scholarly journals Publication Bias in Meta-Analyses of Posttraumatic Stress Disorder Interventions

2020 ◽  
Vol 4 ◽  
Author(s):  
Helen Niemeyer ◽  
Robbie C.M. Van Aert ◽  
Sebastian Schmid ◽  
Dominik Uelsmann ◽  
Christine Knaevelsrud ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Publication Bias ◽  
Statistical Power ◽  
Stress Disorder ◽  
Psychotherapy Research ◽  
Psychotherapeutic Treatment ◽  
Method Performance ◽  
Monte Carlo Simulation Study ◽  
Meta Analyses

Meta-analyses are susceptible to publication bias, the selective publication of studies with statistically significant results. If publication bias is present in psychotherapy research, the efficacy of interventions will likely be overestimated. This study has two aims: (1) investigate whether the application of publication bias methods is warranted in psychotherapy research on posttraumatic stress disorder (PTSD) and (2) investigate the degree and impact of publication bias in meta-analyses of the efficacy of psychotherapeutic treatment for PTSD. A comprehensive literature search was conducted and 26 meta-analyses were eligible for bias assessment. A Monte-Carlo simulation study closely resembling characteristics of the included meta-analyses revealed that statistical power of publication bias tests was generally low. Our results showed that publication bias tests had low statistical power and yielded imprecise estimates corrected for publication bias due to characteristics of the data. We recommend to assess publication bias using multiple publication bias methods, but only include methods that show acceptable performance in a method performance check that researchers first have to conduct themselves.

scholarly journals Publication Bias in Meta-Analyses of Posttraumatic Stress Disorder Interventions

2020 ◽  
Author(s):  
Helen Niemeyer ◽  
Robbie Cornelis Maria van Aert
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Publication Bias ◽  
Statistical Power ◽  
Stress Disorder ◽  
Psychotherapy Research ◽  
Psychotherapeutic Treatment ◽  
Method Performance ◽  
Monte Carlo Simulation Study ◽  
Meta Analyses

Meta-analyses are susceptible to publication bias, the selective publication of studies with statistically significant results. If publication bias is present in psychotherapy research, the efficacy of interventions will likely be overestimated. This study has two aims: (1) investigate whether the application of publication bias methods is warranted in psychotherapy research on posttraumatic stress disorder (PTSD) and (2) investigate the degree and impact of publication bias in meta-analyses of the efficacy of psychotherapeutic treatment for PTSD. A comprehensive literature search was conducted and 26 meta-analyses were eligible for bias assessment. A Monte-Carlo simulation study closely resembling characteristics of the included meta-analyses revealed that statistical power of publication bias tests was generally low. Our results showed that publication bias tests had low statistical power and yielded imprecise estimates corrected for publication bias due to characteristics of the data. We recommend to assess publication bias using multiple publication bias methods, but only include methods that show acceptable performance in a method performance check that researchers first have to conduct themselves.

scholarly journals Attention to threat in posttraumatic stress disorder as indexed by eye-tracking indices: a systematic review

2018 ◽  
Vol 49 (5) ◽  
pp. 705-726 ◽  
Author(s):  
Amit Lazarov ◽  
Benjamin Suarez-Jimenez ◽  
Amanda Tamman ◽  
Louise Falzon ◽  
Xi Zhu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Posttraumatic Stress Disorder ◽  
Eye Tracking ◽  
Posttraumatic Stress ◽  
Sustained Attention ◽  
Stress Disorder ◽  
Experimental Studies ◽  
Group Comparison ◽  
Attentional Processes ◽  
Meta Analyses

AbstractBackgroundCognitive models of posttraumatic stress disorder (PTSD) implicate threat-related attentional biases in the etiology and phenomenology of the disorder. However, extant attentional research using reaction time (RT)-based paradigms and measures has yielded mixed results. Eye-tracking methodology has emerged in recent years to overcome several inherent drawbacks of RT-based tasks, striving to better delineate attentional processes.MethodsA systematic review of experimental studies examining threat-related attention biases in PTSD, using eye-tracking methodology and group-comparison designs, was conducted conforming to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies were selected following a systematic search for publications between 1980 and December 2017 in PsycINFO, MEDLINE and the National Center for PTSD Research's Published International Literature on Traumatic Stress (PILOTS) database. Additional records were identified by employing the Similar Articles feature in PubMed, and the Cited Reference Search in ISI Web of Science. Reference sections of review articles, book chapters and studies selected for inclusion were searched for further studies. Ongoing studies were also sought through Clinicaltrials.gov.ResultsA total of 11 studies (n = 456 participants in total) were included in the final review. Results indicated little support for enhanced threat detection, hypervigilance and attentional avoidance. However, consistent evidence emerged for sustained attention on threat (i.e. attention maintenance) in PTSD.ConclusionsThis review is the first to systematically evaluate extant findings in PTSD emanating from eye-tracking studies employing group-comparison designs. Results suggest that sustained attention on threat might serve as a potential target for therapeutic intervention.

Omissions and Errors in the Institute of Medicine’s Report on Scientific Evidence of Treatment for Posttraumatic Stress Disorder

2009 ◽  
Vol 3 (1) ◽  
pp. 32-38
Author(s):  
Christopher W. Lee ◽  
Sarah Schubert
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Scientific Evidence ◽  
Veterans Affairs ◽  
Critical Examination ◽  
Institute Of Medicine ◽  
Department Of Veterans Affairs ◽  
Pharmacological Treatments ◽  
Meta Analyses

A recently released report by the Institute of Medicine (IOM, 2008) commissioned by the U.S. Department of Veterans Affairs examined the evidence for psychotherapeutic and pharmacological treatments for posttraumatic stress disorder (PTSD). It concluded that the evidence was inadequate to determine the efficacy of eye movement desensitization and reprocessing (EMDR) in the treatment of PTSD. However, a critical examination of the basis for this conclusion reveals errors in three areas. First, the findings of key studies that reported positive outcomes for EMDR were misrepresented; second, a number of positive studies were excluded without apparent justification; and, finally, the IOM report failed to consider additional readily available studies that also reported benefits for EMDR. These factors appear to explain why the conclusions of the IOM report are at odds with the numerous meta-analyses and practice guidelines of PTSD treatments issued by other scientific committees worldwide.

scholarly journals Eye Movement Desensitization Reprocessing for Children and Adolescents With Posttraumatic Stress Disorder: A Systematic Narrative Review

2019 ◽  
Vol 13 (4) ◽  
pp. 270-283 ◽  
Author(s):  
Ian G. Barron ◽  
Caitlin Bourgaize ◽  
Daniela Lempertz ◽  
Colleen Swinden ◽  
Susan Darker-Smith
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Children And Adolescents ◽  
Posttraumatic Stress ◽  
Eye Movement ◽  
Stress Disorder ◽  
Narrative Review ◽  
Ptsd Symptoms ◽  
Eye Movement Desensitization Reprocessing ◽  
Literature Reviews ◽  
Meta Analyses

There is currently a limited number of studies into the efficacy of eye movement desensitization reprocessing (EMDR) therapy with children and adolescents with posttraumatic stress disorder (PTSD). The current study utilizes a systematic narrative review of methodologies and findings of previous literature reviews and meta-analyses as well as analyzing randomized control trials (RCTs) conducted from 2002 to 2018. Following initial scoping of the extent of studies, two systematic literature searches were conducted, firstly for literature reviews and secondly for recent RCTs. Nine databases were utilized. Eight reviews and seven RCTs were identified and analyzed for quality of methodology and outcome as measured by impact on PTSD symptoms. EMDR was found to be efficacious in reducing children's PTSD symptoms compared to waitlist conditions, with similar outcomes to cognitive behavior therapy (CBT). EMDR was effective with both single-event trauma as well as cumulative trauma such as sexual abuse. EMDR was equally effective with girls and boys as well as children from different cultures. EMDR achieved medium to large effect sizes. Reductions in PTSD were maintained at 2-, 3-, 6-, and 12-month follow-up. In conclusion, EMDR was consistently found to be an efficacious treatment for children with PTSD. Recommendations are made for future practice and research.

scholarly journals Treatment of posttraumatic stress disorder: Focus on pharmacotherapy

2019 ◽  
Vol 9 (6) ◽  
pp. 373-382 ◽  
Author(s):  
Megan Ehret
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Stress Disorder ◽  
Psychotropic Medications ◽  
Current Clinical Practice ◽  
Comorbid Conditions ◽  
First Line ◽  
Direct Head ◽  
Meta Analyses

Abstract Current clinical practice guidelines for the treatment of posttraumatic stress disorder offer varying recommendations regarding the use of pharmacotherapy. Many direct head-to-head comparisons of pharmacotherapy are lacking, and recommendations are based on meta-analyses and small trials. While selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors are considered first-line pharmacotherapy, clear distinctions do not exist when considering other classes of psychotropic medications. Ultimately, when selecting an appropriate medication for a patient diagnosed with posttraumatic stress disorder, the clinician needs to consider the current symptomatology being experienced, comorbid conditions, and evidence for efficacy of specific treatments prior to initiating medications.

scholarly journals Autonomic dysfunction in posttraumatic stress disorder indexed by heart rate variability: a meta-analysis

2020 ◽  
Vol 50 (12) ◽  
pp. 1937-1948
Author(s):  
Martha Schneider ◽  
Andreas Schwerdtfeger
Keyword(s):  
Heart Rate ◽  
Posttraumatic Stress Disorder ◽  
Heart Rate Variability ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Meta Analysis ◽  
Low Frequency ◽  
Parasympathetic Activity ◽  
Significant Group ◽  
Meta Analyses

AbstractBackgroundChanges in autonomic nervous system (ANS) function have been observed in a variety of psychological disorders, including posttraumatic stress disorder (PTSD). Analysis of heart rate variability (HRV) provides insight into the functioning of the ANS. Previous research on PTSD found lower HRV in PTSD patients compared to controls, indicating altered sympathetic and parasympathetic activity, but findings are inconsistent. The purpose of this meta-analysis was to examine differences in HRV indices between individuals with PTSD and healthy controls at baseline and during stress.MethodsThe included primary studies present an aggregate of studies analyzing different HRV indices. Examined HRV indices were standard deviation of the normalized NN-intervals (SDNN), root mean square of successive differences (RMSSD), low-frequency (LF) and high-frequency (HF) spectral components, LF/HF ratio, and heart rate (HR). Moderating effects of study design, HRV and PTSD assessment, and sample characteristics were examined via subgroup-analyses and meta-regressions.ResultsRandom-effects meta-analyses for HRV parameters at rest revealed significant group differences for RMSSD and HF-HRV, suggesting lower parasympathetic activity in PTSD. The aggregated effect size for SDNN was medium, suggesting diminished total variability in PTSD. A small effect was found for LF-HRV. A higher LF/HF ratio was found in the PTSD sample as compared to controls. Individuals with PTSD showed significantly higher HR. During stress, individuals with PTSD showed higher HR and lower HF-HRV, both indicated by small effect sizes.ConclusionsFindings suggest that PTSD is associated with ANS dysfunction.

scholarly journals An examination of individual provider characteristics in the dissemination and uptake of cognitive-behavioral conjoint therapy for posttraumatic stress disorder

2021 ◽  
Author(s):  
Amy Brown-Bowers
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Couple Therapy ◽  
Stress Disorder ◽  
Psychotherapy Research ◽  
Behavioural Therapy ◽  
Cognitive Behavioral ◽  
Provider Characteristics ◽  
Conjoint Therapy ◽  
Individual Provider

Support for the use of evidence-based psychological practice in Canada is growing, but there remains a large gap between psychotherapy research and real-world psychotherapy practice. There also exists a chasm between the number of clinicians who attend psychotherapy trainings and those who implement the training material into their clinical practice. The present study examined individual provider characteristics in the uptake of Cognitive-Behavioral Conjoint Therapy for Posttraumatic Stress Disorder. There was a trend for an interaction between attitudes toward manualized treatments and attitudes toward the use of couple therapy to treat individuals with PTDS. Specifically, as attitudes in each area were more positive, piecemeal uptake of the protocol decreased. Contrary to hypothesis, prior training in couple therapy or in cognitive-behavioural therapy for PTDS, years since the highest degree was completed, and therapeutic orientation were not associated with uptake.

scholarly journals Feasibility of Present-Centered Therapy for Prolonged Grief Disorder: Results of a Pilot Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Anna Vogel ◽  
Hannah Comtesse ◽  
Agnes Nocon ◽  
Anette Kersting ◽  
Winfried Rief ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Psychological Distress ◽  
Posttraumatic Stress ◽  
Symptom Severity ◽  
Stress Disorder ◽  
Effect Sizes ◽  
Prolonged Grief ◽  
General Psychological Distress ◽  
Meta Analyses

Present-centered therapy (PCT) was originally developed as a strong comparator for the non-specific effects of psychotherapy in the treatment of posttraumatic stress disorder. PCT qualifies as a not strictly supportive treatment as it is structured and homework is assigned between sessions. It does not focus on cognitive restructuring or exposure. A growing body of literature supports its beneficial effects. For example, it demonstrated only slightly inferior effect sizes and lower dropout rates compared to that of trauma-focused cognitive behavioral therapy in several trials with patients suffering from posttraumatic stress disorder. The current study is the first to evaluate the feasibility and the treatment effects of PCT in adults with prolonged grief disorder (PGD). Meta-analyses on psychotherapy for PGD have yielded moderate effect sizes. N = 20 individuals suffering from PGD were treated with PCT by novice therapists as part of a preparation phase for an upcoming RCT in an outpatient setting. Treatment consisted of 20–24 sessions á 50 min. All outcomes were assessed before treatment, at post-treatment, and at the 3-month follow-up. The primary outcome, PGD symptom severity, was assessed using the Interview for Prolonged Grief-13. Secondary outcomes were self-reported PGD severity, depression, general psychological distress, and somatic symptom severity. Furthermore, therapists evaluated their experiences with their first PCT patient and the treatment manual. In intent-to-treat analyses of all patients we found a significant decrease in interview-based PGD symptom severity at post-treatment (d = 1.26). Decreases were maintained up to the 3-month follow-up assessment (d = 1.25). There were also significant decreases in self-reported PGD symptoms, depression, and general psychological distress. No changes were observed for somatic symptoms. The completion rate was 85%. Therapists deemed PCT to be a learnable treatment program that can be adapted to the patient's individual needs. The preliminary results of PCT as a treatment for PGD demonstrate large effects and indicate good feasibility in outpatient settings. The treatment effects were larger than those reported in meta-analyses. Thus, PCT is a promising treatment for PGD. Possible future research directions are discussed.

Sign in / Sign up

Export Citation Format

Share Document