Interventions for the Prevention of Posttraumatic Stress Disorder (PTSD) in Adults After Exposure to Psychological Trauma [open pdf - 305KB]
"Posttraumatic stress disorder (PTSD) may develop following exposure to a traumatic event. According to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, Text Revision (DSM-IV-TR), the essential feature of PTSD is the development of characteristic symptoms following exposure to an extreme traumatic stressor. The stressor may include having direct personal experience of an event that involves actual or threatened death or serious injury or other threat to one's physical integrity; witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate. The DSM-IV-TR also requires that the person's subjective response to the event involve intense fear, helplessness, or horror. […] Prevention of PTSD can potentially reduce a significant burden of individual and societal suffering. Two different prevention strategies have been used. The first strategy, universal prevention, is to deliver interventions to all people exposed to a trauma, regardless of symptoms or risk of developing PTSD. The second strategy, targeted prevention, is based on the fact that although many people experience some symptoms of PTSD after trauma, only a relatively small percentage develop the psychiatric disorder of PTSD and its associated disability. The goal of targeted prevention is to identify, from among all people exposed to a trauma, those who are at high risk of developing the disorder of PTSD and then intervene only with those at high risk. […] This review compares the efficacy, effectiveness, and harms of psychological, pharmacological, and emerging interventions to prevent PTSD in adults. We include studies of both universal and targeted prevention. We also address the clinical importance of effect modifiers or subgroup status that may affect the impact of traumatic exposure on specific outcomes; these include sex, comorbidities, refugee status, and military or civilian status."
AHRQ Pub. No. 13-EHC062-1-EF; Agency for Healthcare Research and Quality Publication Number 13-Effective Healthcare 062-1-Effectivenes
Agency for Healthcare Research and Quality: http://www.effectivehealthcare.ahrq.gov/
Comparative Effectiveness Review (April 2013) no. 109