Four decades of military posttraumatic stress: Protocol for a meta-analysis and systematic review of treatment approaches and efficacy (Preprint)

2021 ◽  
Author(s):  
Jenny Jing Wen Liu ◽  
Anthony Nazarov ◽  
Bethany Easterbrook ◽  
Rachel A. Plouffe ◽  
Tri Le ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Outcomes ◽  
Posttraumatic Stress ◽  
Clinical Decision Making ◽  
Ptsd Symptom ◽  
Service Providers ◽  
Meta Analysis ◽  
Well Being ◽  
Effect Sizes ◽  
Treatment Approaches

BACKGROUND Over 85% of active members of the Canadian Armed Forces (CAF) have been exposed to potentially traumatic events linked to the development of posttraumatic stress disorder (PTSD). At the time of transition to civilian life, as high as one in eight Veterans has a diagnosis of PTSD. Given high rates of PTSD in military and Veteran populations, the provision of effective treatment with considerations for their unique challenges and lived experiences is critical in the support of their mental health and well-being. OBJECTIVE The current paper overviews the protocol for conducting a meta-analysis and systematic review substantiating evidence of treatment approaches and effectiveness in treating military-related PTSD. METHODS The PROSPERO pre-registered meta-analysis is being conducted in accordance with PRISMA and Cochrane guidelines. A comprehensive search of the literature was conducted using the databases PsycInfo, Medline, Embase, CINAHL, and ProQuest Dissertations and Theses. After removal of duplicates, a total of 12,002 studies were screened for inclusion. RESULTS Effect sizes will be computed based on changes in PTSD symptom scores over time across studies using validated PTSD scales. A multi-level meta-analysis will examine the overall effects, between-studies effects, and within-studies effects of available evidence for PTSD treatments in military populations. Effect sizes will be compared between pharmacotherapeutic, psychotherapeutic, and alternative/emerging treatment interventions. Finally, meta-regression and sub-group analyses will explore the moderating roles of clinical characteristics (e.g., PTSD symptom clusters), treatment approaches (e.g., therapeutic orientations in psychotherapy and alternative therapies and classifications of drugs in pharmacotherapy), and treatment characteristics (e.g., length of intervention) on treatment outcomes. CONCLUSIONS This meta-analysis will provide the current state of evidence on the efficacy and effectiveness of various treatment approaches in military-related PTSD while identifying factors that may influence treatment outcomes. Results will inform clinical decision-making for service providers and service users. Finally, findings will provide insights for future treatment development and practice recommendations to better support the well-being of military and Veteran populations.

scholarly journals Updated systematic review and meta-analysis of studies examining the relationship between reported racism and health and well-being for children and youth: a protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e043722
Author(s):  
Naomi Priest ◽  
Kate Doery ◽  
Mandy Truong ◽  
Shuaijun Guo ◽  
Ryan Perry ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Research Policy ◽  
Meta Analysis ◽  
Well Being ◽  
Children And Youth ◽  
Effect Sizes ◽  
Future Research ◽  
Critical Determinant ◽  
Health And Well Being

IntroductionRacism is a critical determinant of health and health inequities for children and youth. This protocol aims to update the first systematic review conducted by Priest et al (2013), including a meta-analysis of findings. Based on previous empirical data, it is anticipated that child and youth health will be negatively impacted by racism. Findings from this review will provide updated evidence of effect sizes across outcomes and identify moderators and mediators of relationships between racism and health.Methods and analysisThis systematic review and meta-analysis will include studies that examine associations between experiences of racism and racial discrimination with health outcomes of children and youth aged 0–24 years. Exposure measures include self-reported or proxy reported systemic, interpersonal and intrapersonal racism. Outcome measures include general health and well-being, physical health, mental health, biological markers, healthcare utilisation and health behaviours. A comprehensive search of studies from the earliest time available to October 2020 will be conducted. A random effects meta-analysis will examine the average effect of racism on a range of health outcomes. Study-level moderation will test the difference in effect sizes with regard to various sample and exposure characteristics. This review has been registered with the International Prospective Register of Systematic Reviews.Ethics and disseminationThis review will provide evidence for future research within the field and help to support policy and practice development. Results will be widely disseminated to both academic and non-academic audiences through peer-review publications, community summaries and presentations to research, policy, practice and community audiences.PROSPERO registration numberCRD42020184055.

scholarly journals Measurement Discrepancies Between Logged and Self-Reported Digital Media Use: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Douglas Parry ◽  
Brittany I Davidson ◽  
Craig Sewall ◽  
Jacob T. Fisher ◽  
Hannah Mieczkowski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Digital Media ◽  
Media Use ◽  
Meta Analysis ◽  
Well Being ◽  
Self Report ◽  
Effect Sizes ◽  
Objective Measures ◽  
Valid Index ◽  
Accurate Reflection

The influence of digital media on personal and social well-being is a question of immense public and academic interest. Scholars in this domain often use retrospective self-report measures of the quantity or duration of media use as a proxy for more objective measures, but the validity of these self-report measures remains unclear. Recent advancements in log-based data collection techniques have produced a growing collection of studies indexing both self-reported media use and device-logged measurements. Herein, we report a meta-analysis of this body of research. Based on 104 effect sizes, we found that self-reported media use was only moderately correlated with device-logged measurements, and that these self-report measures were rarely an accurate reflection of logged media use. These results demonstrate that self-reported measures of the quantity or duration of media use are not a valid index of the amount of time people actually spend using media. These findings have serious implications for the study of media use and well- being, suggesting that cautiousness is warranted in drawing conclusions regarding media effects from studies relying solely on self-reported measures of media use.

scholarly journals Four decades of military posttraumatic stress: Protocol for a meta-analysis and systematic review of treatment approaches and efficacy (Preprint)

10.2196/33151 ◽  
2021 ◽  
Author(s):  
Jenny Jing Wen Liu ◽  
Anthony Nazarov ◽  
Bethany Easterbrook ◽  
Rachel A. Plouffe ◽  
Tri Le ◽  
...  
Keyword(s):  
Systematic Review ◽  
Posttraumatic Stress ◽  
Meta Analysis ◽  
Treatment Approaches

scholarly journals Proactive psychological programs designed to mitigate posttraumatic stress injuries among at-risk workers: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Paula M. Di Nota ◽  
Anees Bahji ◽  
Dianne Groll ◽  
R. Nicholas Carleton ◽  
Gregory S. Anderson
Keyword(s):  
Systematic Review ◽  
At Risk ◽  
Posttraumatic Stress ◽  
Psychological Health ◽  
Healthcare Professionals ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Effect Sizes ◽  
Psychological Wellness ◽  
Stress Injuries

Abstract Background Public safety personnel and frontline healthcare professionals are at increased risk of exposure to potentially psychologically traumatic events (PPTE) and developing posttraumatic stress injuries (PTSI, e.g., depression, anxiety) by the nature of their work. PTSI are also linked to increased absenteeism, suicidality, and performance decrements, which compromise occupational and public health and safety in trauma-exposed workers. Evidence is lacking regarding the effectiveness of “prevention” programs designed to mitigate PTSI proactively. The purpose of this review is to measure the effectiveness of proactive PTSI mitigation programs among occupational groups exposed to PPTE on measures of PTSI symptoms, absenteeism, and psychological wellness. Methods Five electronic databases were searched per PRISMA guidelines for English or French peer-reviewed studies from 2008 to 2019 evaluating PTSI and psychological wellness in adults exposed to occupational PPTE. The risk of bias was assessed using the Newcastle-Ottawa Scale. Results We identified 42 studies evaluating 3182 public safety and frontline healthcare professionals, PPTE-exposed educational staff, and miners. Significant overlap was found across program themes that included mindfulness, psychoeducation, resilience promotion, and stress management strategies. Post-program effect sizes were small (SMD < 0.5) to moderate (SMD < 0.8) for reductions in PTSI symptoms and for promoting measures of well-being as indicated by a meta-analysis on 36 studies. There was no evidence for significant reductions in substance use, absenteeism, or biomarkers of distress except for heart rate. Subgroup analyses indicated that multimodal programs effectively improved general psychological health, while resilience programs improved measures of depression, burnout, coping, and resilience. Effect sizes for resilience, depression, and general psychological health improvements were greatest immediately or 1-month post-training, while improvements in PTSD symptoms and coping were larger at longer follow-up. Studies were of moderate quality and risk of bias. Conclusions The current results showcase modest evidence for time-limited reductions in PTSI following participation in holistic programs that promote resilience, stress, and emotion regulation among at-risk workers. Implications for organizational implementation of proactive PTSI mitigation programs and areas of future research are discussed. Systematic review registration PROSPERO (CRD42019133534)

scholarly journals Predictors of the Length of Stay of Psychiatric Inpatients: Protocol for a Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Farid Carranza ◽  
Neri Alejandro Álvarez ◽  
Andrea Muriel Contreras ◽  
Andrea Fernanda Guerrero ◽  
Natalia Sofía Tamayo ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Length Of Stay ◽  
Service Providers ◽  
Meta Analysis ◽  
Mental Healthcare ◽  
Psychiatric Inpatients ◽  
Regression Coefficients ◽  
Effect Sizes ◽  
Point Estimate

Abstract Background: Length of stay (LOS) for inpatient psychiatric services is an important factor with serious drawbacks when it is extended more than needed. Impacts on economy, social functioning and stigma can hamper improvement and affect the patients’ experiences on future mental healthcare. Predictions of which patients have a higher chance for prolonged LOS have been extensively researched. Previous systematic reviews found consistent predictors of both longer and shorter LOS. However, they do not provide an estimate from the pooled effect sizes. Furthermore, to our knowledge, there are no meta-analysis on the influence of these factors. The primary objective of this study will be to provide point estimates on the effect sizes of all studied predictors of the LOS of psychiatric inpatients.Methods: We will conduct a systematic search in PubMed, MEDLINE, EMBASE and PsycINFO for observational studies evaluating the effect size of independent factors on the length of stay of psychiatric inpatients. Prospective and retrospective cohorts that assess the influence of predictors through the reporting of standardized regression coefficients will be included. We will provide a qualitative synthesis of the findings from each study and perform a meta-analysis from pooled regression coefficients that were adjusted for other variables or confounders in order to obtain a point estimate and confidence interval for all factors extracted from the included studies.Discussion: The results from this study may provide more accurate predictions for mental health institutions, psychiatrists, mental health service providers, patients, and families on the prognosis regarding the length of stay for needed inpatient care. This information may be used to anticipate individuals with a higher chance for prolonged hospitalization to plan the necessary interventions for these specific situations. Considering both the benefits and disadvantages of longer and shorter stays, the pooled estimates for independent factors may be used by mental healthcare providers and patients for informed decision-making. The results from this study will also update results presented in previous studies and identify the strengths and limitations from the current available evidence. Systematic Review Registration: PROSPERO ID CRD42020172840

scholarly journals Predictors of the length of stay of psychiatric inpatients: protocol for a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Farid Carranza Navarro ◽  
Neri Alejandro Álvarez Villalobos ◽  
Andrea Muriel Contreras Muñoz ◽  
Andrea Fernanda Guerrero Medrano ◽  
Natalia Sofía Tamayo Rodríguez ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Length Of Stay ◽  
Service Providers ◽  
Meta Analysis ◽  
Mental Healthcare ◽  
Psychiatric Inpatients ◽  
Regression Coefficients ◽  
Effect Sizes ◽  
Point Estimate

Abstract Background Length of stay (LOS) for inpatient psychiatric services is an important factor with serious drawbacks when it is extended more than needed. Impacts on economy, social functioning, and stigma can hamper improvement and affect the patients’ experiences on future mental healthcare. Predictions of which patients have a higher chance for prolonged LOS have been extensively researched. Previous systematic reviews found consistent predictors of both longer and shorter LOS. However, they do not provide an estimate from the pooled effect sizes. Furthermore, to our knowledge, there is no meta-analysis on the influence of these factors. The primary objective of this study will be to provide point estimates on the effect sizes of all studied predictors of the LOS of psychiatric inpatients. Methods We will conduct a systematic search in PubMed, MEDLINE, EMBASE, and PsycINFO for observational studies evaluating the effect size of independent factors on the length of stay of psychiatric inpatients. Prospective and retrospective cohorts that assess the influence of predictors through the reporting of standardized regression coefficients will be included. We will provide a qualitative synthesis of the findings from each study and perform a meta-analysis from pooled regression coefficients that were adjusted for other variables or confounders in order to obtain a point estimate and confidence interval for all factors extracted from the included studies. Discussion The results from this study may provide more accurate predictions for mental health institutions, psychiatrists, mental health service providers, patients, and families on the prognosis regarding the length of stay for needed inpatient care. This information may be used to anticipate individuals with a higher chance for prolonged hospitalization to plan the necessary interventions for these specific situations. Considering both the benefits and disadvantages of longer and shorter stays, the pooled estimates for independent factors may be used by mental healthcare providers and patients for informed decision-making. The results from this study will also update results presented in previous studies and identify the strengths and limitations from the current available evidence. Systematic review registration PROSPERO ID CRD42020172840 

scholarly journals Is Mindfulness-Based Stress Reduction Effective for People with Hypertension? A Systematic Review and Meta-Analysis of 30 Years of Evidence

2021 ◽  
Vol 18 (6) ◽  
pp. 2882
Author(s):  
Ciro Conversano ◽  
Graziella Orrù ◽  
Andrea Pozza ◽  
Mario Miccoli ◽  
Rebecca Ciacchini ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stress Reduction ◽  
Effect Size ◽  
Meta Analysis ◽  
Well Being ◽  
Effect Sizes ◽  
Medical Conditions ◽  
Antihypertensive Medications ◽  
Positive Effects ◽  
Mindfulness Based Stress Reduction

Background: Hypertension is among the most important risk factors for cardiovascular diseases, which are considered high mortality risk medical conditions. To date, several studies have reported positive effects of mindfulness-based stress reduction (MBSR) interventions on physical and psychological well-being in other medical conditions, but no meta-analysis on MBSR programs for hypertension has been conducted. Objectives: The objective of this study was to determine the effectiveness of MBSR programs for hypertension. Methods: A systematic review and meta-analysis of randomized controlled trials examining the effects of MBSR on systolic and diastolic blood pressure (BP), anxiety, depression, and perceived stress in people with hypertension or pre-hypertension was conducted. The PubMed/MEDLINE and PsycINFO databases were searched in November 2020 to identify relevant studies. Results: Six studies were included. The comparison of MBSR versus control conditions on diastolic BP was associated with a statistically significant mean effect size favoring MBSR over control conditions (MD = −2.029; 95% confidence interval (CI): −3.676 to −0.383, p = 0.016, k = 6; 22 effect sizes overall), without evidence of heterogeneity (I2 = 0.000%). The comparison of MBSR versus control conditions on systolic BP was associated with a mean effect size which was statistically significant only at a marginal level (MD = −3.894; 95% CI: −7.736–0.053, p = 0.047, k = 6; 22 effect sizes overall), without evidence of high heterogeneity (I2 = 20.772%). The higher the proportion of participants on antihypertensive medications was, the larger the effects of MBSR were on systolic BP (B = −0.750, z = −2.73, p = 0.003). Conclusions: MBSR seems to be a promising intervention, particularly effective on the reduction of diastolic BP. More well-conducted trials are required.

scholarly journals Sleep duration during COVID-19 lockdown: systematic review and meta-analysis

2021 ◽  
Author(s):  
Yelena Stukalin ◽  
Anat Lan ◽  
Noga Kronfeld-Schor ◽  
Erez Shmueli ◽  
Haim Einat
Keyword(s):  
Systematic Review ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Meta Analysis ◽  
Well Being ◽  
Fixed Effect Model ◽  
Effect Sizes ◽  
Modern World ◽  
Cohen’S D ◽  
Cohen's D

Abstract In attempts to slow down the spread of COVID-19 pandemic, countries took different measures including lockdowns. Several studies reported the effects of lockdowns on sleep mostly suggesting an increase in sleep duration during lockdowns. This is an interesting outcome as life in the modern world were associated with insufficient sleep. The present study is a systematic review and meta-analysis of work regarding sleep duration during lockdowns. We searched PubMed using the terms “COVID-19”, “SARS-CoV-2”, “lockdown”, “stay at home”, “quarantine” and “sleep” and found 262 papers. After applying exclusion criteria, we identified 26 papers (with 35 discrete studies) for the meta-analysis. A fixed effect model was used with effect sizes estimated using Cohen’s d and heterogeneity of effect sizes tested using the Cochran’s Q test statistics. Most studies (31/35) report an increase in sleep duration during lockdown periods with a mean (± STD) of 31.5 ± 21.2 minutes. Effect sizes (Cohen’s d) ranged between 0.08 and 3.34, which are considered between very small and huge. Q statistics was 4859.3 (p < 0.0001) and with no indication for publication bias (Egger’s test, p = 0.45). Eight studies also reported measures of “sleep quality” with 6/8 reporting worsening of sleep quality with small to large effect sizes Cohen’s d range between 0.09 and 1.86). The study demonstrates increased sleep duration during lockdowns. Increased sleep duration is a positive change, but effects on well-being during lockdowns might be overshadowed by reduced sleep quality, increased stress, and lowered mood. It is interesting whether longer sleep duration habits may survive to post-COVID-19 days.

scholarly journals Predictors of the Length of Stay of Psychiatric Inpatients: Protocol for a Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Farid Carranza ◽  
Natalia Sofía Tamayo ◽  
Neri Alejandro Álvarez ◽  
Andrea Muriel Contreras ◽  
Andrea Fernanda Guerrero ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Length Of Stay ◽  
Service Providers ◽  
Meta Analysis ◽  
Mental Healthcare ◽  
Psychiatric Inpatients ◽  
Regression Coefficients ◽  
Effect Sizes ◽  
Point Estimate

Abstract Background : Length of stay (LOS) for inpatient psychiatric services is an important factor with serious drawbacks when it is extended more than needed. Impacts on economy, social functioning and stigma can hamper improvement and affect the patients’ experiences on future mental healthcare. Prediction of which patients have a higher risk for prolonged LOS has been extensively researched. Previous systematic reviews found consistent predictors of both longer and shorter LOS. However, they do not provide an estimate from the pooled effect sizes. Furthermore, to our knowledge, there are no meta-analysis on the influence of these factors. The primary objective of this study will be to provide point estimates on the effect sizes of all studied predictors of the LOS of psychiatric inpatients. Methods : We will conduct a systematic search in PubMed, MEDLINE, EMBASE and PsycINFO for observational studies evaluating the effect size of independent factors on the length of stay of psychiatric inpatients. Prospective and retrospective cohorts that assess the influence of risk factors through the reporting of standardized regression coefficients will be included. We will provide a qualitative synthesis of the findings from each study and perform a meta-analysis from pooled regression coefficients that were adjusted for other variables or confounders in order to obtain a point estimate and confidence interval for all factors extracted from the included studies. Discussion : The results from this study may provide more accurate predictions for mental health institutions, psychiatrists, mental health service providers, patients, and families on the prognosis regarding the length of stay for needed inpatient care. This information may be used to anticipate individuals at a higher risk for prolonged hospitalization to plan the necessary interventions for these specific situations. Considering both the benefits and disadvantages of longer and shorter stays, the pooled estimates for independent factors may be used by mental healthcare providers and patients for informed decision-making. The results from this study will also update results presented in previous studies and identify the strengths and limitations from the current available evidence. Systematic Review Registration : PROSPERO ID CRD42020172840

Delayed Posttraumatic Stress Disorder: Systematic Review, Meta-Analysis, and Metaregression

2009 ◽  
Author(s):  
Geert Smid ◽  
Trudy Mooren ◽  
Roos Van der Mast ◽  
Berthold Gersens ◽  
Rolf Kleber
Keyword(s):  
Systematic Review ◽  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Meta Analysis
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