Treating Posttraumatic Stress Disorder in Military Populations: A Meta-Analysis

Jenny J W Liu^{1

2

3}, Anthony Nazarov^{1

2

4}, Natalie Ein^{1

2}, Bethany Easterbrook^{1

5}, Tri Le¹, Clara Baker¹, Julia Gervasio^{1

6}, Edouard Auger^{7

8}, Ken Balderson^{2

9}, Mathieu Bilodeau^{7

8}, Amer M Burhan^{10

11}, Murray W Enns^{12

13}, Fardous Hosseiny¹⁴, Vicky Lavoie⁷, Natalie Mota^{13

15}, Maya L Roth^{1

2

16}, Sonya G Wanklyn^{9

17}, J Don Richardson^{1

2

4

18}

Affiliations

¹ MacDonald Franklin OSI Research and Innovation Centre, Lawson Health Research Institute, London, Ontario, Canada.
² Department of Psychiatry, Western University, London, Ontario, Canada.
³ Corresponding Author: Jenny J. W. Liu, PhD, The MacDonald Franklin OSI Research and Innovation Centre, Finch Mental Health Care Building, Parkwood Institute St. Joseph's Health Care London 550 Wellington Rd, F4-367, London, ON N6C 0A7 (jenny.liu@sjhc.london.on.ca).
⁴ Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada.
⁵ Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario, Canada.
⁶ Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada.
⁷ Clinique TSO du CIUSSS de la Capitale Nationale, Québec, Canada.
⁸ Département de Psychiatrie et de Neurosciences, Faculté de Médecine, Université Laval, Québec, Canada.
⁹ St. Joseph's OSI Clinic, Greater Toronto Area Services, Parkwood Institute, St. Joesph's Healthcare London, Ontario, Canada.
¹⁰ Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
¹¹ Ontario Shores Centre of Mental Health Sciences, Whitby, Ontario, Canada.
¹² Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
¹³ Deer Lodge Centre OSI Clinic, Winnipeg, Manitoba, Canada.
¹⁴ The Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada.
¹⁵ Department of Clinical Health Psychology and Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.
¹⁶ Yeates School of Graduate Studies, Toronto Metropolitan University, Toronto, Ontario, Canada.
¹⁷ Lawson Health Research Institute, London, Ontario, Canada.
¹⁸ St. Joseph's OSI Clinic, St. Joseph's Health Care London, London, Ontario, Canada.

PMID: 40215380
DOI: 10.4088/JCP.24r15571

Meta-Analysis

Treating Posttraumatic Stress Disorder in Military Populations: A Meta-Analysis

Jenny J W Liu et al. J Clin Psychiatry. 2025.

. 2025 Mar 24;86(2):24r15571.

doi: 10.4088/JCP.24r15571.

Authors

Affiliations

¹ MacDonald Franklin OSI Research and Innovation Centre, Lawson Health Research Institute, London, Ontario, Canada.
² Department of Psychiatry, Western University, London, Ontario, Canada.
³ Corresponding Author: Jenny J. W. Liu, PhD, The MacDonald Franklin OSI Research and Innovation Centre, Finch Mental Health Care Building, Parkwood Institute St. Joseph's Health Care London 550 Wellington Rd, F4-367, London, ON N6C 0A7 (jenny.liu@sjhc.london.on.ca).
⁴ Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada.
⁵ Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario, Canada.
⁶ Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada.
⁷ Clinique TSO du CIUSSS de la Capitale Nationale, Québec, Canada.
⁸ Département de Psychiatrie et de Neurosciences, Faculté de Médecine, Université Laval, Québec, Canada.
⁹ St. Joseph's OSI Clinic, Greater Toronto Area Services, Parkwood Institute, St. Joesph's Healthcare London, Ontario, Canada.
¹⁰ Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
¹¹ Ontario Shores Centre of Mental Health Sciences, Whitby, Ontario, Canada.
¹² Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
¹³ Deer Lodge Centre OSI Clinic, Winnipeg, Manitoba, Canada.
¹⁴ The Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada.
¹⁵ Department of Clinical Health Psychology and Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.
¹⁶ Yeates School of Graduate Studies, Toronto Metropolitan University, Toronto, Ontario, Canada.
¹⁷ Lawson Health Research Institute, London, Ontario, Canada.
¹⁸ St. Joseph's OSI Clinic, St. Joseph's Health Care London, London, Ontario, Canada.

PMID: 40215380
DOI: 10.4088/JCP.24r15571

Abstract

Background: Military and Veteran populations experience higher rates of posttraumatic stress disorder (PTSD) compared to civilians. While trauma focused psychotherapies are generally recommended as first-line treatments, the effectiveness of various treatments in military populations requires further investigation.

Objective: This meta-analysis aims to synthesize the current literature regarding effectiveness of psychotherapies, pharmacotherapies, and combination treatments for PTSD in military populations.

Data Sources: This preregistered review (PROSPERO: CRD42021245754) was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta Analyses and Cochrane guidelines. A search was conducted using PsycINFO, MEDLINE, Embase, CINAHL, and ProQuest Dissertations and Theses.

Study Selection: The final sample included data from 414 studies.

Data Extraction: Full study methodologies can be found in the published protocol (Liu et al, 2021).

Results: The pooled random-effects model found effect size across all PTSD treatments (k = 712) was g=0.96, compared to g=0.45 for control conditions (k = 122). Clinician administered measures indicated larger treatment effects (g= 1.02) than self reported measures (g =0.82). Combination therapies yielded the largest effects (g =2.17), outperforming both psychotherapies and pharmacotherapies alone. No significant differences were found across control conditions.

Conclusion: Findings suggest that integrating psychotherapies and pharmacotherapies may address multiple dimensions of PTSD more effectively than monotherapies. However, these results contrast with the prioritization of trauma-informed psychotherapies over pharmacotherapies, as recommended by the 2023 US Department of Veterans Affairs/Department of Defense guidelines. Future research should focus on subclass analyses and long-term outcomes to refine treatment strategies for PTSD in military populations. Tailoring treatment plans to individual needs remains crucial for optimizing recovery and long-term symptom management.

PubMed Disclaimer

Publication types

Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
- Physicians Postgraduate Press, Inc.
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Treating Posttraumatic Stress Disorder in Military Populations: A Meta-Analysis

Affiliations

Treating Posttraumatic Stress Disorder in Military Populations: A Meta-Analysis

Authors

Affiliations

Abstract

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical