Department of Anesthesiology, University of North Carolina, Chapel Hill, North Carolina.
Department of Psychology, Florida State University, Tallahassee, Florida.
Depress Anxiety. 2020 Oct;37(10):1047-1059. doi: 10.1002/da.23030. Epub 2020 May 22.
Women who have experienced a recent sexual assault (SA) are at high risk for posttraumatic stress disorder (PTSD) and related conditions, with approximately half of women experiencing SA meeting criteria for PTSD. There are no guidelines for the prevention of PTSD and other common mental health disorders after SA. Thus, the purpose of this systematic review and meta-analysis is to synthesize research on secondary preventions for PTSD after SA, determine efficacy whether any intervention seems promising, and ascertain when, how, and to whom interventions should be delivered.
After searching electronic databases for secondary preventions for PTSD and related conditions among women who have experienced a recent SA, 17 studies were reviewed, their quality was rated on the clinical trial assessment measure, and 10 studies were meta-analyzed (7 were excluded, as they were not randomized controlled trials or due to the absence of heterogeneity).
Results suggested a small-to-moderate effect of prevention on reducing PTSD and related symptoms. There was no moderating effect of medication versus psychosocial interventions, timing, treatment modality, or targeted versus universal prevention. Half of the studies were of high quality.
Cognitive-behavioral secondary preventions for PTSD appear to be safe and effective among women who have experienced a recent SA. Future research should identify best practices and mechanisms of treatment, and once identified, it should move toward implementation science.
近期遭受性侵犯（SA）的女性患有创伤后应激障碍（PTSD）和相关疾病的风险很高，大约一半经历过 SA 的女性符合 PTSD 的标准。目前尚无针对 SA 后 PTSD 和其他常见心理健康障碍的预防指南。因此，本系统评价和荟萃分析的目的是综合研究 SA 后 PTSD 的二级预防措施，确定任何干预措施是否有效，并确定何时、如何以及向谁提供干预措施。
在搜索电子数据库中针对近期经历过 SA 的女性 PTSD 和相关疾病的二级预防措施后，共审查了 17 项研究，对临床试验评估量表进行了质量评估，并对 10 项研究进行了荟萃分析（有 7 项研究被排除在外，因为它们不是随机对照试验，或者由于缺乏异质性）。
结果表明，预防措施对减少 PTSD 和相关症状有较小到中等的效果。药物与心理社会干预、时间、治疗方式或有针对性与普遍性预防之间没有调节作用。一半的研究质量较高。
认知行为二级预防措施对近期经历过 SA 的女性似乎是安全有效的。未来的研究应确定最佳实践和治疗机制，一旦确定，就应转向实施科学。
