Systematic Review of the Efficacy of Cognitive-Behavior Therapy Related Treatments for Victims of Natural Disasters: A Worldwide Problem

Abstract

Natural disasters can have devastating consequences. Each year, about 225 million people are victims of natural disasters worldwide, and up to 13,5 million of these people can develop post-traumatic stress disorder (PTSD) in the first or second year following the disaster. Cognitive-behavior therapy (CBT) is the first-choice treatment for this disorder. In order to evaluate the efficacy of psychotherapeutic treatment based on cognitive-behavior therapy for people who developed post traumatic stress disorder after natural disasters we conducted a systematic search of published studies. We used the terms reported below in the electronic databases ISI Web of Science, PsycINFO, PubMed, PILOTS and Scopus with no restrictions of language or publication date. Articles that described randomized controlled, non-randomized controlled and non controlled studies on the efficacy of cognitive-behavior therapy for individuals diagnosed with post-traumatic stress disorder after exposure to a natural disaster were eligible for inclusion. The studies were required to use a standardized measure of effectiveness before and after the intervention and have a group of patients who had used cognitive-behavior therapy as the only intervention. Our search identified 820 studies, and 11 were selected for this review. These 11 studies involved 742 subjects, 10 related to earthquakes and 1 to a hurricane. The cognitive-behavior therapy techniques used were various: 7 studies used exposure therapy, 2 studies used problem solving, and the only 2 studies with adolescents used techniques including reconstructions and reprocessing of the traumatic experience. As limitations, the search involved only five electronic databases, no experts in the field were consulted, and the heterogeneity of the findings made it impossible to perform a meta-analysis. The results suggest the efficacy of cognitive-behavior therapy, particularly exposure techniques, for the treatment of post-traumatic stress disorder after earthquakes. However, further studies with stronger methodologies, i.e. randomized-control trials and non-randomized controlled trials, are needed.

Health-Related Rehabilitation after the 2008 Great Wenchuan Earthquake in China: A Ten Year Retrospective Systematic Review

“…The interventions were also effective in treating and reducing the survivors' PTSD symptoms like anxiety and depression, and also in enhancing their psychological resilience [35,36,38,39]. These findings are consistent with previous results from a broad systematic literature review and meta-analysis studies that similarly explored the different rehabilitation interventions, services and outcomes in post-earthquake settings, and those following other disasters within and outside China [2,[13][14][15]43,44,[48][49][50][51][52]. Encouragingly, some of the HRR programs after the 2008 Wenchuan earthquake, such as physical and physiological rehabilitation, commenced within the first 5 months after the earthquake, which is commendable and helped to ameliorate long-term impacts such as injuries and PTSD from turning into acute problems for survivors that would prevent them from returning to normal life.…”

“…PTSD is a psychological disorder caused by unusual threats or catastrophic events such as earthquakes [12,14,15,43]. It can also occur in people who have experienced, witnessed or known about traumatic events that posed to them a risk of death, serious harm or threat to physical integrity, and that as a response to such have felt intense fear, helplessness or horror [44]. Thus, various rehabilitation interventions were warranted in the prevention of the loss of function, the restoration of function and the increase or maintenance of current function [22,23,45], not only for the over 374,000 individuals injured in the 2008 Wenchuan earthquake [6,9], but also for PTSD victims.…”

“…Indeed, this is attested to in the results of six studies in our systematic review [35][36][37][38][39]41]-which showed a high prevalence of PTSD among the different groups of survivors of the 2008 Wenchuan earthquake. PTSD aroused several symptoms such as anxiety, depression, anger, stress, psychoticism, somatization, sleep disorders, interpersonal sensitivity and violence, as well as thoughts, feelings, or stimuli associated with the traumatic events, among victims [2,[12][13][14][15][35][36][37][38][39]41,44,51,52,56,57]. Again, this argument concurs with the findings of an earlier systematic review and meta-analysis studies, which affirmed how a real burden of PTSD is prevalent in many earthquake survivors [12][13][14][15]43,44,49,56,58].…”

Post-traumatic stress disorder associated with natural and human-made disasters in the World Mental Health Surveys

“…Natural and human-made disasters are increasingly common occurrences around the globe (Lopes et al 2014; Warsini et al 2014). Systematic research on development of post-traumatic stress disorder (PTSD) following disasters has been undertaken for more than three decades, with most studies reporting only short-term consequences.…”

Brief Intervention Effectiveness on Stress among Nepalese People Indirectly Exposed to the Nepal Earthquake

“…The efficacy of several types of interventions for the treatment of PTSD and depression symptoms after earthquakes has been documented including psychoeducation intervention with medication (Oflaz et al 2008), cognitive-behavior therapy, particularly exposure techniques (Lopes et al 2014), and single sessions of behavioral treatment (Başoglu et al 2007). …”