Moving beyond symptom reduction: A meta-analysis on the effect of exposure therapy for PTSD on quality of life

IF 2.5 3区心理学 Q2 PSYCHOLOGY, CLINICAL Journal of Clinical Psychology Pub Date : 2024-06-14 DOI:10.1002/jclp.23727

Kiran Kaur, Anu Asnaani, Hannah C. Levy, Madeleine L. Miller, David F. Tolin, Carmen P. McLean

{"title":"Moving beyond symptom reduction: A meta-analysis on the effect of exposure therapy for PTSD on quality of life","authors":"Kiran Kaur, Anu Asnaani, Hannah C. Levy, Madeleine L. Miller, David F. Tolin, Carmen P. McLean","doi":"10.1002/jclp.23727","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>Quality of life (QOL) is a multidimensional construct including emotional well-being, life satisfaction, and physical health. Individuals with posttraumatic stress disorder (PTSD) consistently report low QOL, highlighting the importance of assessing the effectiveness of first-line PTSD treatments (e.g., exposure-based therapies) on QOL. This meta-analysis examined the efficacy of exposure therapy for PTSD on QOL compared to control conditions (e.g., waitlist, medication, treatment-as-usual) at posttreatment and follow-up (ranging from 1 month to 2 years).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Building on a previous meta-analysis of exposure-based therapy for PTSD, we searched PsycINFO and Medline in December 2021, July 2022, and March 2023 to include randomized controlled trials of exposure-based treatments for adult PTSD assessing QOL. We screened 295 abstracts for initial eligibility; 20 articles met inclusion criteria and were included (<i>N</i> = 2729 participants). Risk of bias was evaluated using the Cochrane Risk of Bias tool 2.0.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>At posttreatment, exposure-based therapies showed a medium effect on QOL relative to control conditions (<i>k</i> = 25, <i>g</i> = 0.67). This effect was not observed at follow-up for the small subset of studies with follow-up data (<i>k</i> = 8, <i>g</i> = 0.16). At posttreatment, effect size varied significantly as a function of the control condition (<i>p</i> < .0001). There were no differences in QOL effects across exposure therapies at posttreatment or follow-up (<i>p</i> = .09).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Exposure therapy was associated with greater improvement in QOL compared to control conditions at posttreatment. Exposure was not superior to control conditions at follow-up, and the longer-term impact of exposure on QOL is unclear. The implications of these findings are discussed, along with the need for more PTSD treatment studies to examine QOL outcomes at posttreatment and follow-up.</p>\n </section>\n </div>","PeriodicalId":15395,"journal":{"name":"Journal of Clinical Psychology","volume":"80 10","pages":"2134-2146"},"PeriodicalIF":2.5000,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jclp.23727","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Psychology","FirstCategoryId":"102","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/jclp.23727","RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

Quality of life (QOL) is a multidimensional construct including emotional well-being, life satisfaction, and physical health. Individuals with posttraumatic stress disorder (PTSD) consistently report low QOL, highlighting the importance of assessing the effectiveness of first-line PTSD treatments (e.g., exposure-based therapies) on QOL. This meta-analysis examined the efficacy of exposure therapy for PTSD on QOL compared to control conditions (e.g., waitlist, medication, treatment-as-usual) at posttreatment and follow-up (ranging from 1 month to 2 years).

Methods

Building on a previous meta-analysis of exposure-based therapy for PTSD, we searched PsycINFO and Medline in December 2021, July 2022, and March 2023 to include randomized controlled trials of exposure-based treatments for adult PTSD assessing QOL. We screened 295 abstracts for initial eligibility; 20 articles met inclusion criteria and were included (N = 2729 participants). Risk of bias was evaluated using the Cochrane Risk of Bias tool 2.0.

Results

At posttreatment, exposure-based therapies showed a medium effect on QOL relative to control conditions (k = 25, g = 0.67). This effect was not observed at follow-up for the small subset of studies with follow-up data (k = 8, g = 0.16). At posttreatment, effect size varied significantly as a function of the control condition (p < .0001). There were no differences in QOL effects across exposure therapies at posttreatment or follow-up (p = .09).

Conclusion

Exposure therapy was associated with greater improvement in QOL compared to control conditions at posttreatment. Exposure was not superior to control conditions at follow-up, and the longer-term impact of exposure on QOL is unclear. The implications of these findings are discussed, along with the need for more PTSD treatment studies to examine QOL outcomes at posttreatment and follow-up.

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

超越症状缓解：创伤后应激障碍暴露疗法对生活质量影响的荟萃分析。

目的：生活质量（QOL）是一个多维度的概念，包括情感幸福感、生活满意度和身体健康。创伤后应激障碍（PTSD）患者的生活质量始终较低，这凸显了评估创伤后应激障碍一线治疗（如暴露疗法）对生活质量的影响的重要性。这项荟萃分析研究了暴露疗法治疗创伤后应激障碍在治疗后和随访（1 个月至 2 年）期间与对照组（如候选名单、药物治疗、照常治疗）相比对 QOL 的疗效：基于之前对创伤后应激障碍暴露疗法的荟萃分析，我们在 2021 年 12 月、2022 年 7 月和 2023 年 3 月检索了 PsycINFO 和 Medline，以纳入评估 QOL 的成人创伤后应激障碍暴露疗法随机对照试验。我们筛选了 295 篇摘要进行初步资格审查；20 篇文章符合纳入标准并被纳入（N = 2729 名参与者）。我们使用 Cochrane Risk of Bias 工具 2.0 对偏倚风险进行了评估：与对照组相比，暴露疗法在治疗后的 QOL 方面显示出中等效果（k = 25，g = 0.67）。在有随访数据的一小部分研究中，随访时未观察到这种效应（k = 8，g = 0.16）。在治疗后，效果大小随控制条件的不同而有显著差异（p 结论：暴露疗法与心理健康的改善更相关：与对照组相比，暴露疗法在治疗后能更大程度地改善患者的 QOL。暴露疗法在随访时并不优于对照条件，暴露疗法对 QOL 的长期影响尚不清楚。本文讨论了这些研究结果的意义，并指出有必要开展更多创伤后应激障碍治疗研究，以检查治疗后和随访时的 QOL 结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Journal of Clinical Psychology PSYCHOLOGY, CLINICAL-

CiteScore

5.40

自引率

3.30%

发文量

177

期刊介绍： Founded in 1945, the Journal of Clinical Psychology is a peer-reviewed forum devoted to research, assessment, and practice. Published eight times a year, the Journal includes research studies; articles on contemporary professional issues, single case research; brief reports (including dissertations in brief); notes from the field; and news and notes. In addition to papers on psychopathology, psychodiagnostics, and the psychotherapeutic process, the journal welcomes articles focusing on psychotherapy effectiveness research, psychological assessment and treatment matching, clinical outcomes, clinical health psychology, and behavioral medicine.