Effectiveness of interventions for psychological distress following traumatic injury: A systematic review

Ellie Grant, Alan Robert Bowman, Louise Johnson

Research output: Contribution to journalReview articlepeer-review

Abstract

Background
Traumatic injury poses significant physical and psychological challenges, often resulting in psychological distress, encompassing symptoms of anxiety, depression and post-traumatic stress. Despite the recognised need for psychological care in trauma rehabilitation, there is limited empirical evidence of effective interventions tailored specifically for individuals with traumatic injuries, leading to a practice-evidence gap.

Objectives
This review aimed to evaluate the effectiveness of psychological and behavioural interventions for reducing psychological distress in adults following traumatic injury.

Methods
This systematic review followed a published protocol (CRD4202342946) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and the Synthesis Without Meta-analysis (SWiM) in systematic reviews reporting items. Peer-reviewed studies were identified through searches of MEDLINE, APA PsycInfo, CINAHL and Embase databases. Eligible studies involved adults aged 18 and older who had experienced physical trauma requiring immediate medical attention. Studies involving participants with neurological injuries and/or military personnel were not included. Both English- and non-English-language articles were considered. Effect direction was employed as the method of synthesis and risk of bias was assessed using the Cochrane Effective Practice and Organisation of Care (EPOC 9) nine-item assessment tool.

Results
A total of six studies met the review eligibility criteria. There was considerable heterogeneity across the interventions in terms of their nature, timing and duration, however all interventions were delivered within 3-months post-injury. Most studies reported positive intervention effects, with no adverse effects reported. Cognitive Behavioural Therapy (CBT) was the most reported intervention across the studies.

Conclusions
The review findings highlight the preliminary evidence supporting CBT as a viable option for reducing psychological distress following traumatic injury. However, this may be explained by the dominance of CBT in the literature due to its structured nature, availability and suitability for research, potentially limiting the visibility of alternative therapeutic approaches. Further, these findings are constrained by study limitations, including small sample sizes, heterogeneity of injury types and severity, reliance on self-reported outcomes, and limited follow-up data. Future research should aim to include longitudinal follow-up assessments and explore alternative therapeutic approaches to contribute to our understanding of meaningful trauma rehabilitation methods.
Original languageEnglish
Article number112090
Pages (from-to)1-12
Number of pages12
JournalInjury
Volume56
Issue number2
Early online date23 Dec 2024
DOIs
Publication statusE-pub ahead of print - 23 Dec 2024

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