Article 6c: The relationship between childhood psychosocial stressor level and telomere length: a meta-analysis (Hanssen et al., 2017)

Question 1

Design of the study

Answer 1

This study looked into 3 variations of prolonged exposure therapy in patients with CA-PTSD:
1. PE: Prolonged Exposure
2. iPE: Intensified Prolonged Exposure
3. STAIR+PE: skills training and then prolonged exposure
They measures self-reported and clinical assessment after 0, 4, 8, 16 weeks and 6 and 12 months after the treatment.

Question 2

STAIR

Answer 2

Skills Training in Affective and Interpersonal Regulation. Is based on the notion that emotion regulation and interpersonal problems interfere with daily life and processing of trauma memories. Improvements in these capacities during the STAIR phase can thereby facilitate the effectiveness of PE.

Question 3

Primary outcome

Answer 3

All treatments resulted in large improvements in clinician assessed AND self-reported PTSD symptoms (also after a year). There were no significant differences among treatment, but:

Question 4

Non-significant differences among treatments

Answer 4

• iPE led to faster initial symptom reduction than PE for self-reported PTSD symptoms, but not clinician-assessed symptoms.
• iPE led to faster initial symptoms reduction than STAIR+PE for self-reported AND clinician-assessed symptoms.
• STAIR+PE did not results in significantly more improvement on the secondary outcomes: emotion regulation and interpersonal problems.
• All treatments led to improvements in emotion regulation, interpersonal problems and self-esteem.
• All treatments were equally effective in reducing PTSD-symptoms in patients with CA-PTSD.

Question 5

Conclusion

Answer 5

Variants of exposure therapy are tolerated well and lead to large improvements in patients with CA-PTSD. Intensifying treatment may lead to faster improvement, but NOT to overall better outcomes.