AN UPDATE ON THE EFFICACY OF COGNITIVE-BEHAVIORAL THERAPY, COGNITIVE THERAPY, AND EXPOSURE THERAPY FOR POSTTRAUMATIC STRESS DISORDER

作者：Mello Patricia Gaspar; Silva Gustavo Ramos^*; Donat Julia Candia; Kristensen Christian Haag

来源：International Journal of Psychiatry in Medicine, 2013, 46(4): 339-357.

DOI：10.2190/PM.46.4.b

• cognitive behavioral therapy
• cognitive therapy
• exposure therapy
• posttraumatic stress disorder
• systematic review

Objective: Even though cognitive-behavioral therapy (CBT) is the current treatment of choice for posttraumatic stress disorder (PTSD), it is still unclear which components of its protocol are more important for clinical improvement. This study aims to replicate a previous review, updating findings on the efficacy of CBT, cognitive therapy (CT), and exposure therapy (ET) for PTSD when compared with other well-established treatments or conditions without active treatment. Method: The search was performed in the databases Cochrane, Embase, and Medline. Studies were required to be randomized controlled trials published between 2006 and 2012 comparing CBT, CT, or ET with (1) each other, (2) other active treatments (e. g., EMDR, counseling, supportive therapy), or (3) assessment-only conditions. The main outcome measures were diagnostic and symptomatic remission. Results: The final sample contained 29 articles. CBT, CT, and ET were shown to be efficacious treatments individually when compared to assessment-only conditions, with no difference found between treatments. Comparison with other active treatments favored ET. Both included studies comparing CBT and EMDR favored the latter. Conclusions: CBT and its components still appear to be equally efficacious in improving PTSD symptoms and diagnosis. Even so, a current tendency of researchers to focus on ET exists. EMDR shows interesting results compared to CBT. Further research should clarify the lasting effects, efficiency, and other comparative benefits of each protocol.

• 出版日期2013