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Multiple session early psychological interventions for the prevention of post-traumatic stress disorder
Cochrane Reviews, 07/15/09

Roberts NP et al. - The results suggest that no psychological intervention can be recommended for routine use following traumatic events and that multiple session interventions, like single session interventions, may have an adverse effect on some individuals. The clear practice implication of this is that, at present, multiple session interventions aimed at all individuals exposed to traumatic events should not be used. Further, better designed studies that explore new approaches to early intervention are now required.

Methods

Randomised controlled trials of any multiple session early psychological intervention or treatment (two or more sessions) designed to prevent symptoms of PTSD.
Data were entered using Review Manager software.
The methodological quality of included studies was assessed individually by two review authors.
Data were analysed for summary effects using Review Manager 4.2.
Mean difference was used for meta-analysis of continuous outcomes and relative risk for dichotomous outcomes.

Results

Eleven studies with a total of 941 participants were found to have evaluated brief psychological interventions aimed at preventing PTSD in individuals exposed to a specific traumatic event, examining a heterogeneous range of interventions.
Eight studies were entered into meta-analysis.
There was no observable difference between treatment and control conditions on primary outcome measures for these interventions at initial outcome (k=5, n=479; RR 0.84; 95% CI 0.60 to 1.17).
There was a trend for increased self-report of PTSD symptoms at 3 to 6 month follow-up in those who received an intervention (k=4, n=292; SMD 0.23; 95% CI 0.00 to 0.46).
Two studies compared a memory structuring intervention against supportive listening.
There was no evidence supporting the efficacy of this intervention.

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