Table G1Cognitive behavioral therapy compared with an inactive comparator (usual care)

Outcome: Number of Studies; Number of Subjects; DesignRisk of BiasConsistencyDirectnessPrecisionMagnitude of Effect: Summary Effect Size (95% CI)Strength of Evidence
Incidence of PTSD at 6 months: 1; 46; RCTMediumaUnknown, single studyDirectImprecisebCBT vs. UC, CAPS, 9% vs. 55%, p<0.05Insufficient
Incidence of PTSD at 12 months: 1; 46; RCTMediumaUnknown, single studyDirectImprecisebCBT vs. UC, CAPS, 21% vs. 58%, p<0.05Insufficient
PTSD symptom severity at 6 months: 1; 46; RCTMediumaUnknown, single studyDirectImprecisebCBT vs. UC, CAPS total, 31.95 vs. 52.45, p<0.05Insufficient
PTSD symptom severity at 12 months: 1; 46; RCTMediumaUnknown, single studyDirectImprecisebCBT vs. UC, CAPS total, 25.26 vs. 52.50, p<0.05; Cohen’s d (95% CI) = 1.11 (0.34 to 1.88)Insufficient
Incidence of major depression at 6 months: 1; 46; RCTMediumaUnknown, single studyDirectImprecisebCBT vs. UC, MINI MDE, 18% vs. 45%, p=NSInsufficient
Incidence of major depression at 12 months: 1; 46; RCTMediumaUnknown, single studyDirectImprecisebCBT vs. UC, MINI MDE, 11% vs. 50%, p<0.05Insufficient
Incidence of an anxiety disorder at 6 months: 1; 46; RCTMediumaUnknown, single studyDirectImprecisebCBT vs. UC, MINI, 18% vs. 30%, p=NSInsufficient
Incidence of an anxiety disorder at 12 months: 1; 46; RCTMediumaUnknown, single studyDirectImprecisebCBT vs. UC, MINI, 11% vs. 7%, p=NSInsufficient
Depression symptom severity at 6 months: 1; 46; RCTMediumaUnknown, single studyDirectImprecisebCBT vs. UC, BDI, 12.24 vs. 31.20, p<0.05Insufficient
Depression symptom severity at 12 months: 1; 46; RCTMediumaUnknown, single studyDirectImprecisebCBT vs. UC, BDI, 13.95 vs. 29.00, p<0.05, Cohen’s d = 1.45 (0.69 to 2.21)Insufficient
Anxiety symptom severity at 6 months: 1; 46; RCTMediumaUnknown, single studyDirectImprecisebCBT vs. UC, HADS-A, 6.38 vs. 11.87, p<0.05Insufficient
Anxiety symptom severity at 12 months: 1; 46; RCTMediumaUnknown, single studyDirectImprecisebCBT vs. UC, HADS-A, 7.84 vs. 11.00, p<0.05, Cohen’s d (95% CI) = 0.76 (0.06 to 1.46)Insufficient
Quality of Life: 0; 0NANANANANAInsufficient
Return to work/return to active duty or ability to work: 0; 0NANANANANAInsufficient
Incidence of self-injurious or suicidal thoughts, attempts, or behaviors (including suicide): 0; 0NANANANANAInsufficient
Incidence of aggressive or homicidal thoughts, attempts, or behaviors (including homicide) 0; 0NANANANANAInsufficient
Perceived utility: 0; 0NANANANANAInsufficient
a

Downgraded due to lack of blinding

b

Small sample size (< 300 observations)

Abbreviations: BDI = Beck Depression Inventory; CAPS = Clinician Administered PTSD Scale; CBT = Cognitive behavioral therapy; CI = confidence interval; HADS-A = Hospital Anxiety and Depression Scale-Anxiety subscale; MDE = Major Depressive Episode; MINI = Mini International Neuropsychiatric Interview; NA = not applicable; NS = not significant; PTSD = posttraumatic stress disorder; RCT = randomized controlled trial; UC = Usual care

From: Appendix G, Psychological, Pharmacological, and Emerging Interventions: Strength-of-Evidence Grades

Cover of Interventions for the Prevention of Posttraumatic Stress Disorder (PTSD) in Adults After Exposure to Psychological Trauma
Interventions for the Prevention of Posttraumatic Stress Disorder (PTSD) in Adults After Exposure to Psychological Trauma [Internet].
Comparative Effectiveness Reviews, No. 109.
Gartlehner G, Forneris CA, Brownley KA, et al.

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