An investigation of the efficacy of empirically supported treatments (ests) for posttraumatic stress disorder (PTSD): a meta-analytic review

Posttraumatic stress disorder (PTSD) is a psychological disorder that occurs following a psychological trauma, which consists of experiencing or witnessing a life-threatening situation. Examples of traumatic events include, but are not limited to, natural disasters, rape or sexual assault, and combat. Symptoms of PTSD often include symptoms of avoiding triggers or memories of the traumatic event, intrusive thoughts regarding the traumatic event, disturbances in cognition and mood, and hyperarousal. In an effort to evaluate effective treatments for a variety of psychological disorder, Division 12 (Clinical Psychology) of the American Psychological Association (APA) created a task force for evaluating empirically supported treatments (ESTs). ESTs often offer manualized treatment protocols that are disorder specific. In their review of treatments, the APA presidential task force reviewed 7 treatments for PTSD, including Cognitive Processing Therapy (CPT), Present Centered Therapy (PCT), Prolonged Exposure (PE), Eye Movement Desensitization and Reprocessing (EMDR), Stress Inoculation Training (SIT), Seeking Safety, and Psychological Debriefing. While the APA task force of ESTs has identified 6 effective treatments for PTSD, to date, there has not been a meta-analysis conducted examining the efficacy of these treatments in comparison to one another. This dissertation aims to fill this gap in the literature by conducting a meta-analysis on PTSD-related treatment outcomes by each of these treatment protocols. Due to the unique nature of Seeking Safety, it was not included in this analysis. Furthermore, due to limited number of obtained studies, SIT was also excluded from this analysis. Utilizing both random and mixed effects meta-analysis models, this study found that CPT had significantly greater treatment outcomes compared to EMDR and PCT. CPT outcomes did not significantly differ from PE outcomes. Further moderation analysis found that veteran participants tended have a greater treatment response to CPT and PE compared to civilian participants. Conversely, civilian participants appeared to have greater symptom reduction following EMDR when compared to veteran populations. Where data were available, results found that PTSD-specific treatments also appear to have a secondary benefit on reducing symptoms of both anxiety and depression. Results from this study build on prior knowledge by providing additional support for the magnitude of efficacy of various treatment modalities. Implications for practice and policy are discussed.