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.
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Abstract
<h4>Background</h4>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).<h4>Methods</h4>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).<h4>Results</h4>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.<h4>Conclusion</h4>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 and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 16 Nov 2021 08:31 |
| Last Modified: | 18 Jan 2023 21:24 |
| DOI: | 10.1002/da.23221 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3143221 |
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