Psychotherapy is an effective treatment for adults with post-traumatic stress disorder (PTSD) following exposure to multiple traumatic events, according to new research from the University of East Anglia.
The efficacy of psychotherapeutic interventions, or talking therapies, for treating PTSD in adults has been well-documented in various studies.
However, until now, it had not been established whether the benefit of psychotherapeutic interventions varies depending on whether the disorder is caused by one single event - for example, a traffic accident - or by multiple traumatic events such as during warfare or repeated incidents of sexual or physical violence.
An international team of researchers carried out a meta-analysis, based on data from around 10,600 patients, which has now been published in the journal Lancet Psychiatry.
The work was led by psychologists Dr Thole Hoppen and Prof Nexhmedin Morina from the Department for Clinical Psychology and Psychotherapy at the University of Münster, alongside Prof Richard Meiser-Stedman from the University of East Anglia, Dr Ahlke Kip from the University of Münster, and Prof Marianne Skogbrott Birkeland from the Research Centre for Violence and Traumatic Stress Studies in Norway.
PTSD can be a devastating reaction to trauma.
Talking therapies (e.g. trauma-focused cognitive behavioral therapy) are effective treatments for adults with PTSD.
However, such therapies typically involve detailed discussion of trauma, with some mental health professionals being concerned that this approach may not work when people have suffered multiple traumas, such as combat or sexual abuse.
In our review of over 130 clinical trials we found that adults whose PTSD stemmed from multiple trauma experiences gained the same degree of benefit as adults with single-event-related PTSD.
We hope this evidence will encourage therapists and adults suffering from PTSD, regardless of what type of experiences they have had, to consider trying this powerful treatment."
Richard Meiser-Stedman, Professor of Clinical Psychology, Norwich Medical School
These results had, to date, only been reported for the treatment of children and adolescents with PTSD. Now, this study confirms that it also applies in the treatment of PTSD in adults.
The researchers said this was "very encouraging news" for both patients and therapists.
Around four per cent of the global population suffers from PTSD as a result of traumatic events.
The characteristic symptoms of PTSD include distressing intrusive traumatic memories, avoidance behavior and difficulty with emotional regulation.
The new findings have implications for the clinical practice and training of psychotherapists and mental health professionals more generally.
"Our data helps remove treatment barriers for patients with a history of multiple traumatic events," said Prof Hoppen.
"In addition to patients' fear of talking about their traumatic experiences, some psychotherapists hesitate to directly address traumatic experiences during treatment.
"However, trauma-focused cognitive behavioral therapy - a form of psychotherapy which helps process the traumatic memories - is not only very effective according to the accumulated data but more effective than non-trauma-focused interventions."
As a result, trauma-focused cognitive behavioral therapy is the first line of treatment recommended in national and international treatment guidelines.
Prof Hoppen added that future research requires longer-term data to enable a more solid estimation of the long-term efficacy of the treatment.
'The efficacy of psychological interventions for adult posttraumatic stress disorder following exposure to single versus multiple traumatic events: a meta-analysis of randomized controlled trials' is published in The Lancet Psychiatry.
Hoppen, T. H., et al. (2024) The efficacy of psychological interventions for adult post-traumatic stress disorder following exposure to single versus multiple traumatic events: a meta-analysis of randomized controlled trials. The Lancet Psychiatry. doi.org/10.1016/S2215-0366(23)00373-5.