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Department of Clinical Psychology, Bi.C., Islamic Azad University, Birjand, Iran
Abstract: (15 Views)
Introduction: First-line trauma-focused psychotherapies are recommended for posttraumatic stress disorder (PTSD), but their capacity to produce sustained recovery after treatment remains unclear. This review evaluated symptom durability and remission-related outcomes following first-line interventions for adult PTSD.
Methods: This review followed PRISMA 2020 guidelines. PubMed/MEDLINE, Scopus, Cochrane Library, and Web of Science were searched for studies published from 2000 onward, with supplementary Google Scholar screening. Eligible studies included adults with PTSD receiving Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing (EMDR), or manualized trauma-focused cognitive-behavioral therapy variants. Studies required at least 30 participants. Long-term outcomes were defined as assessments conducted at least 6 months after treatment completion. Risk of bias and quality were assessed using RoB 2 and the Newcastle–Ottawa Scale. Findings were synthesized narratively because populations, interventions, follow-up timing, and outcome definitions were heterogeneous.
Results: The search identified 350 records; 62 full-text articles were assessed, and 26 primary reports were included. PE had the densest contemporary long-term evidence base, especially from 2018 onward, reflecting a greater volume of studies but not superior long-term effectiveness. CPT showed durability across populations and delivery formats. EMDR demonstrated supportive long-term benefit, although fewer modern studies were available. Sustained symptom reduction was reported more consistently than remission, loss of diagnosis, relapse, recurrence, or functional recovery.
Conclusions: First-line trauma-focused psychotherapies often produce durable symptom improvement after treatment completion. However, evidence is stronger for sustained symptom reduction than for sustained remission, relapse or recurrence outcomes, or functional recovery. Future studies should standardize remission and relapse definitions and anchor follow-up to treatment completion.
Methods: This review followed PRISMA 2020 guidelines. PubMed/MEDLINE, Scopus, Cochrane Library, and Web of Science were searched for studies published from 2000 onward, with supplementary Google Scholar screening. Eligible studies included adults with PTSD receiving Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing (EMDR), or manualized trauma-focused cognitive-behavioral therapy variants. Studies required at least 30 participants. Long-term outcomes were defined as assessments conducted at least 6 months after treatment completion. Risk of bias and quality were assessed using RoB 2 and the Newcastle–Ottawa Scale. Findings were synthesized narratively because populations, interventions, follow-up timing, and outcome definitions were heterogeneous.
Results: The search identified 350 records; 62 full-text articles were assessed, and 26 primary reports were included. PE had the densest contemporary long-term evidence base, especially from 2018 onward, reflecting a greater volume of studies but not superior long-term effectiveness. CPT showed durability across populations and delivery formats. EMDR demonstrated supportive long-term benefit, although fewer modern studies were available. Sustained symptom reduction was reported more consistently than remission, loss of diagnosis, relapse, recurrence, or functional recovery.
Conclusions: First-line trauma-focused psychotherapies often produce durable symptom improvement after treatment completion. However, evidence is stronger for sustained symptom reduction than for sustained remission, relapse or recurrence outcomes, or functional recovery. Future studies should standardize remission and relapse definitions and anchor follow-up to treatment completion.
Type of Study: Review |
Subject:
Psychology
Received: 2026/07/8 | Accepted: 2026/08/8 | ePublished ahead of print: 2026/10/18
Received: 2026/07/8 | Accepted: 2026/08/8 | ePublished ahead of print: 2026/10/18
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