUSIONS: While the review found some beneficial effects of multiple session early psychological interventions in the prevention of PTSD, the certainty of the evidence was low due to the high risk of bias in the included trials. The clear practice implication of this is that, at present, multiple session interventions aimed at everyone exposed to traumatic events cannot be recommended. There are a number of ongoing studies, demonstrating that this is a fast moving field of research. Future updates of this review will integrate the results of these new studies.

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Authors
Roberts, N. P., Kitchiner, N. J., Kenardy, J., & Bisson, J. I.
Affiliations
  • Cardiff and Vale University Health Board (GB)
  • The University of Queensland (AU)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2009-07-08
Volume
8
Issue
3
Pages
CD006869-CD006869
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd006869.pub2
PMC
PMC6699654
OpenAlex
W2099768839
Cited by
218
References
111
Citations by year
2026: 1 · 2025: 6 · 2024: 13 · 2023: 7 · 2022: 11 · 2021: 20 · 2020: 13 · 2019: 14 · 2018: 8 · 2017: 11 · 2016: 9 · 2015: 20 · 2014: 19 · 2013: 15 · 2012: 11
FWCI
2.28
Type
journal article
Language
en
Update notices
new_version (2019-08-08)
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
Keywords
post-traumatic stress disorder, PTSD prevention, early psychological intervention, traumatic events, psychological debriefing
MeSH terms
Desensitization, Psychologic, Female, Humans, Male, Psychotherapy, Brief, Stress Disorders, Post-Traumatic, Time Factors, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic

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