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Cited by 201Posttraumatic Stress Disorder ResearchPsychotherapy Techniques and ApplicationsPsychoanalysis and Psychopathology Research

Early psychological intervention following recent trauma: a systematic review and meta-analysis

Open access
Roberts, Neil P., Kitchiner, Neil J., Kenardy, Justin, Lewis, Catrin E., Bisson, Jonathan I.·2019·European Journal of Psychotraumatology
DOI 10.1080/20008198.2019.1695486PMC PMC6913678
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Abstract

Background: Post-traumatic stress disorder (PTSD) is a common and debilitating disorder which has a significant impact on the lives of sufferers. A number of early psychological interventions have been developed to try to prevent chronic difficulties. Objective: The objective of this study was to establish the current evidence for the effectiveness of multiple session early psychological interventions aimed at preventing or treating traumatic stress symptoms beginning within three months of trauma exposure. Methods: Randomized controlled trials of early multiple session psychological interventions aimed at preventing or reducing traumatic stress symptoms of individuals exposed to a traumatic event, fulfiling trauma criteria for an ICD or DSM diagnosis of PTSD were identified through a search of the Cochrane Common Mental Disorders Group Clinical Trials Registers database, the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PsycINFO and PILOTS. Two authors independently extracted study details and data and completed risk of bias assessments. Analyses were undertaken using Review Manager software. Quality of findings were rated according to ‘Grades of Recommendation, Assessment, Development, and Evaluation’ (GRADE) and appraised for clinical importance. Results: Sixty-one studies evaluating a variety of interventions were identified. For individuals exposed to a trauma who were not pre-screened for traumatic stress symptoms there were no clinically important differences between any intervention and usual care. For individuals reporting traumatic stress symptoms we found clinically important evidence of benefits for trauma-focused cognitive-behavioural therapy (CBT-T), cognitive therapy without exposure and eye movement desensitization and reprocessing (EMDR). Differences were greatest for those diagnosed with acute stress disorder (ASD) and PTSD. Conclusions: There is evidence for the effectiveness of several early psychological interventions for individuals with traumatic stress symptoms following trauma exposure, especially for those meeting the diagnostic threshold for ASD or PTSD. Evidence is strongest for trauma-focused CBT.

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Crossref · 10.1080/20008198.2019.1695486

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98 of 98 references verified0 citation errors · 0 not checkable

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  • Certain early interventions, especially trauma-focused cognitive behavioral therapy, are effective at preventing PTSD.

    “A recent meta-analysis indicates that certain such interventions (especially trauma-focused cognitive behavioral therapy) are effective at preventing PTSD (Roberts et al., 2019)”

    From PTSD in the Year Following Sexual Assault: A Meta-Analysis of Prospective Studies (2023) · cites this paper as Roberts et al., 2019

    The Abstract (page unavailable) reports benefits from several early interventions for people already reporting traumatic stress symptoms, with the strongest evidence for trauma-focused CBT. It also finds no clinically important benefit over usual care for people who were not pre-screened for symptoms. The claim omits that distinction and presents the finding broadly as prevention of PTSD. (LLM, conf=0.88)

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  • 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 [78]

    The Discussion (Main findings; page not provided) reports that several interventions reduced traumatic stress symptoms among participants who were symptomatic when they entered the studies. But the Method (Study selection; page not provided) explicitly says that the presence or absence of symptoms was not used to determine whether a study was included. Thus, the effectiveness finding is supported, but the description of this review as having higher-risk-profile inclusion criteria is not. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Efforts to prevent PTSD in the aftermath of trauma exposure have long focused on the first three months post-trauma as a critical period for delivering interventions.

    “Efforts to prevent PTSD in the aftermath of trauma exposure have long focused on the first three months post-trauma as a critical period for delivering interventions (Roberts et al., 2019).”

    From PTSD in the Year Following Sexual Assault: A Meta-Analysis of Prospective Studies (2023) · cites this paper as Roberts et al., 2019

  • There are reviews that summarize interventions for individuals with a diagnosed mental health disorder, such as PTSD.

    “There are also a number of reviews that summarize interventions for individuals with a diagnosed mental health disorder, such as PTSD, e.g., [16,17].”

    From Promoting Recovery from Disasters, Pandemics, and Trauma: A Systematic Review of Brief Psychological Interventions to Reduce Distress in Adults, Children, and Adolescents (2023) · cites this paper as [16]

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Cites

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1 of the 99 references couldn’t be matched to a known paper.

Research works printed but not linked: 5

  1. Andre C., Lelord F., Legeron P., Reignier A., & Delattre A. (1997). Etude controlee sur l’efficacite a 6 mois d’une prise en charge precoce de 132 conducteurs d’autobus victims d’agression [Effectiveness of early intervention on 132 bus drivers victims of aggressions: A controlled trial]. L’Encephale, 23, 65– 25. 9172970
  2. Freedman S. (in press). Early telephone cognitive behavioral therapy (ET-CBT) for the prevention of PTSD. European Journal of Psychotraumatology.
  3. International Society for Traumatic Stress Studies (2018). Posttraumatic stress disorder prevention and treatment guidelines. Author Retrieved from http://www.istss.org/treating-trauma/new-istss-guidelines.aspx 31283056
  4. National Institute for Health and Care Excellence (2018). Evidence reviews for psychological, psychosocial and other non-pharmacological interventions for the prevention of PTSD in adults: NICE guideline NG116. Retrieved from https://www.nice.org.uk/guidance/ng116 32757552
  5. Review Manager (RevMan) [ Computer program]. (2014). Version 5.3 Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration.

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Authors
Roberts, N. P., Kitchiner, N. J., Kenardy, J., Lewis, C. E., & Bisson, J. I.
Affiliations
  • Cardiff and Vale University Health Board (GB)
  • The University of Queensland (AU)
  • Cardiff University (GB)
Corresponding author
Roberts, Neil P.
ORCID
Venue
European Journal of Psychotraumatology
Publisher
Informa UK Limited
Published
2019-12-06
Volume
10
Issue
1
Pages
1695486-1695486
ISSN
2000-8066 (ISSN-L)
DOI
10.1080/20008198.2019.1695486
PMC
PMC6913678
OpenAlex
W2992254139
Cited by
200
References
99
Citations by year
2026: 37 · 2025: 28 · 2024: 36 · 2023: 22 · 2022: 31 · 2021: 33 · 2020: 12 · 2019: 1
FWCI
3.05
Type
journal article
Language
en
Open access
Licence
Locations
  • European Journal of Psychotraumatology (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • ORCA Online Research @Cardiff (Cardiff University) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
International Society for Traumatic Stress Studies
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, acute stress disorder, early psychological intervention, trauma-focused cognitive behavioral therapy, EMDR, cognitive therapy, traumatic stress symptoms, trauma exposure

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