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. 2000;2002(2):CD000560.
doi: 10.1002/14651858.CD000560.

Brief psychological interventions ("debriefing") for trauma-related symptoms and the prevention of post traumatic stress disorder

S Wessely  1 , S Rose, J Bisson
Affiliations

Brief psychological interventions ("debriefing") for trauma-related symptoms and the prevention of post traumatic stress disorder

S Wessely et al. Cochrane Database Syst Rev. 2000.

Update in

Abstract

Objectives: To assess the effectiveness of brief psychological debriefing for the management of psychological distress after trauma, and the prevention of post traumatic stress disorder.

Search strategy: Electronic searching of MEDLINE, EMBASE, PsychLit, PILOTS, Biosis, Pascal, Occ.Safety and Health, CDSR and the Trials Register of the Depression, Anxiety and Neurosis group. Hand search of Journal of Traumatic Stress. Contact with leading researchers.

Selection criteria: The inclusion criteria for all randomized studies was that they should focus on persons recently (one month or less) exposed to a traumatic event, should consist of a single session only, and that the intervention involve some form of emotional processing/ventilation by encouraging recollection/reworking of the traumatic event accompanied by normalisation of emotional reaction to the event.

Data collection and analysis: 8 trials fulfilled the inclusion criteria. Quality was generally poor. Data from two trials could not be synthesised.

Main results: Single session individual debriefing did not reduce psychological distress nor prevent the onset of post traumatic stress disorder (PTSD). Those who received the intervention showed no significant short term (3-5 months) in the risk of PTSD (pooled odds ratio 1.0, 95% ci 0.6-1.8). At one year one trial reported that there was a significantly increased risk of PTSD in those receiving debriefing (odds ratio 2.9, 95% ci 1.1-7.5). The pooled odds ratio for the two trials with follow ups just included unity (odds ratio 2.0, 95% ci 0.9-4.5). There was also no evidence that debriefing reduced general psychological morbidity, depression or anxiety.

Reviewer's conclusions: There is no current evidence that psychological debriefing is a useful treatment for the prevention of post traumatic stress disorder after traumatic incidents. Compulsory debriefing of victims of trauma should cease.

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Conflict of interest statement

Both JB and SR were responsible for two of the trials included in this review. SW and RC have no conflict of interest.

Figures

1.1
1.1. Analysis
Comparison 1 Debriefing versus Control, Outcome 1 PTSD diagnosis ‐ ITT data.
1.2
1.2. Analysis
Comparison 1 Debriefing versus Control, Outcome 2 PTSD severity ‐ using self‐report measures.
1.3
1.3. Analysis
Comparison 1 Debriefing versus Control, Outcome 3 PTSD severity ‐ clinician rating measures.
1.4
1.4. Analysis
Comparison 1 Debriefing versus Control, Outcome 4 PTSD ‐ self‐reported symptoms.
1.5
1.5. Analysis
Comparison 1 Debriefing versus Control, Outcome 5 Depression diagnosis ‐ completers only.
1.6
1.6. Analysis
Comparison 1 Debriefing versus Control, Outcome 6 Depression severity.
1.7
1.7. Analysis
Comparison 1 Debriefing versus Control, Outcome 7 Anxiety diagnosis.
1.8
1.8. Analysis
Comparison 1 Debriefing versus Control, Outcome 8 General Anxiety.
1.9
1.9. Analysis
Comparison 1 Debriefing versus Control, Outcome 9 Travel anxiety.
1.10
1.10. Analysis
Comparison 1 Debriefing versus Control, Outcome 10 All psychiatric morbidity.
1.11
1.11. Analysis
Comparison 1 Debriefing versus Control, Outcome 11 Reduced Functioning.
1.12
1.12. Analysis
Comparison 1 Debriefing versus Control, Outcome 12 Dropout.
2.1
2.1. Analysis
Comparison 2 Debriefing versus Educational intervention, Outcome 1 PTSD diagnosis ‐ ITT data.
2.2
2.2. Analysis
Comparison 2 Debriefing versus Educational intervention, Outcome 2 PTSD severity ‐ using self‐report measures ‐ completers.
2.3
2.3. Analysis
Comparison 2 Debriefing versus Educational intervention, Outcome 3 Depression severity ‐ completers.
2.4
2.4. Analysis
Comparison 2 Debriefing versus Educational intervention, Outcome 4 Dropout.
3.1
3.1. Analysis
Comparison 3 Immediate Debriefing versus Delayed Debriefing, Outcome 1 PTSD severity ‐ self‐report.
See this image and copyright information in PMC

References

References to studies included in this review

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References to ongoing studies

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