Active duty and ex-serving military personnel with post-traumatic stress disorder treated with psychological therapies: systematic review and meta-analysis
Review to determine which psychological therapies are efficacious in treating active duty and ex-serving military personnel with PTSD.
Article Abstract
“Background: Post-traumatic stress disorder (PTSD) is a major cause of morbidity amongst active duty and ex-serving military personnel. In recent years increasing efforts have been made to develop more effective treatments.
Objective: To determine which psychological therapies are efficacious in treating active duty and ex-serving military personnel with post-traumatic stress disorder (PTSD).
Method: A systematic review was undertaken according to Cochrane Collaboration Guidelines. The primary outcome measure was reduction in PTSD symptoms and the secondary outcome dropout.
Results: Twenty-four studies with 2386 participants were included. Evidence demonstrated that CBT with a trauma focus (CBT-TF) was associated with the largest evidence of effect when compared to waitlist/usual care in reducing PTSD symptoms post treatment (10 studies; n = 524; SMD −1.22, −1.78 to −0.66). Group CBT-TF was less effective when compared to individual CBT-TF at reducing PTSD symptoms post treatment (1 study; n = 268; SMD −0.35, −0.11 to −0.59). Eye Movement Desensitization and Reprocessing (EMDR) therapy was not effective when compared to waitlist/usual care at reducing PTSD symptoms post treatment (4 studies; n = 92; SMD −0.83, −1.75 to 0.10). There was evidence of greater dropout from CBT-TF therapies compared to waitlist and Present Centred Therapy.
Conclusions: The evidence, albeit limited, supports individual CBT-TF as the first-line psychological treatment of PTSD in active duty and ex-serving personnel. There is evidence for Group CBT-TF, but this is not as strong as for individual CBT-TF. EMDR cannot be recommended as a first line therapy at present and urgently requires further evaluation. Lower effect sizes than for other populations with PTSD and high levels of drop-out suggest that CBT-TF in its current formats is not optimally acceptable and further research is required to develop and evaluate more effective treatments for PTSD and complex PTSD in active duty and ex-serving military personnel.
HIGHLIGHTS
- PTSD is a common psychiatric condition amongst active duty and ex-serving military personnel.
- Evidence supports individual CBT-TF as the first-line psychological treatment of PTSD in active duty and ex-serving personnel.
- High levels of drop-out suggest that CBT-TF in its current formats of delivery is not optimally acceptable to active duty and ex-serving military personnel.
- EMDR currently cannot be recommended as a first line therapy for active duty and ex-serving military personnel and further evaluation is urgently required.”
—Description from publisher
Article Access
Open Access
Kitchiner, N. J., Lewis, C., Roberts, N. P., & Bisson, J. I. (2019). Active duty and ex-serving military personnel with post-traumatic stress disorder treated with psychological therapies: systematic review and meta-analysis. European Journal of Psychotraumatology, 10(1):1684226. https://doi.org/10.1080/20008198.2019.1684226
Date
November 8, 2019
Creator(s)
Neil J. Kitchiner, Catrin Lewis, Neil P. Roberts
Contributor(s)
Jonathan I. Bisson
Topics
PTSD
Client Population
Military/Veterans
Extent
17 pages
Publisher
Taylor & Francis
Rights
© 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
APA Citation
Kitchiner, N. J., Lewis, C., Roberts, N. P., & Bisson, J. I. (2019). Active duty and ex-serving military personnel with post-traumatic stress disorder treated with psychological therapies: systematic review and meta-analysis. European Journal of Psychotraumatology, 10(1). https://doi.org/10.1080/20008198.2019.1684226
Audience
EMDR Therapists, Other Mental Health Professionals
Language
English
Content Type
Article, Meta-analyses/Systematic Reviews, Peer-Reviewed
Access Type
External Resource, Open Access