Prevention of chronic PTSD with early cognitive behavioral therapy. A meta-analysis using mixed-effects modeling
Abstract
Post-traumatic stress disorder (PTSD) is of great interest to public health, due to the high burden it places on both the individual and society. We meta-analyzed randomized-controlled trials to examine the effectiveness of early trauma-focused cognitive-behavioral treatment (TFCBT) for preventing chronic PTSD. Systematic bibliographic research was undertaken to find relevant literature from on-line databases (Pubmed, PsycINFO, Psyndex, Medline). Using a mixed-effect approach, we calculated effect sizes (ES) for the PTSD diagnoses (main outcome) as well as PTSD and depressive symptoms (secondary outcomes), respectively. Calculations of ES from pre-intervention to first follow-up assessment were based on 10 studies. A moderate effect (ES = 0.54) was found for the main outcome, whereas ES for secondary outcomes were predominantly small (ES = 0.27-0.45). The ES for the main outcome decreased to small (ES = 0.34) from first follow-up to long-term follow-up assessment. The mean dropout rate was 16.7% pre- to post-treatment. There was evidence for the impact of moderators on different outcomes (e.g., the number of sessions on PTSD symptoms). Future studies should include survivors of other trauma types (e.g., burn injuries) rather than predominantly survivors of accidents and physical assault, and should compare early TFCBT with other interventions that previously demonstrated effectiveness.
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There were 44 reviews of psychological interventions which reported on distress-related outcomes in the time following injury.
“There were 44 reviews of psychological interventions which reported on distress-related outcomes in the time following injury (online supplemental table 1).333541”
From Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: A scoping review of systematic reviews (2024) · cites this paper as [41]
Three reviews evaluated CBT following injury, and all reported CBT to improve distress-related outcomes, although overall quality of evidence was described as low.
“Three reviews evaluated CBT following injury,4143 and all reviews reported CBT to improve distress-related outcomes although, overall the quality of evidence was described as low.”
From Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: A scoping review of systematic reviews (2024) · cites this paper as [41]
Five reviews had inclusion criteria requiring studies to have included participants on the basis of identified risk or analysed these studies separately from studies that did not have such inclusion criteria.
“Five reviews had inclusion criteria requiring studies to have included participants on the basis of identified risk or analysed these studies separately from studies that did not have such inclusion criteria.41 42 73 77 78”
From Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: A scoping review of systematic reviews (2024) · cites this paper as [41]
The remaining two reviews that had inclusion criteria for studies to include participants on the basis of higher-risk profiles reported that interventions in this population were effective.
“Similarly, the remaining two reviews that had inclusion criteria for studies to include participants on the basis of higher-risk profiles reported that interventions in this population were effective.41 78”
From Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: A scoping review of systematic reviews (2024) · cites this paper as [41]
In five reviews of psychological interventions, higher levels of risk were a criterion for study inclusion.
“In five reviews of psychological interventions, higher levels of risk were a criterion for study inclusion.41 42 73 77 78”
From Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: A scoping review of systematic reviews (2024) · cites this paper as [41]
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- Authors
- Kliem, S., & Kröger, C.
- Affiliations
- Criminological Research Institute of Lower Saxony (DE)
- Technische Universität Braunschweig (DE)
- Corresponding author
- Kröger, Christoph
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2013-11
- Volume
- 51
- Issue
- 11
- Pages
- 753-761
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W2087996271
- Cited by
- 62
- References
- 85
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 5 · 2023: 5 · 2022: 6 · 2021: 4 · 2020: 4 · 2019: 5 · 2018: 10 · 2017: 5 · 2016: 7 · 2015: 5 · 2014: 4
- FWCI
- 0.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- chronic posttraumatic stress disorder, early intervention, trauma-focused cognitive behavioral therapy, PTSD prevention, depressive symptoms, treatment discontinuation, trauma survivors, accident survivors, burns
- MeSH terms
- Chronic Disease, Depression, Humans, Models, Psychological, Outcome and Process Assessment, Health Care, Stress Disorders, Post-Traumatic, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Early Medical Intervention
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