Skip to main content

LUP Student Papers

LUND UNIVERSITY LIBRARIES

Psychological interventions for posttraumatic stress disorder in adult refugees: A scoping review

Fredriksson, Lisa LU (2023) PSPR14 20222
Department of Psychology
Abstract
Refugees are at significantly increased risk of mental health difficulties, including Post-Traumatic Stress Disorder (PTSD). There is a large evidence base showing that trauma-focused psychological treatments for PTSD are effective. However, the majority of trials do not include refugees and less is known about response to PTSD treatments in refugees. The present scoping review explores the current state of the literature about psychological interventions for PTSD in adult refugees. Two literature searches were conducted to identify: 1) recent meta-analyses of randomized controlled trials (RCTs) of psychological interventions for PTSD in adult refugees; and 2) RCT’s published after the meta-analyses that address knowledge gaps identified... (More)
Refugees are at significantly increased risk of mental health difficulties, including Post-Traumatic Stress Disorder (PTSD). There is a large evidence base showing that trauma-focused psychological treatments for PTSD are effective. However, the majority of trials do not include refugees and less is known about response to PTSD treatments in refugees. The present scoping review explores the current state of the literature about psychological interventions for PTSD in adult refugees. Two literature searches were conducted to identify: 1) recent meta-analyses of randomized controlled trials (RCTs) of psychological interventions for PTSD in adult refugees; and 2) RCT’s published after the meta-analyses that address knowledge gaps identified in the meta-analyses. The status of the evidence base is summarized from these sources. A total of four meta-analyses were included, all yielding support for trauma-focused psychological interventions, primarily trauma-focused cognitive behavioural therapy (TF-CBT). Included meta-analyses indicated that the majority of RCTs involved inactive comparisons and short follow-ups. In the secondary search, 12 recent RCTs were identified. However, only one involved active treatment comparison and long-term follow-up, and the majority of trials are of varying methodological quality. Across included studies, the most frequently evaluated interventions are TF-CBT, Eye Movement Desensitization and Reprocessing Therapy (EMDR) and Narrative Exposure Therapy (NET). The available evidence suggests that these interventions yield moderate to large effect sizes for PTSD at post-treatment relative to no-treatment in refugee populations, which is similar to effect sizes found in RCTs with non-refugee populations. However, firm conclusions awaits more rigorous RCTs involving active comparisons and long-term follow-ups. In the interim, the available evidence suggests that TF-CBT, EMDR and NET interventions should be made available to refugees with PTSD. (Less)
Abstract (Swedish)
Flyktingar löper signifikant högre risk för att utveckla psykisk ohälsa, däribland posttraumatiskt stressyndrom (PTSD). Det finns en stor evidensbas som visar att traumafokuserade psykologiska behandlingar för PTSD är effektiva. Majoriteten av denna forskning inkluderar dock inte flyktingar, vilket innebär att mindre är känt om responsen för behandling av PTSD hos flyktingar. Den aktuella översikten utforskade det rådande forskningsläget om psykologiska interventioner för PTSD hos vuxna flyktingar. En litteratursökning genomfördes i två stadier för att identifiera: 1) nyligen publicerade meta-analyser om randomiserade kontrollerade studier (RCTs); och 2) RCTs publicerade efter meta-analyserna som fyller de kunskapsluckor inom... (More)
Flyktingar löper signifikant högre risk för att utveckla psykisk ohälsa, däribland posttraumatiskt stressyndrom (PTSD). Det finns en stor evidensbas som visar att traumafokuserade psykologiska behandlingar för PTSD är effektiva. Majoriteten av denna forskning inkluderar dock inte flyktingar, vilket innebär att mindre är känt om responsen för behandling av PTSD hos flyktingar. Den aktuella översikten utforskade det rådande forskningsläget om psykologiska interventioner för PTSD hos vuxna flyktingar. En litteratursökning genomfördes i två stadier för att identifiera: 1) nyligen publicerade meta-analyser om randomiserade kontrollerade studier (RCTs); och 2) RCTs publicerade efter meta-analyserna som fyller de kunskapsluckor inom behandlingslitteraturen som identifierats i meta-analyserna. Det aktuella evidensläget summerades utifrån dessa informationskällor. Sammantaget inkluderades fyra meta-analyser, som alla gav stöd för psykologiska interventioner för PTSD, med mest stöd för traumafokuserad kognitiv beteendeterapi (TF-KBT). Alla fyra meta-analyser indikerade att majoriteten av RCTs varken involverade kontrollgrupper med aktiv behandling eller långsiktig uppföljning, samt var av varierande metodologisk kvalitet. I den andra litteratursökningen identifierades 12 RCTs. Endast en av dessa involverade dock både en aktiv kontrollgrupp och långtidsuppföljning. I de inkluderade studierna var TF-KBT, Eye Movement Desensitization and Reprocessing (EMDR) and Narrativ Exponeringsterapi (NET) de oftast utvärderade psykologiska interventionerna för PTSD hos flyktingar. Den tillgängliga evidensen tyder på att dessa interventioner ger måttliga till stora effektstorlekar vid behandlingsavslut jämfört med ingen behandling hos flyktingar, vilket liknar funna effektstorlekar i RCTs med icke- flyktingar. För att dra säkra slutsatser krävs dock mer omfattande RCTs med aktiva jämförelser och långtidsuppföljning. Det vetenskapliga underlaget tyder tills vidare på att behandling med TF-KBT, EMDR and NET bör göras tillgänglig för flyktingar med PTSD. (Less)
Please use this url to cite or link to this publication:
author
Fredriksson, Lisa LU
supervisor
organization
course
PSPR14 20222
year
type
H3 - Professional qualifications (4 Years - )
subject
keywords
Posttraumatic Stress Disorder, Refugees, Psychotherapy, Randomized Controlled Trials, Posttraumatiskt stressyndrom, Flyktingar, Psykoterapi, Randomiserade kontrollerade studier
language
English
id
9112914
date added to LUP
2023-03-27 15:16:51
date last changed
2023-03-27 15:16:51
@misc{9112914,
  abstract     = {{Refugees are at significantly increased risk of mental health difficulties, including Post-Traumatic Stress Disorder (PTSD). There is a large evidence base showing that trauma-focused psychological treatments for PTSD are effective. However, the majority of trials do not include refugees and less is known about response to PTSD treatments in refugees. The present scoping review explores the current state of the literature about psychological interventions for PTSD in adult refugees. Two literature searches were conducted to identify: 1) recent meta-analyses of randomized controlled trials (RCTs) of psychological interventions for PTSD in adult refugees; and 2) RCT’s published after the meta-analyses that address knowledge gaps identified in the meta-analyses. The status of the evidence base is summarized from these sources. A total of four meta-analyses were included, all yielding support for trauma-focused psychological interventions, primarily trauma-focused cognitive behavioural therapy (TF-CBT). Included meta-analyses indicated that the majority of RCTs involved inactive comparisons and short follow-ups. In the secondary search, 12 recent RCTs were identified. However, only one involved active treatment comparison and long-term follow-up, and the majority of trials are of varying methodological quality. Across included studies, the most frequently evaluated interventions are TF-CBT, Eye Movement Desensitization and Reprocessing Therapy (EMDR) and Narrative Exposure Therapy (NET). The available evidence suggests that these interventions yield moderate to large effect sizes for PTSD at post-treatment relative to no-treatment in refugee populations, which is similar to effect sizes found in RCTs with non-refugee populations. However, firm conclusions awaits more rigorous RCTs involving active comparisons and long-term follow-ups. In the interim, the available evidence suggests that TF-CBT, EMDR and NET interventions should be made available to refugees with PTSD.}},
  author       = {{Fredriksson, Lisa}},
  language     = {{eng}},
  note         = {{Student Paper}},
  title        = {{Psychological interventions for posttraumatic stress disorder in adult refugees: A scoping review}},
  year         = {{2023}},
}