Four Decades of Military Posttraumatic Stress: Protocol for a Meta-analysis and Systematic Review of Treatment Approaches and Efficacy

BackgroundOver 85% of active members of the Canadian Armed Forces have been exposed to potentially traumatic events linked to the development of posttraumatic stress disorder (PTSD). At the time of transition to civilian life, as high as 1 in 8 veterans may be diagnosed with...

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Main Authors: Jenny J W Liu, Anthony Nazarov, Bethany Easterbrook, Rachel A Plouffe, Tri Le, Callista Forchuk, Alec Brandwood, Kate St Cyr, Edouard Auger, Ken Balderson, Mathieu Bilodeau, Amer M Burhan, Murray W Enns, Patrick Smith, Fardous Hosseiny, Gabrielle Dupuis, Maya Roth, Natalie Mota, Vicky Lavoie, J Don Richardson
Format: Article
Language:English
Published: JMIR Publications 2021-10-01
Series:JMIR Research Protocols
Online Access:https://www.researchprotocols.org/2021/10/e33151
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author Jenny J W Liu
Anthony Nazarov
Bethany Easterbrook
Rachel A Plouffe
Tri Le
Callista Forchuk
Alec Brandwood
Kate St Cyr
Edouard Auger
Ken Balderson
Mathieu Bilodeau
Amer M Burhan
Murray W Enns
Patrick Smith
Fardous Hosseiny
Gabrielle Dupuis
Maya Roth
Natalie Mota
Vicky Lavoie
J Don Richardson
author_facet Jenny J W Liu
Anthony Nazarov
Bethany Easterbrook
Rachel A Plouffe
Tri Le
Callista Forchuk
Alec Brandwood
Kate St Cyr
Edouard Auger
Ken Balderson
Mathieu Bilodeau
Amer M Burhan
Murray W Enns
Patrick Smith
Fardous Hosseiny
Gabrielle Dupuis
Maya Roth
Natalie Mota
Vicky Lavoie
J Don Richardson
author_sort Jenny J W Liu
collection DOAJ
description BackgroundOver 85% of active members of the Canadian Armed Forces have been exposed to potentially traumatic events linked to the development of posttraumatic stress disorder (PTSD). At the time of transition to civilian life, as high as 1 in 8 veterans may be diagnosed with PTSD. Given the high prevalence of PTSD in military and veteran populations, the provision of effective treatment considering their unique challenges and experiences is critical for mental health support and the well-being of these populations. ObjectiveThis paper presents the protocol for a meta-analysis and systematic review that will examine the effectiveness of treatment approaches for military-related PTSD. MethodsThis PROSPERO-preregistered meta-analysis is being conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Cochrane guidelines. A comprehensive search of the literature was conducted using the databases PsycInfo, Medline, Embase, CINAHL, and ProQuest Dissertation & Theses. Effect sizes will be computed based on changes in PTSD symptom scores over time across studies using validated PTSD scales. A multilevel meta-analysis will examine the overall effects, between-study effects, and within-study effects of available evidence for PTSD treatments in military populations. Effect sizes will be compared between pharmacotherapeutic, psychotherapeutic, and alternative/emerging treatment interventions. Finally, meta-regression and subgroup analyses will explore the moderating roles of clinical characteristics (eg, PTSD symptom clusters), treatment approaches (eg, therapeutic orientations in psychotherapy and alternative therapies and classifications of drugs in pharmacotherapy), as well as treatment characteristics (eg, length of intervention) on treatment outcomes. ResultsThe literature search was completed on April 14, 2021. After the removal of duplicates, a total of 12,002 studies were screened for inclusion. As of July 2021, title and abstract screening has been completed, with 1469 out of 12,002 (12.23%) studies included for full-text review. Full review is expected to be completed in the summer of 2021, with initial results expected for publication by early winter of 2021. ConclusionsThis meta-analysis will provide information on the current state of evidence on the efficacy and effectiveness of various treatment approaches for military-related PTSD and identify factors that may influence treatment outcomes. The results will inform clinical decision-making for service providers and service users. Finally, the findings will provide insights into future treatment development and practice recommendations to better support the well-being of military and veteran populations. Trial RegistrationPROSPERO CRD42021245754; https://tinyurl.com/y9u57c59 International Registered Report Identifier (IRRID)DERR1-10.2196/33151
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spelling doaj.art-09550dbd4f20493f9f707d399cc2bb6a2023-08-28T19:42:03ZengJMIR PublicationsJMIR Research Protocols1929-07482021-10-011010e3315110.2196/33151Four Decades of Military Posttraumatic Stress: Protocol for a Meta-analysis and Systematic Review of Treatment Approaches and EfficacyJenny J W Liuhttps://orcid.org/0000-0003-2213-1346Anthony Nazarovhttps://orcid.org/0000-0002-3288-7609Bethany Easterbrookhttps://orcid.org/0000-0001-8741-9864Rachel A Plouffehttps://orcid.org/0000-0003-0393-9008Tri Lehttps://orcid.org/0000-0001-6059-3870Callista Forchukhttps://orcid.org/0000-0001-9085-0620Alec Brandwoodhttps://orcid.org/0000-0003-1595-5734Kate St Cyrhttps://orcid.org/0000-0002-5858-7612Edouard Augerhttps://orcid.org/0000-0002-2302-6225Ken Baldersonhttps://orcid.org/0000-0003-2221-1610Mathieu Bilodeauhttps://orcid.org/0000-0002-4850-0560Amer M Burhanhttps://orcid.org/0000-0002-9888-008XMurray W Ennshttps://orcid.org/0000-0002-8375-0151Patrick Smithhttps://orcid.org/0000-0003-1746-9932Fardous Hosseinyhttps://orcid.org/0000-0002-4448-2457Gabrielle Dupuishttps://orcid.org/0000-0002-5413-4536Maya Rothhttps://orcid.org/0000-0002-3668-6361Natalie Motahttps://orcid.org/0000-0003-2832-2223Vicky Lavoiehttps://orcid.org/0000-0002-7041-6912J Don Richardsonhttps://orcid.org/0000-0002-2927-6735 BackgroundOver 85% of active members of the Canadian Armed Forces have been exposed to potentially traumatic events linked to the development of posttraumatic stress disorder (PTSD). At the time of transition to civilian life, as high as 1 in 8 veterans may be diagnosed with PTSD. Given the high prevalence of PTSD in military and veteran populations, the provision of effective treatment considering their unique challenges and experiences is critical for mental health support and the well-being of these populations. ObjectiveThis paper presents the protocol for a meta-analysis and systematic review that will examine the effectiveness of treatment approaches for military-related PTSD. MethodsThis PROSPERO-preregistered meta-analysis is being conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Cochrane guidelines. A comprehensive search of the literature was conducted using the databases PsycInfo, Medline, Embase, CINAHL, and ProQuest Dissertation & Theses. Effect sizes will be computed based on changes in PTSD symptom scores over time across studies using validated PTSD scales. A multilevel meta-analysis will examine the overall effects, between-study effects, and within-study effects of available evidence for PTSD treatments in military populations. Effect sizes will be compared between pharmacotherapeutic, psychotherapeutic, and alternative/emerging treatment interventions. Finally, meta-regression and subgroup analyses will explore the moderating roles of clinical characteristics (eg, PTSD symptom clusters), treatment approaches (eg, therapeutic orientations in psychotherapy and alternative therapies and classifications of drugs in pharmacotherapy), as well as treatment characteristics (eg, length of intervention) on treatment outcomes. ResultsThe literature search was completed on April 14, 2021. After the removal of duplicates, a total of 12,002 studies were screened for inclusion. As of July 2021, title and abstract screening has been completed, with 1469 out of 12,002 (12.23%) studies included for full-text review. Full review is expected to be completed in the summer of 2021, with initial results expected for publication by early winter of 2021. ConclusionsThis meta-analysis will provide information on the current state of evidence on the efficacy and effectiveness of various treatment approaches for military-related PTSD and identify factors that may influence treatment outcomes. The results will inform clinical decision-making for service providers and service users. Finally, the findings will provide insights into future treatment development and practice recommendations to better support the well-being of military and veteran populations. Trial RegistrationPROSPERO CRD42021245754; https://tinyurl.com/y9u57c59 International Registered Report Identifier (IRRID)DERR1-10.2196/33151https://www.researchprotocols.org/2021/10/e33151
spellingShingle Jenny J W Liu
Anthony Nazarov
Bethany Easterbrook
Rachel A Plouffe
Tri Le
Callista Forchuk
Alec Brandwood
Kate St Cyr
Edouard Auger
Ken Balderson
Mathieu Bilodeau
Amer M Burhan
Murray W Enns
Patrick Smith
Fardous Hosseiny
Gabrielle Dupuis
Maya Roth
Natalie Mota
Vicky Lavoie
J Don Richardson
Four Decades of Military Posttraumatic Stress: Protocol for a Meta-analysis and Systematic Review of Treatment Approaches and Efficacy
JMIR Research Protocols
title Four Decades of Military Posttraumatic Stress: Protocol for a Meta-analysis and Systematic Review of Treatment Approaches and Efficacy
title_full Four Decades of Military Posttraumatic Stress: Protocol for a Meta-analysis and Systematic Review of Treatment Approaches and Efficacy
title_fullStr Four Decades of Military Posttraumatic Stress: Protocol for a Meta-analysis and Systematic Review of Treatment Approaches and Efficacy
title_full_unstemmed Four Decades of Military Posttraumatic Stress: Protocol for a Meta-analysis and Systematic Review of Treatment Approaches and Efficacy
title_short Four Decades of Military Posttraumatic Stress: Protocol for a Meta-analysis and Systematic Review of Treatment Approaches and Efficacy
title_sort four decades of military posttraumatic stress protocol for a meta analysis and systematic review of treatment approaches and efficacy
url https://www.researchprotocols.org/2021/10/e33151
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