{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:57:35Z","timestamp":1792515455128,"version":"4.5.0"},"reference-count":51,"publisher":"Royal College of Psychiatrists","issue":"3","license":[{"start":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T00:00:00Z","timestamp":1589846400000},"content-version":"unspecified","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:sec id=\"S2056472420000307_sec_a1\" sec-type=\"other\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>Many patients with post-traumatic stress disorder (PTSD) experience dissociative symptoms. The question of whether these dissociative symptoms negatively influence the effectiveness of psychotherapy for PTSD is unresolved.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472420000307_sec_a2\" sec-type=\"other\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>To determine the influence of dissociative symptoms on psychotherapy outcome in PTSD.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472420000307_sec_a3\" sec-type=\"methods\">\n\t    <jats:title>Method<\/jats:title>\n\t    <jats:p>We conducted a systematic search in Cochrane, Embase, PILOTS, PsycINFO, PubMed and Web of Science for relevant clinical trials. A random-effects meta-analysis examined the impact of dissociation on psychotherapy outcome in PTSD (pre-registered at Prospero CRD42018086575).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472420000307_sec_a4\" sec-type=\"results\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>Twenty-one trials (of which nine were randomised controlled trials) with 1714 patients were included. Pre-treatment dissociation was not related to treatment effectiveness in patients with PTSD (Pearson's correlation coefficient 0.04, 95% CI \u22120.04 to 0.13). Between-study heterogeneity was high but was not explained by moderators such as trauma focus of the psychotherapy or risk of bias score. There was no indication for publication bias.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472420000307_sec_a5\" sec-type=\"conclusions\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>We found no evidence that dissociation moderates the effectiveness of psychotherapy for PTSD. The quality of some of the included studies was relatively low, emphasising the need for high-quality clinical trials in patients with PTSD. The results suggest that pre-treatment dissociation does not determine psychotherapy outcome in PTSD.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1192\/bjo.2020.30","type":"journal-article","created":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T08:55:14Z","timestamp":1589878514000},"source":"Crossref","is-referenced-by-count":71,"title":["Impact of dissociation on the effectiveness of psychotherapy for post-traumatic stress disorder: meta-analysis"],"prefix":"10.1192","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5991-1963","authenticated-orcid":false,"given":"C. M.","family":"Hoeboer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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