Post-Traumatic Stress Disorder Psychological Interventions in Sub-Saharan Africa: Protocol for a Systematic Review of Literature

2020 ◽  
Author(s):  
Vuyokazi Ntlantsana ◽  
Keneilwe Molebatsi ◽  
Sibongile Mashaphu ◽  
Bonginkosi Chiliza ◽  
Dickens H Akena

Abstract Background: While untreated post-traumatic stress disorder (PTSD) results in considerable morbidity and higher risk of mortality, little has been done to treat PTSD in low resourced sub-Saharan Africa settings where there is mass exposure of the population to traumatic events. This systematic review aims to summarise available evidence on the efficacy of psychological therapies for PTSD in sub-Saharan Africa (SSA).Methods: A systematic search of literature in the PubMed, PsychInfo, EMBASE and Cochrane Register of Controlled Trials electronic databases will be conducted using keywords related to “PTSD”, “psychological therapies” and “SSA”. Two independent researchers will screen for studies eligible for inclusion if set in SSA and randomised controlled trial study design. Data on intervention types, population, comorbidities, comparison group intervention and PTSD outcomes will be extracted from included studies. Risk of bias will be assessed, qualitative synthesis of data will be conducted, and pooled effect estimates calculated.Discussion: Trauma in SSA occurs within the context of unique conditions necessitating applicable interventions. The results of the systematic review will be important in providing a guide for clinicians and researchers in low resource settings in development of effective interventions. Systematic review registration: PROSPERO (CRD42020181638)

2018 ◽  
Vol 2 ◽  
pp. 247054701877906 ◽  
Author(s):  
Juliana Martins Scalabrin ◽  
Marcelo F. Mello ◽  
Walter Swardfager ◽  
Hugo Cogo-Moreira

Objective To evaluate the factorial validity and internal consistency of a measurement model underlying risk of bias as endorsed by Cochrane for use in systematic reviews; more specifically, how the risk of bias tool behaves in the context of studies on psychological therapies used for treatment of post-traumatic stress disorder in adults. Methods We applied confirmatory factor analysis to a systematic review containing 70 clinical trials entitled “Psychological Therapies for Chronic Post-Traumatic Stress Disorder in Adults” under a Bayesian estimator. Seven observed categorical risk of bias items (answered categorically as low, unclear, or high risk of bias) were collected from the systematic review. Results A unidimensional model for the Cochrane risk of bias tool items returned poor fit indices and low factor loadings, indicating questionable validity and internal consistency. Conclusion Although the present evidence is restricted to psychological interventions for post-traumatic stress disorder, it demonstrates that the way risk of bias has been measured in this context may not be adequate. More broadly, the results suggest the importance of testing the risk of bias tool, and the possibility of rethinking the methods used to assess risk of bias in systematic reviews and meta-analyses.


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