The DOI matches its Crossref record; 76 of the 76 references it cites were found in a registry or an index.
Meta-analysis of dropout in treatments for posttraumatic stress disorder
Open accessAbstract
OBJECTIVE: Many patients drop out of treatments for posttraumatic stress disorder (PTSD); some clinicians believe that trauma-focused treatments increase dropout. METHOD: We conducted a meta-analysis of dropout among active treatments in clinical trials for PTSD (42 studies; 17 direct comparisons). RESULTS: The average dropout rate was 18%, but it varied significantly across studies. Group modality and greater number of sessions, but not trauma focus, predicted increased dropout. When the meta-analysis was restricted to direct comparisons of active treatments, there were no differences in dropout. Differences in trauma focus between treatments in the same study did not predict dropout. However, trauma-focused treatments resulted in higher dropout compared with present-centered therapy (PCT), a treatment originally designed as a control but now listed as a research-supported intervention for PTSD. CONCLUSION: Dropout varies between active interventions for PTSD across studies, but variability is primarily driven by differences between studies. There do not appear to be systematic differences across active interventions when they are directly compared in the same study. The degree of clinical attention placed on the traumatic event does not appear to be a primary cause of dropout from active treatments. However, comparisons of PCT may be an exception to this general pattern, perhaps because of a restriction of variability in trauma focus among comparisons of active treatments. More research is needed comparing trauma-focused interventions to trauma-avoidant treatments such as PCT.
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“This focus may lead to low adherence to treatment and high dropout rates (Imel et al., 2013; Garcia et al., 2011).”
From Efficacy and mechanisms of mobile application-delivered Acceptance and Commitment Therapy for posttraumatic stress disorder in China: Study protocol for a randomized controlled trial (2022) · cites this paper as Imel et al., 2013
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“Imel et al. (2013) did find evidence across three relatively large trials that dropout is lower in present centered therapy (PCT; 22%) compared to trauma specific treatments (36%).”
From Treating PTSD: A Review of Evidence-Based Psychotherapy Interventions (2018) · cites this paper as Imel et al., 2013
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“In addition, an increase in trauma focus did not predict an increase in the dropout rate.”
From Treating PTSD: A Review of Evidence-Based Psychotherapy Interventions (2018) · cites this paper as Imel et al., 2013
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“The aggregate proportion of dropout across all active treatments was 18.28%, however, there was a large amount of variability across studies.”
From Treating PTSD: A Review of Evidence-Based Psychotherapy Interventions (2018) · cites this paper as Imel et al., 2013
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BackgroundA Multidimensional Meta-Analysis of Psychotherapy for PTSD
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MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study
Mitchell, J. M., Bogenschutz, M., Lilienstein, A., Harrison, C., Kleiman, S., Parker-Guilbert, K., Ot’alora G., M., Garas, W., Paleos, C., Gorman, I., et al. (2021) · Nature Medicine · doi:10.1038/s41591-021-01336-3 · Cited by 1,004
Carpenter, J. K., Andrews, L. A., Witcraft, S. M., Powers, M. B., Smits, J. A. J., & Hofmann, S. G. (2018) · Depression and Anxiety · doi:10.1002/da.22728 · Cited by 846
Treating PTSD: A Review of Evidence-Based Psychotherapy Interventions
Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2018.00258 · Cited by 563
Mindfulness Meditation and Psychopathology
Wielgosz, J., Goldberg, S. B., Kral, T. R. A., Dunne, J. D., & Davidson, R. J. (2019) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-021815-093423 · Cited by 435
Lewis, C., Roberts, N. P., Gibson, S., & Bisson, J. I. (2020) · European Journal of Psychotraumatology · doi:10.1080/20008198.2019.1709709 · Cited by 382
Metadata
- Authors
- Imel, Z. E., Laska, K., Jakupcak, M., & Simpson, T. L.
- Affiliations
- University of Utah (US)
- Edith Nourse Rogers Memorial Veterans Hospital (US)
- VA Puget Sound Health Care System (US)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2013
- Volume
- 81
- Issue
- 3
- Pages
- 394-404
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- PMC
- PMC3893277
- OpenAlex
- W2136341379
- Cited by
- 633
- References
- 76
- Citations by year
- 2026: 40 · 2025: 53 · 2024: 59 · 2023: 52 · 2022: 60 · 2021: 60 · 2020: 86 · 2019: 61 · 2018: 51 · 2017: 30 · 2016: 34 · 2015: 28 · 2014: 15 · 2013: 2
- FWCI
- 3.89
- Type
- journal article
- Language
- en
- Update notices
- correction (2016-08-15)
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1RR025014)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- post-traumatic stress disorder, treatment discontinuation, trauma-focused psychotherapy, present-centered therapy, group therapy, number of treatment sessions, medication adherence
- MeSH terms
- Humans, Patient Dropouts, Psychotherapy, Stress Disorders, Post-Traumatic
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