Evidence map›Paper›PMID 39537555›Full record

SynthesisBMJ mental health2024

Predictors of study dropout in cognitive-behavioural therapy with a trauma focus for post-traumatic stress disorder in adults: An individual participant data meta-analysis.

Simonne Wright, Eirini Karyotaki, Pim Cuijpers, Jonathan Bisson, Davide Papola, Anke B Witteveen, Sudie E Back, Dana Bichescu-Burian, Liuva Capezzani, Marylene Cloitre and 37 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ mental health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

47 authors.

Simonne WrightSouth Africa PTSD Research Programme of Excellence, Department of Psychiatry, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa simonnewright87@gmail.com.ORCID 0000-0003-3295-256X
Eirini KaryotakiDepartment of Clinical, Neuro- and Developmental Psychology, World Health Organization Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.ORCID 0000-0002-0071-2599
Pim CuijpersDepartment of Clinical, Neuro- and Developmental Psychology, World Health Organization Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.ORCID 0000-0001-5497-2743
Jonathan BissonDivision of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
Davide PapolaWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.ORCID 0000-0001-6482-8593
Anke B WitteveenDepartment of Clinical, Neuro- and Developmental Psychology, World Health Organization Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, Netherlands.
Sudie E BackDepartment of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.
Dana Bichescu-Burian6 Center for Psychiatry Reichenau, Academic Hospital of the University of Konstanz, Konstanz, Germany.
Liuva CapezzaniInternational School of Psychotherapy in the Institutional Setting (SIPSI), Rome, Italy.
Marylene CloitreNational Center for PTSD Dissemination and Training Division. Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA.
Grant J DevillySchool of Applied Psychology & Griffith, Criminology Institute, Griffith University, Brisbane, Queensland, Australia.
Thomas ElbertDepartment of Psychology, University of Konstanz, Konstanz, Germany.
Marcelo MelloDepartamento de Psiquiatria Escola Paulista de Medicina, UNIFESP, Sao Paulo, São Paulo, Brazil.
Julian D FordUniversity of Connecticut School of Medicine, Farmington, Connecticut, USA.
Damion GrassoUniversity of Connecticut School of Medicine, Farmington, Connecticut, USA.
Pedro GamitoUniversidade Lusófona/HEI-Lab, Lisboa, Portugal.
Richard GrayResearch at Research and Recognition Project, New York, New York, USA.
Moira HallerNational Center for PTSD. San Diego School of Medicine, University California, White River Junction, California, USA.
Nigel HuntFaculty of Medicine & Health Sciences, School of Medicine, The University of Nottingham, Nottingham, UK.
Rolf J KleberDepartment of Clinical Psychology, Utrecht University, Utrecht, Netherlands.
Julia KönigDepartment of Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt and Ingolstadt, Germany.
Claire KullackPax Centre, West Leederville, Perth, Australia.
Jonathan LaugharneFaculty of Health and Medical Sciences, The University of Western Australia, Perth, Perth, Australia.
Rachel LiebmanDepartment of Psychology, University of Toronto, Toronto, Ontario, Canada.
Christopher William LeeFaculty of Health and Medical Sciences, The University of Western Australia, Perth, Perth, Australia.
Jeannette LelyARQ Centrum'45, Diemen, Noord-Holland, Netherlands.
John C MarkowitzNew York State Psychiatric Institute, New York, New York, USA.
Candice MonsonToronto Metropolitan University, Toronto, Ontario, Canada.
Mirjam J NijdamARQ National Psychotrauma Centre, Diemen, Netherlands.
Sonya B NormanNational Center for PTSD, White River Junction, Vermont, USA.
Miranda OlffARQ National Psychotrauma Centre, Diemen, Netherlands.
Tahereh Mina OrangInternational Psychosocial Organisation, Berlin, Germany.
Luca OstacoliDepartment of Clinical and Biological Sciences, University of Turin, Torino, Italy.
Nenad PaunovicDepartment of Psychology, Stockholm University, Stockholm, Sweden.
Eva PetkovaDepartment of Population Health. Langone School of Medicine, New York University, New York, New York, USA.
Patricia ResickDuke Health, Durham, North Carolina, USA.
Rita RosnerDepartment of Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt and Ingolstadt, Germany.
Maggie SchauerDepartment of Psychology, University of Konstanz, Konstanz, Germany.
Joy M SchmitzCenter for Neurobehavioral Research on Addiction. Department of Psychiatry and Behavioral Sciences. McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA.
Ulrich SchnyderUniversity of Zurich, Zurich, Switzerland.
Brian N SmithNational Center for PTSD Women's Health Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA.
Anka A VujanovicDepartment of Psychological and Brain Sciences, Texas A&M University, College Station, Texas, USA.
Yinyin ZangSchool of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China.
Érica Panzani DuranInstitute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
Francisco Lotufo NetoInstitute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
Soraya SeedatSouth Africa PTSD Research Programme of Excellence, Department of Psychiatry, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa.
Marit SijbrandijDepartment of Clinical, Neuro- and Developmental Psychology, World Health Organization Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAvailable empirical evidence on participant-level factors associated with dropout from psychotherapies for post-traumatic stress disorder (PTSD) is both limited and inconclusive. More comprehensive understanding of the various factors that contribute to study dropout from cognitive-behavioural therapy with a trauma focus (CBT-TF) is crucial for enhancing treatment outcomes.

objectiveUsing an individual participant data meta-analysis (IPD-MA) design, we examined participant-level predictors of study dropout from CBT-TF interventions for PTSD.

methodsA comprehensive systematic literature search was undertaken to identify randomised controlled trials comparing CBT-TF with waitlist control, treatment-as-usual or another therapy. Academic databases were screened from conception until 11 January 2021. Eligible interventions were required to be individual and in-person delivered. Participants were considered dropouts if they did not complete the post-treatment assessment.

findingsThe systematic literature search identified 81 eligible studies (n=3330). Data were pooled from 25 available CBT-TF studies comprising 823 participants. Overall, 221 (27%) of the 823 dropped out. Of 581 civilians, 133 (23%) dropped out, as did 75 (42%) of 178 military personnel/veterans. Bivariate and multivariate analyses indicated that military personnel/veterans (RR 2.37) had a significantly greater risk of dropout than civilians. Furthermore, the chance of dropping out significantly decreased with advancing age (continuous; RR 0.98).

conclusionsThese findings underscore the risk of premature termination from CBT-TF among younger adults and military veterans/personnel. CLINICAL IMPLICATION: Understanding predictors can inform the development of retention strategies tailored to at-risk subgroups, enhance engagement, improve adherence and yield better treatment outcomes.

Indexed as

Cognitive Behavioral TherapyPatient DropoutsStress Disorders, Post-TraumaticAdultFemaleHumansMalePSYCHIATRY

Identifiers

PMID39537555
PMCPMC11580285

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.