Efficacy of psychological interventions for complex post-traumatic stress disorder in adults exposed to complex traumas : A meta-analysis of randomized controlled trials

Introduction: Effective treatments for post-traumatic stress disorder (PTSD) have been established, but their applicability in complex post-traumatic stress disorder (CPTSD) is largely unknown.
 

Methods: We searched Pubmed, Web of Science, PsycInfo, Embase, CNKI, wanfang data, and SinoMed databases to seek out studies assessing the impact of psychological therapies on CPTSD among individuals with complex trauma. The quality of studies was assessed using the Cochrane Risk of Bias tool, and the moderating influence of study characteristics on the effect was examined.
 

Results: The pooled effect of psychotherapies compared with the control groups was significant, with PTSD (k = 27, g = −1.16, 95 % CI: −1.49 to −0.82), depression (k = 23, g = −1.12, 95%CI: −1.47 to −0.75), anxiety (k = 13, g = −1.25, 95%CI: −1.82 to −0.68), and dissociation (k = 7, g = −0.47, 95%CI: −0.74 to −0.19). At follow-up, the effect sizes decreased slightly, but there was still significant remission of symptoms except for anxiety and dissociation symptoms. Subgroup analysis and meta-regression showed that participants with childhood trauma had lower effects than those with other trauma types, and risk of bias and female proportion were the moderators. There were some indications of publication bias.
 

Conclusion: Psychological interventions for CPTSD showed significant effects after the intervention, and the effect was largely maintained during follow-up. Future studies could investigate how interventions can be further optimized and tailored to suit individuals' performance.

Highlights
•  Psychotherapies significantly relieved PTSD, depression, anxiety, and dissociation.
•  At follow-up, symptoms were still alleviated except for anxiety and dissociation.
•  Patients with childhood trauma had lower effects than those with other traumas.
•  Risk of bias and female proportion were the moderators.