Effective therapies for the treatment of complex posttraumatic stress disorder: A qualitative systematic review

Carmen Fernández Fillol, Elena Rocío Serrano-Ibáñez, Gema Teresa Ruiz-Párraga, Carmen Ramírez Maestre, Rosa Esteve Zarazaga, Alicia Eva López Martínez

DOI: https://doi.org/10.17711/SM.0185-3325.2018.013


Background. Current literature shows that posttraumatic stress disorder and complex posttraumatic stress disorder symptoms differ. Although the psychological treatments available for posttraumatic disorder are well established, little is known about the effectiveness of those aimed at the treatment of complex posttraumatic stress.

Objective. To evaluate the efficacy of psychological treatments for complex posttraumatic stress disorder.

Method. A systematic qualitative search was conducted according to PRISMA guidelines, searching four psychological and health electronic databases: Medline, Pilots, PsycINFO, and Pubmed. Three reviewers independently selected the studies in two phases: preselection (criteria for complex posttraumatic stress disorder, replicable psychological treatment, and treatment effect) and selection (additional criteria: type of study, participants, and treatment).

Results. Of the 615 studies reviewed, 25 were preselected, eight of which met the inclusion and methodological quality criteria. Five studies explored adult populations (with one exception, all were randomized clinical trials) and three child populations (clinical studies with pre- post-treatment design, with and without control group). Most studies with adult populations included psychoeducation, cognitive restructuration, and exposure therapy. The studies with child samples included EMDR and mindfulness as the most frequent treatment components.

Discussion and conclusion. The evidence was insufficient to determine the most effective treatment. More research on this issue is required.


Complex posttraumatic stress disorder; psychological treatment; effectiveness; therapy efficacy

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