The Efficacy of Psychological Interventions for Posttraumatic Stress Disorder Symptoms in Incarcerated Forensic Populations A Meta-analysis of Randomized Controlled Trials

Objective: Given the high prevalence of posttraumatic stress disorder (PTSD) symptoms in incarcerated forensic populations, this meta-analysis estimated the efficacy of interventions in this field and explored predictors of intervention outcomes. Method: Twelve randomized controlled trials of psychological interventions for PTSD symptoms in incarcerated forensic populations were included. A combined Hedges’s g effect size was synthesized, quality assessments and risk of bias analyses were performed, and publication bias was assessed. Gender and type of control group were explored as predictors. Results: Thirteen comparisons from 12 studies were included in the main analysis. A small to medium combined effect size (g = 0.43, p =.005) was found at posttreatment. The type of control group ( p =.156) and gender (p =.953) did not predict outcomes. When we analyzed the available follow-up data (k = 5), the effect was nonsignificant (g = 0.36, p =.123). Study quality was poor and risk of bias high, and studies of first-line PTSD treatments were not found in the literature. Conclusions: A few studies suggest that PTSD treatment may improve symptoms in incarcerated forensic populations, at least temporarily. Follow-up data are still too scarce to draw conclusions about long-term outcomes. Findings of this study indicate that methodologically rigorous outcome research in these populations is needed, with a specific focus on firstline PTSD treatments, long-term efficacy, measuremen of recidivism, as well as addressing comorbid conditions given the common complex clinical and social needs in this population.