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Gartlehner G, Forneris CA, Brownley KA, et al. Interventions for the Prevention of Posttraumatic Stress Disorder (PTSD) in Adults After Exposure to Psychological Trauma [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Apr. (Comparative Effectiveness Reviews, No. 109.)

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  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

Cover of Interventions for the Prevention of Posttraumatic Stress Disorder (PTSD) in Adults After Exposure to Psychological Trauma

Interventions for the Prevention of Posttraumatic Stress Disorder (PTSD) in Adults After Exposure to Psychological Trauma [Internet].

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Appendix HSensitivity Analyses

KEY QUESTION 1

Cognitive Behavioral Therapy (CBT)

Sensitivity Analyses: Including the high risk of bias study Bryant, 1999

Figure H1 is titled “Mean change from baseline to end of treatment in PTSD incidence rates for CBT compared with SC.” The figure displays a forest plot reporting the combined relative risk of developing a PTSD diagnosis according to the CAPS-2 or the CIDI-PTSD in the CBT group versus the supportive counseling group after including the high risk of bias study Bryant, 1999. The sensitivity analysis results show that the CBT group had a statistically significantly lower risk of PTSD at the end of treatment compared to the supportive counseling group (relative risk, 0.33, 95% CI, 0.12 to 0.86). Overall I2 = 58.7%.

Figure H1

Mean change from baseline to end of treatment in PTSD incidence rates for CBT compared with supportive counseling.

Figure H2 is titled “Mean change from baseline to 6-month follow-up in PTSD incidence rates for CBT compared with SC.” The figure displays a forest plot reporting the combined relative risk of developing a PTSD diagnosis according to the CAPS-2 or the CIDI-PTSD in the CBT group versus the supportive counseling group after including the high risk of bias study Bryant, 1999. The sensitivity analysis results show that the CBT group had a statistically significantly lower risk of PTSD at 6-month follow-up compared to the supportive counseling group (relative risk, 0.45, 95% CI, 0.25 to 0.82). Overall I2 = 32.0%.

Figure H2

Mean change from baseline to 6-month followup in PTSD incidence rates for CBT compared with supportive counseling.

Figure H3 is titled “Mean change from baseline to end of treatment in IES Avoidance Subscale symptom scores for CBT compared with SC.” The figure displays a forest plot reporting the change in weighted mean difference in IES Avoidance symptom scores between the CBT group and the supportive counseling group after including the high risk of bias study Bryant, 1999. The sensitivity analysis results show that the CBT group experienced a significantly greater reduction in IES Avoidance scores at the end of treatment compared to the supportive counseling group (weighted mean difference, −14.17, 95% CI, −17.82 to −10.51). Overall I2 = 31.9%.

Figure H3

Mean change from baseline to end of treatment in IES Avoidance Subscale symptom scores for CBT compared with supportive counseling.

Figure H4 is titled “Mean change from baseline to 6-month follow-up in IES Avoidance Subscale symptom scores for CBT compared with SC.” The figure displays a forest plot reporting the change in weighted mean difference in IES Avoidance symptom scores between the CBT group and the supportive counseling group after including the high risk of bias study Bryant, 1999. The sensitivity analysis results show that the CBT group experienced a significantly greater reduction in IES Avoidance scores at 6-month follow-up compared to the supportive counseling group (weighted mean difference, −11.49, 95% CI, −16.09 to −6.90). Overall I2 = 52.7%.

Figure H4

Mean change from baseline to 6-month follow-up in IES Avoidance Subscale symptom scores for CBT compared with supportive counseling.

Figure H5 is titled “Mean change from baseline to end of treatment in IES Intrusion Subscale symptom scores for CBT compared with SC.” The figure displays a forest plot reporting the change in weighted mean difference in IES Intrusion symptom scores between the CBT group and the supportive counseling group after including the high risk of bias study Bryant, 1999. The sensitivity analysis results show that the CBT group experienced a significantly greater reduction in IES Intrusion scores at the end of treatment compared to the supportive counseling group (weighted mean difference, −8.39, 95% CI, −11.45 to −5.34). Overall I2 = 0.0%.

Figure H5

Mean change from baseline to end of treatment in IES Intrusion Subscale symptom scores for CBT compared with supportive counseling.

Figure H6 is titled “Mean change from baseline to 6-month follow-up of treatment in IES Intrusion Subscale symptom scores for CBT compared with SC.” The figure displays a forest plot reporting the change in weighted mean difference in IES Intrusion symptom scores between the CBT group and the supportive counseling group after including the high risk of bias study Bryant, 1999. The sensitivity analysis results show that the CBT group experienced a significantly greater reduction in IES Intrusion scores at the end of treatment compared to the supportive counseling group (weighted mean difference, −7.91, 95% CI, −10.85 to −4.98). Overall I2 = 0.0%.

Figure H6

Mean change from baseline to 6-month follow-up in IES Intrusion Subscale symptom scores for CBT compared with supportive counseling.

Figure H7 is titled “Mean change from baseline to end of treatment in anxiety symptom scores for CBT compared with SC.” The figure displays a forest plot reporting the change in standardized mean difference in anxiety symptom scores measured using the BAI or the STAI between the CBT group and the supportive counseling group after including the high risk of bias study Bryant, 1999. The sensitivity analysis results show a statistically significant difference in anxiety symptom score changes at the end of treatment in the CBT group compared to the supportive counseling group (standardized mean difference, −0.39, 95% CI, −0.74 to −0.04). Overall I2 = 2.2%.

Figure H7

Mean change from baseline to end of treatment in anxiety symptom scores for CBT compared with supportive counseling.

Figure H8 is titled “Mean change from baseline to 6-month follow-up in anxiety symptom scores for CBT compared with SC.” The figure displays a forest plot reporting the change in standardized mean difference in anxiety symptom scores measured using the BAI or the STAI between the CBT group and the supportive counseling group after including the high risk of bias study Bryant, 1999. The sensitivity analysis results show a statistically significant difference in anxiety symptom score changes at the end of treatment in the CBT group compared to the supportive counseling group (standardized mean difference, −0.59, 95% CI, −1.16 to −0.01). Overall I2 = 58.7%.

Figure H8

Mean change from baseline to 6-month follow-up in anxiety symptom scores for CBT compared with supportive counseling.

Figure H9 is titled “Mean change from baseline to end of treatment in depression symptom scores for CBT compared with SC.” The figure displays a forest plot reporting the change in standardized mean difference in depression symptom scores measured using the BDI or the BDI-2 between the CBT group and the supportive counseling group after including the high risk of bias study Bryant, 1999. The sensitivity analysis results show no statistically significant difference in depression symptom score changes at the end of treatment in the CBT group compared to the supportive counseling group (standardized mean difference, −0.22, 95% CI, −0.56 to 0.12). Overall I2 = 0.0%.

Figure H9

Mean change from baseline to end of treatment in depression symptom scores for CBT compared with supportive counseling.

Figure H10 is titled “Mean change from baseline to 6-month follow-up in depression symptom scores for CBT compared with SC.” The figure displays a forest plot reporting the change in standardized mean difference in depression symptom scores measured using the BDI or the BDI-2 between the CBT group and the supportive counseling group after including the high risk of bias study Bryant, 1999. The sensitivity analysis results show no statistically significant difference in depression symptom score changes at the end of treatment in the CBT group compared to the supportive counseling group (standardized mean difference, −0.25, 95% CI, −0.62 to 0.12). Overall I2 = 10.1%.

Figure H10

Mean change from baseline to 6-month follow-up in depression symptom scores for CBT compared with supportive counseling.

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