OBJECTIVE A comprehensive quantitative summary of the efficacy and acceptability of psychological interventions (PIs) for adult posttraumatic stress disorder (PTSD) is lacking. METHOD We conducted a systematic literature search to identify randomized controlled trials (RCTs) examining the efficacy and acceptability (all-cause dropout) of psychological interventions (i.e., trauma-focused cognitive behavior therapy [TF-CBT], eye movement desensitization and reprocessing [EMDR], other trauma-focused interventions and non-trauma-focused interventions). RESULTS One hundred fifty-seven RCTs were included comprising 11,565 patients. Most research (64% of RCTs) accumulated for TF-CBT. In network meta-analyses, all therapies were effective when compared to control conditions. Interventions did not differ significantly in their efficacy. Yet, TF-CBT yielded higher short- (g = 0.17, 95% CI [0.03-0.31], number of comparisons kes = 190), mid- (i.e., ≤5 months posttreatment, g = 0.23, 95% CI [0.06-0.40], kes = 73) and long-term efficacy (i.e., >5 months posttreatment, g = 0.20, 95% CI [0.04-0.35], kes = 41) than non-trauma-focused interventions. There was some evidence of network inconsistencies, and heterogeneity in outcomes was large. In pairwise meta-analysis, slightly more patients dropped out from TF-CBT than non-trauma-focused interventions (RR = 1.36; 95% CI [1.08-1.70], kes = 22). Other than that, interventions did not differ in their acceptability. CONCLUSIONS Interventions with and without trauma focus are effective and acceptable in the treatment of PTSD. While TF-CBT yields the highest efficacy, slightly more patients discontinued TF-CBT than non-trauma-focused interventions. Altogether, the present results align with results of most previous quantitative reviews. Yet, results need to be interpreted with caution in light of some network inconsistencies and high heterogeneity in outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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成人创伤后应激障碍心理干预的有效性和可接受性：随机对照试验的网络和成对荟萃分析。

目的 对于成人创伤后应激障碍（PTSD）的心理干预（PI）的有效性和可接受性缺乏全面的定量总结。方法 我们进行了系统的文献检索，以确定随机对照试验 (RCT)，这些试验检查心理干预措施（即以创伤为中心的认知行为疗法 [TF-CBT]、眼动脱敏和再处理 [ EMDR]，其他以创伤为重点的干预措施和非以创伤为重点的干预措施）。结果 纳入 157 项随机对照试验，涉及 11,565 名患者。大多数研究（占 RCT 的 64%）都是针对 TF-CBT 积累的。在网络荟萃分析中，与对照条件相比，所有疗法均有效。干预措施的功效没有显着差异。然而，TF-CBT 产生了更高的短期（g = 0.17，95% CI [0.03-0.31]，比较次数 kes = 190）、中期（即治疗后 ≤ 5 个月，g = 0.23，95% CI [0.06） -0.40]，kes = 73）和长期疗效（即治疗后 >5 个月，g = 0.20，95% CI [0.04-0.35]，kes = 41）优于非针对创伤的干预措施。有一些证据表明网络存在不一致，并且结果的异质性很大。在配对荟萃分析中，退出 TF-CBT 的患者略多于非创伤重点干预措施的患者（RR = 1.36；95% CI [1.08-1.70]，kes = 22）。除此之外，干预措施的可接受性没有差异。结论 有或没有创伤焦点的干预措施在治疗 PTSD 方面都是有效且可接受的。虽然 TF-CBT 的疗效最高，但停止 TF-CBT 的患者略多于非创伤干预干预措施。总而言之，目前的结果与大多数先前定量评价的结果一致。然而，鉴于一些网络不一致和结果的高度异质性，需要谨慎解释结果。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。