University of Malta, Msida, Malta.
Medical Imaging Department, Mater Dei Hospital, Msida, Malta.
Issues Ment Health Nurs. 2020 Feb;41(2):91-101. doi: 10.1080/01612840.2019.1650853. Epub 2019 Oct 29.
Narrative Exposure Therapy (NET) is a relatively new treatment that may be beneficial as a standalone approach or as an adjunct for use in individuals who suffer from simple or complex Posttraumatic Stress Disorder (PTSD). The main objective of this review was to explore the effectiveness of NET in remediating PTSD symptoms as compared to Non Trauma-Focused-Therapy (NTFT). A systematic search in Medline, PsycINFO, EMBASE and The Cochrane Central Register of Controlled Trials (CENTRAL) was carried out. Reference lists of papers and grey literature were hand searched. Experimental studies that compare NET to NTFT with no preference to age, gender or nationality of participants that include a baseline and 3-6 month measurement of PTSD outcomes using tools with good psychometric properties were included. The search resulted in 10 randomised controlled trials. Data extraction, collection and analysis was then carried out by the authors. In all of the studies, the difference in the PTSD symptoms' mean score after 3-6 months between the NET group and the NTFT group was in favour of NET. However, the level of significance was attained in six of the studies only. The overall effect size (standardised mean difference) of the trials is 0.684 in favour of NET ( < .001). NET was shown to be superior to NTFT in post-traumatic stress disorder. The most important recommendations are in relation to research and target the methodological limitations of existing studies in particular the small sample sizes, lack of blindness and inadequate rigour during the trials. More research is needed to further explore the benefits of NET for different populations and trauma-types.
叙事暴露疗法(NET)是一种相对较新的治疗方法,可作为单一方法或作为辅助治疗方法用于患有单纯或复杂创伤后应激障碍(PTSD)的个体。本综述的主要目的是探索 NET 在缓解 PTSD 症状方面与非创伤聚焦疗法(NTFT)相比的有效性。在 Medline、PsycINFO、EMBASE 和 The Cochrane Central Register of Controlled Trials(CENTRAL)中进行了系统搜索。手动搜索了论文和灰色文献的参考文献列表。纳入了比较 NET 与 NTFT 的实验研究,这些研究没有对参与者的年龄、性别或国籍进行偏好,并且包括使用具有良好心理测量特性的工具进行基线和 3-6 个月 PTSD 结果测量。搜索结果产生了 10 项随机对照试验。然后由作者进行数据提取、收集和分析。在所有研究中,NET 组和 NTFT 组在 3-6 个月后 PTSD 症状平均评分的差异均有利于 NET。然而,只有 6 项研究达到了显著性水平。试验的总体效应大小(标准化均数差)为 0.684,有利于 NET(<0.001)。NET 在创伤后应激障碍方面优于 NTFT。最重要的建议与研究有关,特别是针对现有研究的方法学局限性,例如样本量小、缺乏盲法和试验过程中不严谨。需要进一步研究以进一步探索 NET 对不同人群和创伤类型的益处。