Residual posttraumatic stress disorder symptoms after provision of brief behavioral intervention in low‐ and middle‐income countries: An individual‐patient data meta‐analysis

Akhtar, Aemal, Koyiet, Phiona, Rahman, Atif ORCID: 0000-0002-2066-4467, Schafer, Alison, Hamdani, Syed Usman, Cuijpers, Pim, Sijbrandij, Marit and Bryant, Richard A (2021) Residual posttraumatic stress disorder symptoms after provision of brief behavioral intervention in low‐ and middle‐income countries: An individual‐patient data meta‐analysis Depression and Anxiety, 39 (1). pp. 71-82. ISSN 1091-4269, 1520-6394

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Abstract

Background: To address shortages of mental health specialists in low- and middle-income countries, task-shifting approaches have been employed to train nonspecialists to deliver evidence-based scalable psychosocial interventions. Problem Management Plus (PM+) is a brief transdiagnostic nontrauma focused intervention for people affected by adversity. This study reports on the capacity of PM+ to address specific symptoms of posttraumatic stress disorder (PTSD). Methods: Individual patient data from three randomised controlled trials were combined and analysed to observe the impacts of PM+ (n = 738) or enhanced treatment as usual (ETAU) (n = 742) interventions on specific PTSD symptoms at posttreatment and 3-month follow-up. The PTSD-Checklist for DSM-5 (PCL-5) was used to index PTSD symptoms, and presence of each symptom was defined as moderate severity (score ≥ 2 on individual items). Results: The average PCL-5 score at baseline was 26.1 (SD: 16.8) with 463 (31.3%) scoring above 33, indicative of a diagnosis of PTSD. Following intervention, 12.5% and 5.8% of participants retained a score greater than 33 at postassessment and follow-up, respectively. There was greater symptom reduction for PM+ than for ETAU for most symptoms. Hyperarousal symptoms were the most common residual symptoms after PM+, with more than 30% of participants reporting persistent sleep disturbance, concentration difficulties, and anger. Conclusion: PM+ led to greater reduction in symptoms relating to re-experiencing and avoidance. The evidence indicates that strategies focusing on hyperarousal symptoms including sleep, concentration, and anger difficulties, could be strengthened in this brief intervention.

Item Type:	Article
Uncontrolled Keywords:	behaviour therapy, posttraumatic stress disorder, problem management plus, randomised controlled trial, residual symptoms, task-sharing
Divisions:	Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Inst. Population Health
Depositing User:	Symplectic Admin
Date Deposited:	16 Nov 2021 08:31
Last Modified:	01 Mar 2026 11:48
DOI:	10.1002/da.23221
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3143221
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