Impact of dissociation on the effectiveness of psychotherapy for post-traumatic stress disorder: meta-analysis

This meta-analysis examined the influence of dissociative symptoms on psychotherapy outcome in PTSD.

Article Abstract

“Background: Many patients with post-traumatic stress disorder (PTSD) experience dissociative symptoms. The question of whether these dissociative symptoms negatively influence the effectiveness of psychotherapy for PTSD is unresolved.

Aims: To determine the influence of dissociative symptoms on psychotherapy outcome in PTSD.
Method: We conducted a systematic search in Cochrane, Embase, PILOTS, PsycINFO, PubMed and Web of Science for relevant clinical trials. A random-effects meta-analysis examined the impact of dissociation on psychotherapy outcome in PTSD (pre-registered at Prospero CRD42018086575).
Results: Twenty-one trials (of which nine were randomised controlled trials) with 1714 patients were included. Pre-treatment dissociation was not related to treatment effectiveness in patients with PTSD (Pearson’s correlation coefficient 0.04, 95% CI −0.04 to 0.13). Between-study heterogeneity was high but was not explained by moderators such as trauma focus of the psychotherapy or risk of bias score. There was no indication for publication bias.
Conclusions: We found no evidence that dissociation moderates the effectiveness of psychotherapy for PTSD. The quality of some of the included studies was relatively low, emphasising the need for high-quality clinical trials in patients with PTSD. The results suggest that pre-treatment dissociation does not determine psychotherapy outcome in PTSD.”

—Description from publisher

Article Access

Open Access

Hoeboer, C. M., De Kleine, R. A., Molendijk, M. L., Schoorl, M., Oprel, D. A. C., Mouthaan, J., Van der Does, W., & Van Minnen, A. (2020). Impact of dissociation on the effectiveness of psychotherapy for post-traumatic stress disorder: meta-analysis. British Journal of Psychotherapy Open, 6(3), E53. Open access: https://doi.org/10.1192/bjo.2020.30

About the Journal

“BJPsych Open is a high-quality, online-only open access journal for the publication of all methodologically sound research in psychiatry and disciplines related to mental health.”

—Description from publisher

View the Resource

Date
May 19, 2020

Creator(s)
C. M. Hoeboer, R. A. De Kleine, M. L. Molendijk

Contributor(s)
M. Schoorl, D. A. C. Oprel, J. Mouthaan, W. Van der Does, A. Van Minnen

Topics
Dissociation, PTSD

Extent
8 pages

Publisher
Cambridge University Press

Rights
Copyright © The Authors, 2020. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

APA Citation
Hoeboer, C. M., De Kleine, R. A., Molendijk, M. L., Schoorl, M., Oprel, D. A. C., Mouthaan, J., Van der Does, W., & Van Minnen, A. (2020). Impact of dissociation on the effectiveness of psychotherapy for post-traumatic stress disorder: meta-analysis. British Journal of Psychotherapy Open, 6(3), E53. Open access: https://doi.org/10.1192/bjo.2020.30

Audience
EMDR Therapists, Other Mental Health Professionals

Language
English

Content Type
Article, Meta-analyses/Systematic Reviews, Peer-Reviewed

Access Type
External Resource, Open Access

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