Open AccessTreatment augmentation for posttraumatic stress disorder: A systematic review
Author(s) -
Metcalf Olivia,
Stone Caleb,
Hinton Mark,
O’Donnell Meaghan,
Hopwood Malcolm,
McFarlane Alexander,
Forbes David,
Kartal Dzenana,
Watson Loretta,
Freijah Isabella,
Varker Tracey
Publication year - 2020
Publication title -
clinical psychology: science and practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 105
eISSN - 1468-2850
pISSN - 0969-5893
DOI - 10.1111/cpsp.12310
Subject(s) - psychological intervention , posttraumatic stress , cognition , psychology , extinction (optical mineralogy) , exposure therapy , clinical psychology , cognitive processing therapy , medicine , psychotherapist , cognitive behavioral therapy , psychiatry , anxiety , paleontology , biology
This systematic review examined the efficacy of all augmentation approaches for first‐line posttraumatic stress disorder (PTSD) interventions. From 9,890 records, 34 trials were eligible for inclusion, covering 28 different augmentation approaches. Overall, augmentation approaches were ineffective if they targeted a mechanism similar to the first‐line treatment. Augmentation approaches combining two guideline‐recommended treatments were largely ineffective, reflecting ceiling effects. Pharmacological augmentation approaches targeting fear extinction mechanisms were largely ineffective, or worsened outcomes relative to prolonged exposure alone, as these approaches may inadvertently strengthen fear memories. Augmentation approaches targeting general cognitive enhancement showed promise and provided support for augmentation interventions that require little cognitive or emotional work and target mechanisms different than the first‐line treatment.