Best Available Evidence on Communicative First Aid Interventions by Laypeople for Preventing and Relieving Posttraumatic Stress Disorder-Related Symptomatology Following Traumatic Events.

Trauma-exposed individuals are at risk of developing mental health problems, including posttraumatic stress disorder (PTSD). As an exposed individual's friend or family member may be the first person to provide posttrauma relief, informing and training laypeople in psychosocial first aid may benefit mental health outcomes of trauma-exposed individuals. We aimed to (a) collect the best available evidence on communication as a first aid intervention in assisting individuals following traumatic events and (b) formulate practical recommendations. Systematic literature searches were conducted in three databases (March 2019). Following study selection, the extracted data were tabulated and synthesized narratively. The evidence was appraised according to the GRADE methodology and evaluated by a multidisciplinary expert panel to formulate recommendations for practice. Out of 1,724 articles, no experimental studies were identified, showing a complete lack of high-quality controlled studies on the efficacy of communicative practices. However, when lower-quality study designs were included, nine cross-sectional studies constituted the best available evidence. The studies suggested that positive communication by family members, r = -.38, aOR = 0.26, β = -.22, p < .001-p < .05, and expressive coping by the victim, β = -.62, p < .001, were associated with PTSD diagnosis and/or symptom severity; however, the evidence was of very low certainty. The expert panel took the methodological limitations into account when formulating weak practical recommendations. Cross-sectional studies currently provide the best possible evidence for developing guidelines on psychosocial first aid. High-quality controlled studies are needed to establish casual associations and identify the most effective interventions.