C M Hoeboer1, R A De Kleine2, M L Molendijk2, M Schoorl1, D A C Oprel1, J Mouthaan2, W Van der Does3, A Van Minnen4. 1. Leiden University, Institute of Psychology; and Parnassiagroep, PsyQ, The Hague, the Netherlands. 2. Leiden University, Institute of Psychology, the Netherlands. 3. Leiden University, Institute of Psychology; Parnassiagroep, PsyQ The Hague, the Netherlands; and Department of Psychiatry, Leiden University Medical Center, the Netherlands. 4. PSYTREC, Bilthoven; and Radboud University, Behavioural Science Institute, the Netherlands.
Abstract
BACKGROUND: Many patients with post-traumatic stress disorder (PTSD) experience dissociative symptoms. The question of whether these dissociative symptoms negatively influence the effectiveness of psychotherapy for PTSD is unresolved. AIMS: To determine the influence of dissociative symptoms on psychotherapy outcome in PTSD. METHOD: We conducted a systematic search in Cochrane, Embase, PILOTS, PsycINFO, PubMed and Web of Science for relevant clinical trials. A random-effects meta-analysis examined the impact of dissociation on psychotherapy outcome in PTSD (pre-registered at Prospero CRD42018086575). RESULTS: Twenty-one trials (of which nine were randomised controlled trials) with 1714 patients were included. Pre-treatment dissociation was not related to treatment effectiveness in patients with PTSD (Pearson's correlation coefficient 0.04, 95% CI -0.04 to 0.13). Between-study heterogeneity was high but was not explained by moderators such as trauma focus of the psychotherapy or risk of bias score. There was no indication for publication bias. CONCLUSIONS: We found no evidence that dissociation moderates the effectiveness of psychotherapy for PTSD. The quality of some of the included studies was relatively low, emphasising the need for high-quality clinical trials in patients with PTSD. The results suggest that pre-treatment dissociation does not determine psychotherapy outcome in PTSD.
BACKGROUND: Many patients with post-traumatic stress disorder (PTSD) experience dissociative symptoms. The question of whether these dissociative symptoms negatively influence the effectiveness of psychotherapy for PTSD is unresolved. AIMS: To determine the influence of dissociative symptoms on psychotherapy outcome in PTSD. METHOD: We conducted a systematic search in Cochrane, Embase, PILOTS, PsycINFO, PubMed and Web of Science for relevant clinical trials. A random-effects meta-analysis examined the impact of dissociation on psychotherapy outcome in PTSD (pre-registered at Prospero CRD42018086575). RESULTS: Twenty-one trials (of which nine were randomised controlled trials) with 1714 patients were included. Pre-treatment dissociation was not related to treatment effectiveness in patients with PTSD (Pearson's correlation coefficient 0.04, 95% CI -0.04 to 0.13). Between-study heterogeneity was high but was not explained by moderators such as trauma focus of the psychotherapy or risk of bias score. There was no indication for publication bias. CONCLUSIONS: We found no evidence that dissociation moderates the effectiveness of psychotherapy for PTSD. The quality of some of the included studies was relatively low, emphasising the need for high-quality clinical trials in patients with PTSD. The results suggest that pre-treatment dissociation does not determine psychotherapy outcome in PTSD.
Entities:
Keywords:
Dissociative disorders; group psychotherapy; individual psychotherapy; post-traumatic stress disorder
Authors: Hannah Murray; Nick Grey; Emma Warnock-Parkes; Alice Kerr; Jennifer Wild; David M Clark; Anke Ehlers Journal: Cogn Behav Therap Date: 2022-07-22
Authors: Aljosha Deen; Sarah V Biedermann; Annett Lotzin; Antje Krüger-Gottschalk; Anne Dyer; Christine Knaevelsrud; Heinrich Rau; Julia Schellong; Thomas Ehring; Ingo Schäfer Journal: Eur J Psychotraumatol Date: 2022-03-03