Exploring psychological peritraumatic risk factors and safety behaviours as key mechanisms in the onset and maintenance of PTSD; a Systematic Review and Meta-Analysis

Birch, Jennifer (2023) Exploring psychological peritraumatic risk factors and safety behaviours as key mechanisms in the onset and maintenance of PTSD; a Systematic Review and Meta-Analysis. Doctoral thesis, University of East Anglia.

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Abstract

Background
After Post-Traumatic Stress Disorder (PTSD) was first conceptualised in 1980, decades of valuable research have contributed to the development of cognitive theories and evidence-based treatments, which are used as front-line treatments in NHS services in line with NICE guidance. However, there are some elements of the cognitive model which are under-researched, such as the role of safety behaviours in the development and maintenance of PTSD. Research is also yet to provide clarity on the role of psychological peritraumatic risk factors for PTSD in adults.

Method
This portfolio contains two systematic reviews and meta-analyses. The first review concerns the relationship between safety behaviours and PTSD in adults, and includes six studies (n = 628). The second review explores peritraumatic risk factors for PTSD in adults, and includes 63 studies (n=20,335).

Results
The first paper regarding safety behaviours yielded a large effect r=0.62, supporting the idea that engaging in safety behaviours is associated with the development and/or maintenance of PTSD in adults. Regarding the second paper, peritraumatic subjective threat and peritraumatic dissociation yielded moderate estimates of population effect size (r=.39, r=.39), and peritraumatic data-driven processing yielded a small estimated population effect size (r=.26). Both studies were affected by high levels of heterogeneity. Each paper discusses the outcome of moderator analyses, limitations, clinical implications and suggestions for future research.

Conclusion
Overall, there were a small number of studies available for inclusion in the first review, despite safety behaviours forming an important part of the cognitive model for over twenty years. While the findings are in line with the Ehlers and Clark model (2020), more research is needed to clarify the directionality of the relationship. The second meta-analysis highlighted the need for more studies to investigate the predictive risk of a wider range of peritraumatic emotions e.g. guilt, shame, anger and disgust.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	18 Jul 2023 07:13
Last Modified:	18 Jul 2023 07:13
URI:	https://ueaeprints.uea.ac.uk/id/eprint/92623
DOI:

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