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Psychological interventions for ICD-11 complex PTSD symptoms: Systematic review and meta-analysis (Psychological Medicine, 2019)

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Home / Resources / Complex Trauma/C-PTSD / Psychological interventions for ICD-11 complex PTSD symptoms: Systematic review and meta-analysis (Psychological Medicine, 2019)

Psychological interventions for ICD-11 complex PTSD symptoms: Systematic review and meta-analysis

Review of interventions for patients with complex PTSD symptom clusters (affect dysregulation, negative self-concept, disturbed relationships).


Article Abstract

“Background: The 11th revision to the WHO International Classification of Diseases (ICD-11) identified complex post-traumatic stress disorder (CPTSD) as a new condition. There is a pressing need to identify effective CPTSD interventions.

Methods: We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) of psychological interventions for post-traumatic stress disorder (PTSD), where participants were likely to have clinically significant baseline levels of one or more CPTSD symptom clusters (affect dysregulation, negative self-concept and/or disturbed relationships). We searched MEDLINE, PsycINFO, EMBASE and PILOTS databases (January 2018), and examined study and outcome quality.

Results: Fifty-one RCTs met inclusion criteria. Cognitive behavioural therapy (CBT), exposure alone (EA) and eye movement desensitisation and reprocessing (EMDR) were superior to usual care for PTSD symptoms, with effects ranging from g = −0.90 (CBT; k = 27, 95% CI −1.11 to −0.68; moderate quality) to g = −1.26 (EMDR; k = 4, 95% CI −2.01 to −0.51; low quality). CBT and EA each had moderate–large or large effects on negative self-concept, but only one trial of EMDR provided useable data. CBT, EA and EMDR each had moderate or moderate–large effects on disturbed relationships. Few RCTs reported affect dysregulation data. The benefits of all interventions were smaller when compared with non-specific interventions (e.g. befriending). Multivariate meta-regression suggested childhood-onset trauma was associated with a poorer outcome.

Conclusions: The development of effective interventions for CPTSD can build upon the success of PTSD interventions. Further research should assess the benefits of flexibility in intervention selection, sequencing and delivery, based on clinical need and patient preferences.”

—Description from publisher

Article Access

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Karatzias, T., Murphy, P., Cloitre, M., Bisson, J., Roberts, N., Shevlin, M., Hyland, P., Maercker, A., Ben-Ezra, M., Coventry, P., Mason-Roberts, S., Bradley, A., & Hutton, P. (2019). Psychological interventions for ICD-11 complex PTSD symptoms: Systematic review and meta-analysis. Psychological Medicine, 49(11), 1761-1775.  https://doi.org/10.1017/S0033291719000436 

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Basic Info Collapse

Date
March 12, 2019

Creator(s)
Thanos Karatzias, Philip Murphy, Marylene Cloitre

Contributor(s)
Jonathan Bisson, Neil Roberts, Mark Shevlin, Philip Hyland, Andreas Maercker, Menachem Ben-Ezra, Peter Coventry, Susan Mason-Roberts, Aoife Bradley, Paul Hutton

Topics
Complex Trauma/C-PTSD

More Info Collapse

Extent
15 pages

Publisher
Cambridge University Press

Rights
Copyright © Cambridge University Press 2019

APA Citation
Karatzias, T., Murphy, P., Cloitre, M., Bisson, J., Roberts, N., Shevlin, M., Hyland, P., Maercker, A., Ben-Ezra, M., Coventry, P., Mason-Roberts, S., Bradley, A., & Hutton, P. (2019). Psychological interventions for ICD-11 complex PTSD symptoms: Systematic review and meta-analysis. Psychological Medicine, 49(11), 1761-1775.  https://doi.org/10.1017/S0033291719000436

Audience
EMDR Therapists, Other Mental Health Professionals

Language
English

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

Access Type
External Resource

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