The Effectiveness of Psychological Interventions on Reducing the Symptoms of Post-Traumatic Stress Disorder in Military Personnel: A Systematic Review

Background and Aim: Considering the nature of post-traumatic stress disorder (PTSD) in the military profession, challenges in the effectiveness of psychological interventions on the symptoms of the disorder and sustainable recovery have been reported among the military population. The present research aims to identify effective psychological interventions for PTSD symptoms and compare their effectiveness as first-line therapy (trauma-focused) and second-line therapy (non-trauma-focused). Methods: The systematic review method has been performed in the present research. Related studies from 2010-2022 were reviewed and 41 qualifying studies were selected. The database included Elmnet, Magiran, Google Scholar, Pubmed, Science Direct, PsycINFO, and SID. Results: Focused first-line interventions included therapies based on mindfulness, cognitive-behavioral, long-term exposure, cognitive processing, and eye movement desensitization and reprocessing (EMDR), which were applied in clinical trials. Other non-trauma-focused therapies had a significant effect on improving PTSD symptoms compared to the wait group. The risk of bias was low in clinical trials and higher in non-trauma-focused therapies. Nevertheless, when the conventional therapies and second-line therapies were performed on the control group, the effectiveness was often equal or with insignificant differences. Including continuous and intensive individual, written, online, and home-based sessions, particularly the integration of non-trauma-focused therapies played a special part in the effectiveness of interventions and reducing the dropout rate. Conclusion: The first-line interventions to treat PTSD also have their pros and cons. Changes can be made to resolve these challenges, including the homogenization of subjects, shorter intervals between sessions, integration of the conventional and non-trauma focused therapies, using writing tools and smart phones, personalized interventions, and trust in second-line therapies in terms of clinical trials