Department of Psychology.
Psychol Trauma. 2022 Jul;14(5):894-901. doi: 10.1037/tra0000566. Epub 2020 Mar 12.
The efficacy of behavioral activation (BA) for depression has been firmly established, and training therapists in BA may be less time-intensive than for standard interventions. Because BA addresses problematic avoidance behaviors, BA holds promise as a treatment for posttraumatic stress disorder (PTSD). We conducted a meta-analysis of both randomized controlled trials and uncontrolled studies involving the use of BA for the treatment of PTSD. Outcomes of interest were PTSD symptoms, anxiety, depression, and grief.
Meta-analyses included published studies in which BA served as the primary form of treatment for PTSD symptoms, whether PTSD was a primary or secondary outcome. Analyses were performed using Comprehensive Meta Analysis software with a random-effects model.
Eight studies (3 controlled, 5 uncontrolled) with a total sample size of 564 participants met final inclusion criteria. The primary analysis for controlled studies indicated a significant improvement in PTSD symptoms for BA compared with the case for wait-list control (Hedges's = 1.484) and for uncontrolled (Hedges's = 0.717) studies. Secondary analyses indicated improvement in anxiety, grief, and depression (Hedges's ranging from 0.28 to 2.29). No significant difference in effectiveness was observed for BA versus 2 active treatment comparison conditions (cognitive processing therapy and Internet-guided exposure). Effect sizes were not moderated by treatment modality (in-person vs. remote delivery) or by use of completer versus intention-to-treat data.
BA appears to be effective for PTSD symptoms, but additional randomized controlled trials are needed to increase confidence in these findings. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
行为激活（BA）治疗抑郁症的疗效已得到充分证实，且培训行为激活治疗师的时间可能比标准干预方法的时间更短。由于行为激活针对的是有问题的回避行为，因此它有望成为创伤后应激障碍（PTSD）的一种治疗方法。我们对使用行为激活治疗 PTSD 的随机对照试验和非对照研究进行了荟萃分析。感兴趣的结果是 PTSD 症状、焦虑、抑郁和悲伤。
元分析包括已发表的研究，其中 BA 作为 PTSD 症状的主要治疗形式，无论 PTSD 是主要还是次要结果。使用 Comprehensive Meta Analysis 软件进行分析，采用随机效应模型。
最终纳入了 8 项研究（3 项对照研究，5 项非对照研究），共有 564 名参与者。对照研究的主要分析表明，BA 组与等待名单对照组相比（Hedges's = 1.484）和非对照研究（Hedges's = 0.717），PTSD 症状均有显著改善。二级分析表明，焦虑、悲伤和抑郁也有所改善（Hedges's 的范围从 0.28 到 2.29）。BA 与 2 种活性治疗比较条件（认知加工疗法和互联网引导暴露）相比，疗效无显著差异。治疗方式（面对面与远程）或使用完成者与意向治疗数据对疗效无影响。
BA 似乎对 PTSD 症状有效，但需要更多的随机对照试验来提高对这些发现的信心。
