Traumatology, Vol 29(2), Jun 2023, 112-124; doi:10.1037/trm0000404
A meta-analysis was conducted to explore the effect of baseline psychological symptom severity on treatment dropout among adults administered trauma-focused cognitive behavior therapy (CBT) for posttraumatic stress disorder (PTSD). This meta-analysis compared baseline severity scores of (a) clinician-rated PTSD symptoms, (b) self-report PTSD symptoms, and (c) comorbid psychological symptoms, between trauma-focused CBT completers and dropouts. Eligible studies were peer-reviewed, original outcome research of CBT interventions with a trauma-focus with adults meeting diagnostic criteria for PTSD. Data included standardized and quantitative baseline scores of clinician-rated and/or self-report PTSD and comorbid psychological symptom severity for treatment completers and dropouts. Searches were conducted of PsycINFO, Web of Science, and SCOPUS and resulted in the identification of 12 studies with data received for 902 adult participants with a primary diagnosis of PTSD. Nine randomized control trials and three non-randomized control trials were included. The interventions in the studies were guideline-recommended and evidence-based treatments of prolonged exposure, cognitive processing therapy, and cognitive behavioral therapy for PTSD. The average dropout rate across the included studies was 41.5%. Findings revealed participants dropping out of treatment had higher clinician-rated PTSD symptom severity at baseline than those who completed, with a significant and moderate effect size observed (g = −.50, 95% CI [−.95, −.04], p