Preventing the onset of post traumatic stress disorder

Bisson, Jonathan I.; Wright, Laurence Astill; Jones, Kimberley A.; Lewis, Catrin; Phelps, Andrea J.; Sijbrandij, Marit; Varker, Tracey; Roberts, Neil P.

doi:10.1016/j.cpr.2021.102004

Cited by 85Posttraumatic Stress Disorder ResearchTraumatic Brain Injury ResearchMigration, Health and Trauma

Preventing the onset of post traumatic stress disorder

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Bisson, Jonathan I., Wright, Laurence Astill, Jones, Kimberley A., Lewis, Catrin, Phelps, Andrea J., Sijbrandij, Marit, Varker, Tracey, Roberts, Neil P.·2021·Clinical Psychology Review

DOI 10.1016/j.cpr.2021.102004

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Abstract

Post-traumatic stress disorder (PTSD) is a common mental health condition that requires exposure to a traumatic event. This provides unique opportunities for prevention that are not available for other disorders. The aim of this review was to undertake a systematic review and evaluation of randomized controlled trials (RCTs) of interventions designed to prevent PTSD in adults. Searches involving Cochrane, Embase, Medline, PsycINFO, PILOTS and Pubmed databases were undertaken to identify RCTs of pre-incident preparedness and post-incident interventions until May 2019. Six pre-incident and 69 post-incident trials were identified that could be included in meta-analyses. The overall quality of the evidence was low. There was emerging evidence that some interventions may be helpful but an absence of evidence for any intervention that can be strongly recommended for universal, selected or indicated prevention before or within the first three months of a traumatic event. The strongest results were found for cognitive-behavioural therapy with a trauma focus (CBT-T) in individuals with a diagnosis of acute stress disorder which supports calls to detect and treat individuals with significant symptoms rather than providing blanket preventative interventions. Further research is required to optimally configure existing interventions with some evidence of effect and to develop novel interventions to address this major public health issue.

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Other pharmacological agents, including benzodiazepines, were not found to be effective in preventing PTSD.
“Other pharmacological agents, including benzodiazepines, were not found to be effective in preventing PTSD.333537”
From Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: A scoping review of systematic reviews (2024) · cites this paper as [35]
Section 3.5 (Pharmacological; page unavailable) reports that hydrocortisone was the only medication found superior to placebo for PTSD symptoms, and that other medications were not superior to placebo in the relative-risk analyses. The passages found do not identify benzodiazepines among the agents evaluated, so the specific claim about them is unsupported by our copy. (LLM, conf=0.83)
Experimental — accuracy not yet measured
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 [35]

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Authors: Bisson, J. I., Wright, L. A., Jones, K. A., Lewis, C., Phelps, A. J., Sijbrandij, M., Varker, T., & Roberts, N. P.
Affiliations: Cardiff University (GB)
The University of Melbourne (AU)
Vrije Universiteit Amsterdam (NL)
Cardiff and Vale University Health Board (GB)
Corresponding author: Bisson, Jonathan I.
ORCID: Bisson, Jonathan I.
Wright, Laurence Astill
Lewis, Catrin
Phelps, Andrea J.
Sijbrandij, Marit
Varker, Tracey
Roberts, Neil P.
Venue: Clinical Psychology Review
Publisher: Elsevier BV
Published: 2021-06
Volume: 86
Pages: 102004
ISSN: 0272-7358 (ISSN-L)
DOI: 10.1016/j.cpr.2021.102004
OpenAlex: W3136375277
Cited by: 85
References: 116
Citations by year: 2026: 13 · 2025: 16 · 2024: 30 · 2023: 10 · 2022: 13 · 2021: 3
FWCI: 1.86
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc-nd
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
creativecommons.org/licenses/by-nc-nd/4.0/ (vor)
Locations: Clinical Psychology Review (publishedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
VU Research Portal (publishedVersion, other-oa)
ORCA Online Research @Cardiff (Cardiff University) (acceptedVersion)
Minerva Access (University of Melbourne) (submittedVersion, cc-by-nc-nd)
Bristol Research (University of Bristol) (submittedVersion, cc-by-nc-nd)
Explore Bristol Research (submittedVersion, cc-by-nc-nd)
Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Funders: International Society for Traumatic Stress Studies
National Institute for Health and Care Research (ACF-2020-25-501)
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
Keywords: post-traumatic stress disorder, PTSD prevention, cognitive behavioral therapy, trauma-focused cognitive behavioral therapy, acute stress disorder, trauma exposure, universal prevention, indicated prevention
MeSH terms: Adult, Humans, Stress Disorders, Post-Traumatic, Cognitive Behavioral Therapy

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