About the PTSD-Repository
Why Is It Needed?
We 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 These sources are useful, but they can quickly become outdated and none include all randomized controlled trials (RCTs) on PTSD. 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 or clinicians.
The PTSD-Repository was designed to address these drawbacks. It brings together data from more than 300 published studies on a wide range of treatments and will be updated annually to capture new research. The PTSD-Repository includes hundreds of variables. The information in it is wide in scope and rich in detail. 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 data stories we’ve created on important topics. Users can also create custom visualizations such as charts, graphs, 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?
Currently, the PTSD-Repository contains data from RCTs of the treatment of PTSD. RCTs are studies that assign the participants in the study randomly -- by chance -- to the treatments being examined.
Only English language studies published from 1988 to 2018 are currently included and the studies could have been conducted in any country. Studies included in the PTSD-Repository all focus on adults with PTSD.
Studies by year
Studies by location
Six types of treatment RCTs
Studies in the PTSD-Repository were categorized into the following six types of treatments: psychotherapy, pharmacotherapy, complementary and integrative health (CIH), nonpharmacologic biological, nonpharmacologic cognitive and collaborative care. The reference guide for each of the study classes and treatment types is found here.
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 and antianxiety medications. Complementary and integrative health (CIH) --sometimes referred to as “alternative medicine” -- represents a wide category of approaches that are considered to be outside the standard in the current practice of Western medicine. Nonpharmacologic biological treatments use a medical device 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. If a study compared more than one 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).
What types of studies are included in the PTSD-Repository?
Keep in mind that not every PTSD treatment study 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.
We identified the studies by searching multiple databases including MEDLINE®, Cochrane CENTRAL, PsycINFO®, and the National Center for PTSD’s PTSDpubs database. We also reviewed reference lists of systematic reviews and clinical practice guidelines for relevant RCTs.
Because we wanted to be able to answer a variety of questions about PTSD treatment, we extracted more than 300 variables from the studies that we identified. For example, we tracked treatment type, assessment instruments used, study sample size, proportion of military/Veteran participants, assessment method, trauma types and treatment response, among others. This table gives details about the population, intervention and study design requirements that studies had to meet in order to be included.
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
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 if you find any mistakes.
Understanding treatment studies
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 account in the PTSD-Repository.
What can I use it for?
There are hundreds of questions PTSD-Repository data can be used to answer. Providers, patients and their families can use it to explore the benefits, side effects 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 in order 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 be updated annually. We are also expanding the pool of studies to include trials of treatments for co-occurring substance abuse and PTSD. We are adding several new variables, including more detailed information on suicidality and participant complexity. We will also add risk of bias assessment for all studies using AHRQ’s risk of bias rating methods. At the same time, we are developing an alternative risk of bias rating system that improves upon some of the limitations of existing methods. We will pilot test that system in fiscal year 2020. We will also take steps to integrate the PTSD-Repository with PTSDpubs, the National Center for PTSD’s free online database that provides access to the world’s literature on PTSD and other mental health consequences of exposure to traumatic events. Finally, we are working to disseminate key findings from the PTSD-Repository by publishing papers and presenting at conferences on analyses of these data. We support and encourage others to do the same. 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!