Developments of Prolonged Exposure in Treatment Effect of PTSD and Controlling Dropout Rate: A meta-analytic review.

Prolonged exposure (PE) has been proved as an efficacious psychological treatment for posttraumatic stress disorder (PTSD). There are mainly two changed formats of PE: the modified PE (mPE) and the PE combined with drug (PE/d). Symptoms reduction following these two PE training formats have been reported in the patients with PTSD. However, very little is focusing on the direct comparison of mPE+PE/d and PE. Therefore, this paper aims to compare the mPE+PE/d with PE on the PTSD treatment effect and the dropout rate directly through the meta-analysis. Eighteen studies with total sample size of 1397 met the final inclusion criteria. The results showed that mPE+PE/d had significantly lower post-treatment PTSD severity than control group (relaxation, wait-list, et al). There was no significant difference between mPE+PE/d and PE on the post-treatment, the follow-up PTSD score, and the post-treatment dropout rate. Compared with PE, lower PTSD symptoms and marginally lower dropout rate following the treatment were observed in the PE/d group. PE/d yielded a significantly larger effect size than mPE when compared with PE on the post-treatment PTSD symptom severity. The significance of above results wouldn't be changed even if studies causing high heterogeneity were removed. Although whilst PE/d enhanced treatment effect and lowered dropout rate when compared with PE, it was still insufficient to draw the conclusion which formats of adjustments would specifically improve the implementation of PE. Further studies are warranted to develop an easy-accomplished and efficacy-guaranteeing PE program for PTSD patients. This article is protected by copyright. All rights reserved.