About the PTSD-Repository
Why Is It Needed?
The National Center for PTSD created the PTSD-Repository to help
people understand what is known about PTSD treatment. Researchers and
clinicians have long relied on published meta-analyses and literature reviews
to get an understanding of effective treatments. These sources are useful, but
they can quickly become outdated and none include all randomized controlled
trials (RCTs) on PTSD treatments. There hasn’t been a single, comprehensive source of
information that can answer questions about all types of interventions or other
study details that might matter to researchers, clinicians, patients and their families.
The PTSD-Repository was designed to
address these drawbacks. It brings together data from 389 published studies on a wide range of treatments and is updated annually to capture new studies. The information in it is wide in scope and rich in detail, including over 300 variables. The
audience is also broad: anyone with an interest in PTSD treatment, including
Veterans, the general public, clinicians, researchers, educators, policymakers and the media.
The PTSD-Repository allows users to
access information in a variety of ways. At the most basic level users can
read our data stories on important topics. Users can also interact with our visualizations or create their own charts, graphs, maps and other ways to “see” data.
These visualizations can be saved and shared with others. Finally, users can
download the data for exploration and data analysis.
What Is In It?
The PTSD-Repository contains
data from RCTs conducted in adults with PTSD. RCTs are studies that assign the participants
in the study randomly--by chance--to the treatments being examined.
The studies included in the PTSD-Repository are specific to PTSD treatment. Most studies target PTSD outcomes. These RCTs may also examine the impact of the PTSD treatment on other mental health conditions and co-occurring problems (such as difficulty sleeping or anger). In addition, the PTSD-Repository includes studies that intentionally target both PTSD and substance use, conditions that often co-occur. Users can choose to look at all the studies, focus specifically on the studies of PTSD treatment alone, or just look at the PTSD plus substance use studies.
Only English language studies published
from January 1988 through May 2020 are currently included. The studies could have been
conducted in any country.
Studies by year
Choose any year in the chart below to see the types of treatments studied in that year's RCTs. Note that studies from 2020 are not included in the graphic because the full calendar year is not included in the data. You can filter the graphic to include those studies.
Studies by location
Types of Treatment in RCTs
Studies in the PTSD-Repository were categorized into the following 6 types of treatment: psychotherapy, pharmacotherapy, complementary and integrative health (CIH), nonpharmacologic biological, nonpharmacologic cognitive and collaborative care. There is also an "other treatments" classification, for 7 total options. See our treatment reference guide that outlines the organization and provides definitions.
Psychotherapy is talk therapy with a licensed provider and can be used with subclassifications of “trauma-focused” or “non-trauma-focused." Pharmacotherapy uses medications; it can be grouped into drug classes such as antidepressants or antianxiety medications. Complementary and integrative health (CIH)--sometimes referred to as “complementary and alternative medicine”--represents a wide category of approaches that are considered to be outside the standard in the current practice of Western medicine or that are used in combination with conventional approaches. Nonpharmacologic biological treatments use a medical device or medical procedure of some kind. Nonpharmacologic cognitive treatments teach cognitive skills to improve attention. Collaborative care treatments are those in which integrated medical and mental health treatment is delivered in primary care, often by nurse managers. The Other Treatments category includes studies that did not fit the main 6 classifications.
If a study compared more than 1 type of treatment, both treatment types were coded. For example, some studies are coded as psychotherapy and pharmacotherapy, psychotherapy and CIH or other mixed.
The PTSD-Repository also allows users to drill down to interventions within treatment arms of each study. The same treatment types outlined above are included, and there is a code for control treatments, which are comparison conditions such as placebo pill, waitlist and treatment as usual (when treatment as usual cannot be clearly defined as another specific treatment). For more information, read our story, Which PTSD Treatments Have Been Studied?
PTSD Treatment Studies Over Time
Keep in mind that not every PTSD treatment is represented in the database. In some cases it's because there haven't been any RCTs conducted on those treatments. In other cases, studies did not meet the criteria to be included.
Each year we identify studies by searching multiple databases
including MEDLINE®, Cochrane CENTRAL, PsycINFO®, and the National Center for
PTSD’s PTSDpubs database. We also review reference lists of systematic
reviews and clinical practice guidelines for relevant RCTs.
This table gives details about the population,
intervention and study design requirements that studies had to meet in order
to be included.
Because we want to be able to answer a variety of questions about PTSD treatment, we extract more than 300 variables from the studies we identify. For example, in addition to treatment type, we track assessment instruments used, assessment method, study sample size, proportion of military/Veteran participants, trauma types and treatment response, among others.
Why Should I Trust It?
Because of who created it
The PTSD-Repository is a project of the National Center for
Posttraumatic Stress Disorder (NCPTSD), the world's leading research and
educational center of excellence on PTSD and traumatic stress. Since the
Center’s founding in 1989, NCPTSD researchers have been recognized for the
contributions they have made studying the causes, assessment and treatment of
PTSD. With guidance from NCPTSD, the data were abstracted by the Pacific
Northwest Evidence-based Practice Center (EPC), a research center at Oregon
Health & Science University with more than 20 years’ experience conducting
systematic reviews as part of the Agency for Healthcare Research and Quality (AHRQ) EPC Program.
Because of how we created it
At the direction of NCPTSD, the Pacific Northwest EPC followed AHRQ's Methods Guide for Effectiveness and Comparative Effectiveness Reviews to develop the PTSD-Repository. This
included convening a technical expert panel whose members represented a range
of clinical and research perspectives on PTSD treatment. We consulted with
these experts throughout the development process. We also received input from
independent peer reviewers and sought public comment before publication, per
AHRQ guidelines. The results of this work were published in an AHRQ report in 2019, an updated AHRQ report in 2020, and a manuscript published in the Journal of Traumatic Stress that provides an overview of the methodology.
Because of what's in it
The PTSD-Repository includes data drawn from the most
rigorous type of treatment research study: randomized controlled trials, or
RCTs. You’ll recall that RCTs are studies that assign participants in the study
randomly--by chance--to the treatment(s) being examined. RCTs provide the
strongest level of scientific evidence because assigning participants randomly
improves our confidence that changes in PTSD symptoms are due to the treatments
themselves.
Our confidence in the quality of the data in the PTSD-Repository
is strong, yet we recognize that there may be errors or omissions. Please
contact us at NCPTSD@va.gov if you find any mistakes.
Understanding treatment studies
Learn
more about RCTs and other types of treatment studies.
How Do I Use It?
There are many ways to use the PTSD-Repository.
You can simply view visualizations and stories we have created
based on PTSD-Repository data. You can interact with the data yourself by
searching, filtering and creating visualizations. Or you can download
the data to explore trends and run your own analyses. You will have the most
options available to you if you create your own free account in the PTSD-Repository.
How can I use what I learn?
There are hundreds of questions that can be answered with PTSD-Repository data. Providers, patients and their families can use it to
explore the benefits and harms of treatments for PTSD that they
are considering. Researchers can draw on the data in the PTSD-Repository when
they conduct their own meta-analyses, systematic reviews or literature
reviews. Funding agencies and researchers can identify evidence gaps to set priorities for future research or support grant applications.
Policymakers, educators, researchers and the media can turn to the PTSD-Repository
for visualizations to use in presentations and articles or to search for
evidence on specific treatments.
What's next for the PTSD-Repository?
The
PTSD-Repository will continue to be updated annually. In 2020, we expanded the pool of
studies to include
trials of treatments for co-occurring substance abuse and PTSD. We also added several new variables, including more detailed information on suicide-related outcomes. Using
AHRQ’s risk of bias rating methods we are now including risk of bias assessment for all studies. Stay tuned for the next annual update which will also include standardized effect sizes which will make it easier to compare treatment effectiveness across studies.
Jump in!
As you dig into the PTSD-Repository, we recommend learning more about how to find the data you want by reading our story, How the Data Were Organized.
When you are ready to use the data, learn some tips in our story, Getting Started with the PTSD-Repository.
We would be interested in hearing from you at NCPTSD@va.gov if you use data from the PTSD-Repository for your own research or dissemination projects!