Efficacy of treatments for posttraumatic stress disorder. An empirical review
S. D. Solomon, E. T. Gerrity and A. M. Muff
Division of Applied and Services Research, National Institute of Mental Health, Rockville, Md. 20857.
OBJECTIVE--The purpose of this article is to review the empirical evidence
for the efficacy of a range of treatments for posttraumatic stress disorder
(PTSD). Reviewed studies focused on rape victims, combat veterans, the
tragically bereaved, torture victims, accident victims, of physical
assault, and child abuse victims. DATA SOURCES--Peer-reviewed journals
(Psych-Info, MEDLINE), book chapters (PILOTS database), active
investigators, abstracts from the 1990 and 1991 International Society for
Traumatic Stress Studies. STUDY SELECTION--We identified 255
English-language reports of treatment for PTSD. We restricted our focus to
randomized, clinical trials that included a systematic assessment of PTSD
using DSM-III or DSM-III-R criteria (N = 11). DATA EXTRACTION--Studies were
assessed according to methodological strength: random assignment to the
treatment of interest, and either an alternative treatment or control
group; sample selection; and inclusion of statistical tests of
significance. DATA SYNTHESIS--Drug studies show a modest but clinically
meaningful effect on PTSD. Stronger effects were found for behavioral
techniques involving direct therapeutic exposure, particularly in terms of
reducing PTSD intrusive symptoms. However, severe complications have also
been reported from the use of these techniques in patients suffering from
other psychiatric disorders. Studies of cognitive therapy, psychodynamic
therapy, and hypnosis suggest that these approaches may also hold promise.
However, further research is needed before any of these approaches can be
pronounced effective as lasting treatment of PTSD. CONCLUSIONS--Further
studies should specifically address combined treatment approaches, optimal
treatment length and timing, effects of comorbidity, and unstudied
traumatized populations.
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Najavits
BRIEF TREAT CRISIS INTERVEN 2006;6:248-254.
ABSTRACT
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Taylor and Chemtob
Arch Pediatr Adolesc Med 2004;158:786-791.
ABSTRACT
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A Randomized Effectiveness Trial of Stepped Collaborative Care for Acutely Injured Trauma Survivors
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ABSTRACT
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ABSTRACT
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Catherall
Traumatology 2003;9:76-92.
ABSTRACT
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Am. J. Psychiatry 2002;159:2081-2086.
ABSTRACT
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Providing Crisis Counseling to New Yorkers after the Terrorist Attack on the World Trade Center
Jordan
The Family Journal 2002;10:139-144.
ABSTRACT
Update in Psychiatry
Schneider and Levenson
ANN INTERN MED 2002;136:293-301.
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Davidson et al.
Arch Gen Psychiatry 2001;58:485-492.
ABSTRACT
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Supportive-Expressive Group Therapy and Distress in Patients With Metastatic Breast Cancer: A Randomized Clinical Intervention Trial
Classen et al.
Arch Gen Psychiatry 2001;58:494-501.
ABSTRACT
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Turner
Adv. Psychiatr. Treat. 2000;6:295-303.
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Brady et al.
JAMA 2000;283:1837-1844.
ABSTRACT
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A Trauma-Focused Individual Therapy Approach for Adolescents with Conduct Disorder
Greenwald
Int J Offender Ther Comp Criminol 2000;44:146-163.
ABSTRACT
ECT Therapy in PTSD
HELSLEY et al.
Am. J. Psychiatry 1999;156:494a-495.
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Lubin et al.
Am. J. Psychiatry 1998;155:1172-1177.
ABSTRACT
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Eye Movement Desensitization and Reprocessing (EMDR): New Hope for Children Suffering from Trauma and Loss
Greenwald
Clin Child Psychol Psychiatry 1998;3:279-287.
ABSTRACT
Response to treatment varies
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BMJ 1995;311:510-510.
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