Wait-list Comparison Research Articles

Preschool Social–Emotional Skills Training

Objective: The purpose of this study was to pilot test a multicomponent program designed to prevent aggressive behavior in preschool children. The first program component was comprised of social–emotional skills training. It focused on improving the social information processing and emotional-regulation skills of children. The second component was a group-based parenting education. It focused on child development and discipline. Method: Participants, recruited from four preschools in high-risk neighborhoods within a large metropolitan area, were assigned to an intervention ( n = 31) or a waitlist comparison ( n = 36) condition. Using worker ratings and child puppet-play assessments, pretest and posttest data were collected on 14 child and caregiver/parent behaviors. Results: The gain scores of children in the intervention group differed significantly from those in the comparison group on academic competence, social competence, depression, and aggressive behavior. Caretaker gain scores differed significantly, favoring the intervention group on parental bonding, child supervision, communication, and developmental expectations. Conditioned on the limitations of the design, skills training for preschool children and their caregivers appears to promote social and academic skills.

Efficacy of Telehealth Treatments for Posttraumatic Stress-Related Symptoms: A Meta-Analysis

This meta-analysis summarizes the findings of outcome research on the degree to which telehealth treatments reduce posttraumatic stress disorder (PTSD)-related symptoms. In a search of the literature, 13 studies were identified for inclusion in the meta-analysis and were coded for relevant variables. A total of 725 participants were included. Results indicate that telehealth treatments are associated with significant pre- to postreduction in PTSD symptoms (d = 0.99, 95% confidence interval [CI]: 0.87–1.11, p < .001), and result in superior treatment effects relative to a wait-list comparison condition (d = 1.01, 95% CI: 0.76–1.26, p < .001). However, no significant findings were obtained for telehealth intervention relative to a supportive counseling telehealth comparison condition (d = 0.11, 95% CI: − 0.38 to 0.60, p = .67), and telehealth intervention produced an inferior outcome relative to a face-to-face intervention (d = − 0.68, 95% CI: − 0.39 to − 0.98, p < .001). Findings for depression symptom severity outcome were generally consistent with those for PTSD outcome. Telehealth interventions produced a significant within-group effect size (d = 0.98, 95% CI: 0.86 to 1.10, p < .001) and superior effect relative to wait-list comparison condition (d = 0.80, 95% CI: 0.56–1.05, p < .001). Relative to face-to-face interventions, telehealth treatments produced comparable depression outcome effects (d = 0.13, 95% CI: − 0.55 to 0.28, p = .53). Taken together, these findings support the use of telehealth treatments for individuals with PTSD-related symptoms.

Urban African American Youth Exposed to Community Violence: A School-Based Anxiety Preventive Intervention Efficacy Study

This study evaluated the efficacy of a school-based anxiety prevention program among urban children exposed to community violence. Students who attended Title 1 public elementary schools were screened. Ninety-eight 3rd–5th-grade students (ages 8–12; 48% female; 92% African American) were randomized into preventive intervention versus waitlist comparison groups. Students attended 13 biweekly one-hour group sessions of a modified version of FRIENDS, a cognitive-behavioral anxiety intervention program. Results indicated that both intervention and control groups manifested significant reductions in anxiety symptomatology and total exposure to community violence, along with improved standardized reading achievement scores. Additional gains observed only in the intervention group were increased standardized mathematics achievement scores, decreased life stressors, and reduced victimization by community violence. The intervention was equally efficacious for both genders and for children exposed to higher, compared to lower, levels of community violence. Implications for comprehensive, culturally and contextually relevant prevention programs and research are discussed.

Does psychological well-being influence oral-health-related quality of life reports in children receiving orthodontic treatment?

Although the associations between oral biologic variables such as malocclusion and oral-health-related quality of life (OHRQOL) have been explored, little research has been done to address the influence of psychological characteristics on perceived OHRQOL. The aim of this study was to assess OHRQOL outcomes in orthodontics while controlling for individual psychological characteristics. We postulated that children with better psychological well-being (PWB) would experience fewer negative OHRQOL impacts, regardless of their orthodontic treatment status. One hundred eighteen children (74 treatment and 44 on the waiting list), aged 11 to 14 years, seeking treatment at the orthodontic clinics at the University of Toronto, participated in this study. The child perception questionnaire (CPQ11-14) and the PWB subscale of the child health questionnaire were administered at baseline and follow-up. Occlusal changes were assessed by using the dental aesthetic index. A waiting-list comparison group was used to account for age-related effects. Although the treatment subjects had significantly better OHRQOL scores at follow-up, the results were significantly modified by each subject's PWB status (P<0.01). Furthermore, multivariate analysis showed that PWB contributed significantly to the variance in CPQ11-14 scores (26%). In contrast, the amount of variance explained by the treatment status alone was relatively small (9%). The results of this study support the postulated mediator role of PWB when evaluating OHRQOL outcomes in children undergoing orthodontic treatment. Children with better PWB are, in general, more likely to report better OHRQOL regardless of their orthodontic treatment status. On the other hand, children with low PWB, who did not receive orthodontic treatment, experienced worse OHRQOL compared with those who received treatment. This suggests that children with low PWB can benefit from orthodontic treatment. Nonetheless, further work, with larger samples and longer follow-ups, is needed to confirm this finding and to improve our understanding of how other psychological factors relate to patients' OHRQOL.

Implementing the Illness Management and Recovery Program in Japan

This study investigated the feasibility and outcomes of the illness management and recovery program in Japan. Thirty-five patients with schizophrenia were recruited. Participants were assigned (not randomly) to the intervention and wait-list comparison groups. Symptom severity, functioning, activation level in self-management, quality of life, satisfaction, self-efficacy in community living, and satisfaction with services were measured before and after the intervention. Over two years 25 patients completed the intervention (some after being wait-listed). In the pre-post comparison, they showed significant improvement in symptoms and functioning, self-reported activation in self-management, quality of life, satisfaction, and self-efficacy in community living. Compared with the ten participants in a wait-list comparison group, the eight participants in the first intervention group showed an increased quality of life in social functioning, satisfaction in living, and self-efficacy for social relationships in community living. Findings suggest that the program is effective for participants with severe mental illness in Japan.

Consultative Care Coordination Through the Medical Home for CSHCN: A Randomized Controlled Trial

The purpose of this study was to examine the impact of a care coordination intervention aimed at improving the medical home for children with special health care needs (CSHCN). 100 CSHCN referred by a Medicaid managed care plan were randomly assigned to a care coordination intervention or to a wait list comparison group that received standard care. For the intervention group, a care coordinator supported the medical home by consulting with primary care providers at multiple practices to develop an integrated, individualized plan to meet child and family needs. During the second phase of the study, the wait list comparison group received the 6-month intervention. At the end of 12 months, the two groups were combined to examine within subject differences (n = 61). Compared to the control group, participants in the initial intervention group reported a decreased need for information and improved satisfaction with mental health services and specialized therapies. This effect was replicated when the wait list control group received the intervention. Additional benefits were observed in the within subject analysis, including a decline in unmet needs, improved satisfaction with specialty care and care coordination, and improved ratings of child health and family functioning. This intervention improved outcomes for CSHCN and their families by supporting the efforts of primary care physicians to provide comprehensive and coordinated care through the medical home. The consulting care coordinator may provide an efficient and cost effective approach to enhancing the quality of care for CSHCN.

School-based Abuse Prevention: Effect on Disclosures

This paper focuses specifically on the analysis of disclosures and forms part of a wider study which evaluated the effectiveness of the Violence is Preventable program. Participants included a survivor group, grade 6 group, and a grade 7/8 group with equivalent waiting-list comparison groups. Lessons were delivered either by voluntary organization workers or class teachers. Disclosures were systematically recorded by presenters. Video was used to analyze interactions around disclosures. Substantial numbers of disclosures occurred when lessons were delivered by survivor organisation presenters. Video analysis suggested this was partly due to adult-student interactions characterized by low levels of adult control. Studies on a larger scale are needed particularly comparing outcomes from different presenters with an analysis of what leads to disclosure in and beyond the classroom.

Psychoeducation for depression, anxiety and psychological distress: a meta-analysis.

BackgroundGiven the high prevalence and burden associated with depression and anxiety disorders and the existence of treatment barriers, there is a clear need for brief, inexpensive and effective interventions such as passive psychoeducational interventions. There are no published meta-analyses of the effectiveness of passive psychoeducation in reducing symptoms of depression, anxiety or psychological distress.MethodsCochrane, PsycInfo and PubMed databases were searched in September 2008. Additional materials were obtained from reference lists. Papers describing passive psychoeducational interventions for depression, anxiety and psychological distress were included if the research design was a randomized controlled trial and incorporated an attention placebo, no intervention or waitlist comparison group.ResultsIn total, 9010 abstracts were identified. Of these, five papers which described four research studies targeting passive psychoeducation for depression and psychological distress met the inclusion criteria. The pooled standardized-effect size (four studies, four comparisons) for reduced symptoms of depression and psychological distress at post-intervention was d = 0.20 (95% confidence interval: 0.01-0.40; Z = 2.04; P = 0.04; the number needed to treat: 9). Heterogeneity was not significant among the studies (I2 = 32.77, Q:4.46; P = 0.22).ConclusionsAlthough it is commonly believed that psychoeducation interventions are ineffective, this meta-analysis revealed that brief passive psychoeducational interventions for depression and psychological distress can reduce symptoms. Brief passive psychoeducation interventions are easy to implement, can be applied immediately and are not expensive. They may offer a first-step intervention for those experiencing psychological distress or depression and might serve as an initial intervention in primary care or community models. The findings suggest that the quality of psychoeducation may be important.

Do Sedentary Older Adults Benefit From Community-Based Exercise? Results From the Active Start Program

This study assessed the effectiveness of Active Start, a community-based behavior change and fitness program, designed to promote physical activity among sedentary community-dwelling older adults. A quasi-experimental design was used. Data were analyzed using a within-group pretest-post-test design to calculate changes in the intervention group and changes in the waitlist comparison group. Further analyses were conducted after the comparison group completed the intervention. Paired t tests were employed to analyze unadjusted mean changes in physical performance measures from pretest to post-test. Repeated measures analysis of covariance (using SAS Proc Mixed) was then conducted to calculate the adjusted mean change for the intervention group. Significant improvement was found on all performance measures (strength, flexibility, and balance) for the intervention group as a whole. Similar improvements were found among subgroups (Whites, African Americans, and Hispanics). No significant changes were found in the comparison group when they were in the control condition; however, they significantly improved on all measures after completing the intervention. This study suggests that a community-based physical activity program benefits sedentary, racially, and ethnically diverse older adults by coupling a behavioral change support group and fitness classes.

Efficacy of an HIV/STI prevention intervention for black men who have sex with men: findings from the Many Men, Many Voices (3MV) project.

Black men who have sex with men (MSM) in the United States experience disproportionately high rates of HIV and other sexually transmitted infections (STIs); however, the number of evidence-based interventions for Black MSM is limited. This study evaluated the efficacy of Many Men, Many Voices (3MV), a small-group HIV/STI prevention intervention developed by Black MSM-serving community-based organizations and a university-based HIV/STI prevention and training program. The study sample included 338 Black MSM of HIV-negative or unknown HIV serostatus residing in New York city. Participants were randomly assigned to the 3MV intervention condition (n = 164) or wait-list comparison condition (n = 174). Relative to comparison participants, 3MV participants reported significantly greater reductions in any unprotected anal intercourse with casual male partners; a trend for consistent condom use during receptive anal intercourse with casual male partners; and significantly greater reductions in the number of male sex partners and greater increases in HIV testing. This study is the first randomized trial to demonstrate the efficacy of an HIV/STI prevention intervention for Black MSM.

The Effectiveness of an Online Mind-Body Intervention for Older Adults With Chronic Pain

The Self-care Pain Management Project assessed the feasibility and efficacy of delivering online mind-body self-care techniques to 78 adults aged 55 and older with chronic pain. To assess feasibility, the study monitored use of the intervention and documented participant satisfaction. A randomized trial with intervention (n = 41) and waiting list comparison groups (n = 37) was used to assess changes in pain intensity, limitations due to pain, pain self-efficacy, depression, anxiety, and awareness of responses to pain from baseline to follow-up at 6 weeks. There were statistically significant results for between-group difference in awareness of responses to pain, improvements in pain intensity and pain interference for both groups, and increases in confidence with using nonmedical self-care techniques to manage pain for the intervention group. Reductions in mean pain scores reported by the intervention group at log on and log off also suggest that the intervention may have an immediate impact on reducing pain. Findings document the feasibility of a relatively short-term, online mind-body pain management intervention that can have benefits for participants. The characteristics of those who volunteered for an online self-care pain management intervention also have implications for identifying target populations for such interventions. This article documents the outcomes of an Internet-based self-care pain management intervention that focused on mind-body exercises. The study suggests that the Internet can be an efficient mode for delivering self-care education to older adults with chronic pain and has potential benefits that complement clinical care.

Regenerate: assessing the feasibility of a strength‐training program to enhance the physical and mental health of chronic post stroke patients with depression

The Regenerate pilot study explored whether a 10-week, community-based progressive resistance training (PRT) program could reduce depressive symptoms in depressed chronic stroke survivors. Participants were screened for depressive status using the PHQ-9 and confirmed by psychiatric assessment. Eligible people (n = 45) were randomised to PRT or a waiting-list comparison group. The PRT program included two high intensity sessions/week for 10 weeks at a community-based gymnasium. Depressive status, physical and mental health and quality of life were measured at baseline, 10 weeks and 6 months. Muscle strength was assessed using 1 repetition maximum (1-RM) for upper and lower limbs. The participants' median age was 69 years: 27 were male. The intervention group had lower depression scores than the comparison group at all time points. At 6-month follow-up, there was a trend for PRT participants to be more likely to be no longer depressed than the comparison group, but the difference was not significant after adjusting for baseline scores. There were modest improvements in health and wellbeing over time, but many scores were lower than reported in non-depressed people. Intervention participants demonstrated significant improvements in strength. Program adherence was good: on average 75% of the 10-week program was completed. The intervention appeared to be feasible within a community-based setting. To optimize stroke recovery and improve the quality of life of stroke survivors, health professionals should continue to focus on helping survivors' mental health recovery as well their physical rehabilitation.

Effects of a computer based beginning reading program on young children

&lt;span&gt;This study was an evaluation of a parent delivered, computer based beginning reading program with a group of 15 Kindergarten and Grade 1 students. Completing the &lt;/span&gt;&lt;em&gt;Funnix&lt;/em&gt;&lt;span&gt; program at home through a CD copy was expected to produce educationally and statistically significant improvements in phonemic awareness, letter-sound fluency, non-word decoding skills, and oral reading fluency, when compared to the outcomes for a similar group of 16 students in a wait list comparison group. Data were analysed using univariate analyses of covariance incorporating effect sizes. Statistically significant treatment effects were found for Kindergarten students in the intervention group on letter-sound fluency, oral reading fluency, non-word decoding, and phonemic awareness skills. Grade 1 students in the intervention group demonstrated significant improvement over time on letter-sound fluency, letter-name knowledge, non-word decoding and oral reading fluency; however, these improvements were not significantly greater than those for the Grade 1 comparison group. It was concluded that Kindergarten students gained the most benefits, and that at risk students may represent a fruitful target audience.&lt;/span&gt;

Cochrane review: Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents

AbstractBackgroundWhile behavioural or cognitive‐behavioural therapy (BT/CBT) is recommended as the psychotherapeutic treatment of choice for children and adolescents with obsessive‐compulsive disorder (OCD), the application of BT/CBT to paediatric OCD may not be straightforward.ObjectivesThis review examines the overall efficacy of BT/CBT for paediatric OCD, its relative efficacy against psychopharmacology and whether there are benefits in using BT/CBT combined with medication.Search strategyWe searched CCDANCTR‐Studies and CCDANCTR‐References (searched on 5/8/2005), MEDLINE, EMBASE, PsycINFO, the reference lists of all selected studies and handsearched journals specifically related to behavioural treatment of OCD.Selection criteriaIncluded studies were randomised controlled trials or quasi‐randomised trials with participants who were 18 years of age or younger and had a diagnosis of OCD, established by clinical assessment or standardised diagnostic interview. Reviewed studies included the standard behavioural or cognitive‐behavioural techniques, either alone or in combination, compared with wait‐list or pill placebo.Data collection and analysisThe quality of selected studies was assessed by two independent reviewers. The primary outcomes comprised of endpoint scores on the gold standard clinical outcome measure of OCD symptoms, distress and interference (CY‐BOCS) and endpoint OCD status.Main resultsFour studies with 222 participants were considered eligible for inclusion and for data extraction. Two studies showed significantly better post‐treatment functioning and reduced risk of continuing with OCD at post‐treatment for the BT/CBT group compared to placebo or wait‐list comparisons. We suggested that the POTS 2004 result, equal to a difference of about eight points on the CY‐BOCS, represented the best available estimate for the efficacy of BT/CBT relative to no treatment. (WMD ‐7.50; 95% CI ‐11.55, ‐3.45). Pooled evidence from two trials indicated that the efficacy of BT/CBT and medication did not differ significantly (WMD ‐3.87; 95% CI ‐8.15, 0.41). There was evidence of the benefit of combined BT/CBT and medication compared to medication alone (WMD ‐4.55; 95% CI ‐7.40, ‐1.70), but not relative to BT/CBT alone (WMD ‐2.80; 95% CI ‐7.55, 1.95). The rates of drop out suggested BT/CBT is an acceptable treatment to child and adolescent patients and their families.Authors' conclusionsAlthough only based on a small number of studies, behavioural or cognitive‐behaviour therapy appears to be a promising treatment for OCD in children and adolescents. It can lead to better outcomes when combined with medication compared to medication alone. Additional trials are needed to confirm these findings. In the interim, consideration should be given to the ways in which BT/CBT might be made more widely available as a treatment for OCD in children and adolescents.Plain language summaryPlain language summaryBehavioural and cognitive‐behavioural therapy for obsessive‐compulsive disorder (OCD) in children and adolescentsThe onset of obsessive‐compulsive disorder often occurs in childhood and adolescence. It can be an extremely debilitating disorder, resulting in high levels of distress, impairment and disruption of psychosocial development. It also has a considerable impact on other family members. While there is evidence that medication can reduce symptoms, behavioural and cognitive‐behavioural therapy (BT/CBT) are often proposed as acceptable alternative treatments. These therapies have various components, but commonly include assisting the child to better tolerate the anxiety provoking situations and thoughts, without the use of compulsive behaviour to manage their anxiety. Other components include psycho‐education about anxiety and OCD, cognitive training involving learning to identify and challenge unhelpful ways of thinking, and parental involvement.This review identified four RCTs, involving 222 participants, evaluating the benefits of behavioural and cognitive‐behavioural therapy. The results from two individual studies show that, compared to a wait‐list or pill placebo, BT/CBT is an effective treatment for reducing OCD symptoms and lowering the risk of having OCD after treatment. Based on two studies that directly compared BT/CBT with anti‐OCD medication, there was no evidence to suggest that either BT/CBT or anti‐OCD medication was superior to the other. When combined with medication, BT/CBT produces better outcomes than medication alone, but combining medication and BT/CBT does not result in better outcomes than BT/CBT alone.Although based on a small number of studies, these findings provide some support for the potential value of BT/CBT in the treatment of children and adolescents with OCD. Sufferers and their families may wish to enquire about the appropriateness of BT/CBT, and to request information about the availability of appropriately skilled clinicians.

Efficacy of a Group Intervention for Adult Women Survivors of Sexual Abuse

ABSTRACT This study evaluates the effects of a group intervention for women sexually abused in childhood or adulthood. The sample consisted of 41 women involved in a group intervention based on a feminist approach offered by help centers for sexual assault victims in Quebec and 11 women in a wait-list comparison group. Results reveal that the group intervention reduced psychological distress and consequences associated with sexual abuse and that gains were maintained at three-month follow-up. Analyses of potential factors related to differential gains indicated that abuse-related variables and concurrent individual interventions were not linked to outcomes. Exploratory analyses suggested that women experiencing severe physical partner violence showed greater gains with respect to self-blame/stigmatization, sexual anxiety, and anxiety related to assertiveness.

Community-based intervention for children exposed to intimate partner violence: An efficacy trial.

A community-based intervention program was tested with 181 children ages 6-12 and their mothers exposed to intimate partner violence during the past year. A sequential assignment procedure allocated participants to 3 conditions: child-only intervention, child-plus-mother intervention (CM), and a wait-list comparison. A 2-level hierarchical linear model consisting of repeated observations within individuals and individuals assigned to conditions was used to evaluate the effects of time from baseline to postintervention comparing the 3 conditions and from postintervention to 8-month follow-up for both intervention conditions. Outcomes were individual children's externalizing and internalizing behavior problems and attitudes about violence. Of the 3 conditions, CM children showed the greatest improvement over time in externalizing problems and attitudes about violence. There were 79% fewer children with clinical range externalizing scores and 77% fewer children with clinical range internalizing scores from baseline to follow-up for CM children.

Building support for language and early literacy in preschool classrooms through in-service professional development: Effects of the Literacy Environment Enrichment Program (LEEP)

There is a substantial and persistent gap in achievement between children from different backgrounds [National Center for Education Statistics. (2002). Children's reading and mathematics achievement in kindergarten and first grade. Washington, DC: U.S. Government Printing Office] that can be traced to the preschool years [Snow, C. E., Burns, M. S., & Griffin, P. (Eds.). (1998). Preventing reading difficulties in young children. Washington, DC: National Research Council, National Academy Press], highlighting the importance of ensuring that preschools that serve low-income populations provide strong support for children's language and early literacy development. The current project sought to improve program quality in Head Start classrooms throughout New England with the Literacy Environment Enrichment Program (LEEP), an in-service intervention that was delivered in the form of a credit-bearing course. The impact of LEEP was studied using a wait-list comparison group strategy to determine whether intervention group teachers (n = 30) showed more fall–spring growth in measures of classroom support for literacy than did comparison group teachers (n = 40). Multiple hierarchical regression analyses that controlled for background measures and fall scores on classroom measures revealed moderate to large positive effects on all measures of classrooms support for language and early literacy with the exception of writing, for which only a small effect was found.

Treatment of Acute Posttraumatic Stress Disorder With Brief Cognitive Behavioral Therapy: A Randomized Controlled Trial

Objective: The purpose of this study was to evaluate the efficacy of brief cognitive behavioral therapy for patients with acute posttraumatic stress disorder (PTSD) resulting from various types of psychological trauma. Method: The authors randomly assigned 143 patients with acute PTSD (irrespective of the time criterion), within 3 months after experiencing a traumatic incident, to either brief cognitive behavioral therapy (N=79) or a waiting list comparison group (N=64). Cognitive behavioral therapy consisted of four weekly sessions containing education, relaxation exercises, imaginal exposure, in vivo exposure, and cognitive restructuring. Main outcome measure was PTSD score measured by structured interview; secondary outcomes were anxiety and depression measured by questionnaire. Assessments took place before the intervention and 1 week and 4 months after the intervention. Results: Symptoms of PTSD, anxiety, and depression decreased in both groups over time. One week after the intervention, the cognitive behavioral therapy group had significantly fewer symptoms of PTSD than the comparison group, but this difference was smaller and no longer significant 4 months after the intervention. Similar results were found for anxiety and depression scores. Subgroup analyses showed that cognitive behavioral therapy led to significantly lower PTSD scores at 4 months in patients with baseline comorbid major depression and in patients who were included within the first month after the traumatic incident both at 1 week and at 4 months. Conclusions: Brief early cognitive behavioral therapy accelerated recovery from symptoms of acute PTSD but did not influence long-term results. Brief early cognitive behavioral therapy showed enhanced efficacy in patients with baseline comorbid depression and patients who were included within 1 month after their traumatic experience.

Randomized Controlled Trials and Psychotherapy Research

Randomized Controlled Trials and Psychotherapy Research

Treatment of Acute Posttraumatic Stress Disorder With Brief Cognitive Behavioral Therapy: A Randomized Controlled Trial

The purpose of this study was to evaluate the efficacy of brief cognitive behavioral therapy for patients with acute posttraumatic stress disorder (PTSD) resulting from various types of psychological trauma. The authors randomly assigned 143 patients with acute PTSD (irrespective of the time criterion), within 3 months after experiencing a traumatic incident, to either brief cognitive behavioral therapy (N=79) or a waiting list comparison group (N=64). Cognitive behavioral therapy consisted of four weekly sessions containing education, relaxation exercises, imaginal exposure, in vivo exposure, and cognitive restructuring. Main outcome measure was PTSD score measured by structured interview; secondary outcomes were anxiety and depression measured by questionnaire. Assessments took place before the intervention and 1 week and 4 months after the intervention. Symptoms of PTSD, anxiety, and depression decreased in both groups over time. One week after the intervention, the cognitive behavioral therapy group had significantly fewer symptoms of PTSD than the comparison group, but this difference was smaller and no longer significant 4 months after the intervention. Similar results were found for anxiety and depression scores. Subgroup analyses showed that cognitive behavioral therapy led to significantly lower PTSD scores at 4 months in patients with baseline comorbid major depression and in patients who were included within the first month after the traumatic incident both at 1 week and at 4 months. Brief early cognitive behavioral therapy accelerated recovery from symptoms of acute PTSD but did not influence long-term results. Brief early cognitive behavioral therapy showed enhanced efficacy in patients with baseline comorbid depression and patients who were included within 1 month after their traumatic experience.