Defining response and nonresponse to posttraumatic stress disorder treatments: A systematic review.

Abstract

There is currently no uniform definition of treatment response for posttraumatic stress disorder (PTSD) to guide researchers and clinicians in the area of posttraumatic mental health. The aim of this systematic review was to explore the operationalization of PTSD treatment response, by reviewing and synthesizing the key criteria used to define treatment response and treatment nonresponse in published trials. Randomized controlled trials (RCTs) assessing the effectiveness of first‐line interventions for PTSD were identified for inclusion. Of those, 143 trials provided 226 definitions of treatment response, grouped under five main categories: treatment response (n = 181), remission (n = 23), recovery (n = 5), treatment nonresponse (n = 5), and worsening (n = 12). Overall, the results showed the PTSD field utilizes diverse and interchangeable operational definitions of treatment response and nonresponse, indicating a need for more precise conceptual definitions and operational criteria. A set of operational research definitions are presented in order to advance the PTSD treatment field.

Let's all get on the same page: A commentary on “Defining response and nonresponse to PTSD treatments: A systematic review”.

“…Unfortunately, the concerns he raised still apply broadly to the treatment outcome literature in PTSD and other mental health disorders, although we believe progress is being made. The review by Varker et al (2020) adds to that progress. The authors are to be commended for synthesizing a difficult literature and for proposing ways to enhance the measurement of treatment outcomes.…”

“…Finally, Varker et al (2020) recommend distinguishing treatment nonresponse definitions (i.e., nonresponse vs. worsening vs. treatment resistance). We agree that these distinctions are important.…”

“…Varker et al (2020) present a good synthesis of a literature that defies easy summarization. The field of mental health is centrally focused on developing treatments that improve patients' lives by reducing symptoms, improving functioning, and enhancing quality of life.…”

“…Below we comment on Varker et al. 's (2020) stated concerns with the literature and their recommendations for validating categorical definitions of treatment outcomes. We then propose research strategies that would advance knowledge about optimal definitions of treatment response, nonresponse, and resistance.…”

Categorizing a continuum: Commentary on “Defining response and nonresponse to posttraumatic stress disorder treatments: A systematic review”

“…In their article, “Defining response and nonresponse to posttraumatic stress disorder treatments: A systematic review,” Varker et al. (2020) have provided a valuable resource for the trauma field. The past two decades have witnessed extraordinary advances in the literature, especially the development, testing, and dissemination of a number of effective treatments for posttraumatic stress disorder (PTSD; American Psychological Association Guideline Development Panel for the Treatment of PTSD, 2017).…”