New Horizons in Post-Traumatic Stress Disorder Treatment: From Current Status to the Future
New Horizons in PTSD Treatment: From Current Status to the Future
DOI:
https://doi.org/10.63175/tjts.25Keywords:
post-traumatic stress disorder, Trauma Treatment, Traumatic Stress, EMDR, PsychotherapyAbstract
Post-traumatic stress disorder (PTSD) remains a significant global mental health challenge, characterized by complex symptomatology and diverse individual trajectories. While trauma-focused psychotherapies such as Prolonged Exposure, Cognitive Processing Therapy, and EMDR remain the gold standard, a substantial proportion of patients do not fully benefit from existing treatments. This editorial reviews the current evidence-based practices in PTSD therapy and critically explores emerging interventions on the horizon, including psychedelic-assisted psychotherapy, neuromodulation techniques, epigenetic-based treatments, and AI-supported digital therapies. By examining the biological, psychological, and technological innovations shaping the future of PTSD care, we argue for a multidimensional, personalized, and interdisciplinary approach to treatment. This synthesis aims to inform clinicians, researchers, and policymakers about promising therapeutic directions and foster dialogue on the future of trauma recovery.
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References
1. Neria Y, Gross R, Litz B, et al. Prevalence and psychological correlates of complicated grief among bereaved adults 2.5–3.5 years after September 11th attacks. J Trauma Stress. 2007;20(3):251-262.
2. Bromet EJ, Atwoli L, Kawakami N, et al. Post-traumatic stress disorder associated with natural and human-made disasters in the World Mental Health Surveys. Psychol Med. 2017;47(2):227-241.
3. Zhang Y, Zhao J, Xi J, et al. The prevalence and determinant of PTSD symptoms among home-quarantined Chinese university students during the COVID-19 pandemic. Healthcare (Basel). 2021;9(10):1383.
4. Koenen KC, Ratanatharathorn A, Ng L, et al. Posttraumatic stress disorder in the World Mental Health Surveys. Psychol Med. 2017;47(13):2260-2274. doi:10.1017/S0033291717000708
5. Gates MA, Holowka DW, Vasterling JJ, Keane TM, Marx BP, Rosen RC. Posttraumatic stress disorder in veterans and military personnel: Epidemiology, screening, and case recognition. Psychol Serv. 2012;9(4):361-382. doi:10.1037/a0027649
6. Bassett D, Buchwald D, Manson SM. Posttraumatic stress disorder and symptoms among American Indians and Alaska Natives: A review of the literature. Soc Psychiatry Psychiatr Epidemiol. 2013;49(3):417-433. doi:10.1007/s00127-013-0759-y
7. Amstadter A, Aggen S, Knudsen G, Reichborn-Kjennerud T, Kendler K. A population-based study of familial and individual-specific environmental contributions to traumatic event exposure and posttraumatic stress disorder symptoms in a norwegian twin sample. Twin Res Hum Genet. 2012;15(5):656-662. doi:10.1017/thg.2012.43
8. Blacker CJ, Frye MA, Morava E, Kozicz T, Veldic M. A review of epigenetics of PTSD in comorbid psychiatric conditions. Genes (Basel). 2019;10(2):140. doi:10.3390/genes10020140
9. Daskalakis NP, Rijal CM, King C, Huckins LM, Ressler KJ. Recent genetics and epigenetics approaches to PTSD. Curr Psychiatry Rep. 2018;20(5):30. doi:10.1007/s11920-018-0898-7
10. Morrison FG, Miller MW, Logue MW, Assef M, Wolf EJ. DNA methylation correlates of PTSD: Recent findings and technical challenges. Prog Neuropsychopharmacol Biol Psychiatry. 2019;90:223-234. doi:10.1016/j.pnpbp.2018.11.011
11. Lewis C, Roberts NP, Andrew M, Starling E, Bisson JI. Psychological therapies for post-traumatic stress disorder in adults: Systematic review and meta-analysis. Eur J Psychotraumatol. 2020;11(1):1729633. doi:10.1080/20008198.2020.1729633
12. Bisson JI, Ehlers A, Matthews R, Pilling S, Richards D, Turner S. Psychological treatments for chronic post-traumatic stress disorder. Br J Psychiatry. 2007;190(2):97-104. doi:10.1192/bjp.bp.106.021402
13. Roberts NP, Kitchiner NJ, Kenardy J, Lewis CE, Bisson JI. Early psychological intervention following recent trauma: A systematic review and meta-analysis. Eur J Psychotraumatol. 2019;10(1):1695486. doi:10.1080/20008198.2019.1695486
14. Ehlers A, Bisson J, Clark DM, et al. Do all psychological treatments really work the same in posttraumatic stress disorder? Clin Psychol Rev. 2010;30(2):269-276. doi:10.1016/j.cpr.2009.12.001
15. Bastien J, Jongsma HE, Kabadayi M, Billings J. The effectiveness of psychological interventions for post-traumatic stress disorder in children, adolescents and young adults: A systematic review and meta-analysis. Psychol Med. 2020;50(10):1598-1612. doi:10.1017/S0033291720002007
16. Forbes D, Creamer M, Phelps A, et al. Australian guidelines for the treatment of adults with acute stress disorder and post-traumatic stress disorder. Aust N Z J Psychiatry. 2007;41(8):637-648. doi:10.1080/00048670701449161
17. Lee E, Bowles K. Navigating treatment recommendations for PTSD: A rapid review. Int J Ment Health. 2020;52:4-44. doi:10.1080/00207411.2020.1781407
18. Meister L, Dietrich A, Stefanovic M, et al. Pharmacological memory modulation to augment trauma-focused psychotherapy for PTSD: A systematic review of randomized controlled trials. Transl Psychiatry. 2023;13(1):1-14. doi:10.1038/s41398-023-02495-2
19. Lewis C, Roberts NP, Bethell A, Robertson L, Bisson JI. Internet-based cognitive and behavioural therapies for post-traumatic stress disorder (PTSD) in adults. Cochrane Database Syst Rev. 2018;12:CD011710. doi:10.1002/14651858.CD011710.pub2
20. Van Den Berg D, De Bont P, Van Der Vleugel B, et al. Prolonged exposure vs eye movement desensitization and reprocessing vs waiting list for posttraumatic stress disorder in patients with a psychotic disorder: a randomized clinical trial. JAMA Psychiatry. 2015;72(3):259-267. doi:10.1001/jamapsychiatry.2014.2637
21. Sciarrino N, Warnecke A, Teng E. A Systematic Review of Intensive Empirically Supported Treatments for Posttraumatic Stress Disorder. J Trauma Stress. 2020. doi:10.1002/jts.22556
22. Cusack K, Jonas D, Forneris C, et al. Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis. Clin Psychol Rev. 2016;43:128-141. doi:10.1016/j.cpr.2015.10.003
23. Yunitri N, Chu H, Kang X, et al. Comparative effectiveness of psychotherapies in adults with posttraumatic stress disorder: a network meta-analysis of randomised controlled trials. Psychol Med. 2023;53:6376-6388. doi:10.1017/S0033291722003737
24. Hudays A, Gallagher R, Hazazi A, Arishi A, Bahari G. Eye Movement Desensitization and Reprocessing versus Cognitive Behavior Therapy for Treating Post-Traumatic Stress Disorder: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022;19(24):16836. doi:10.3390/ijerph192416836
25. Pierce Z, Johnson E, Kim I, Lear B, Mast A, Black J. Therapeutic interventions impact brain function and promote post-traumatic growth in adults living with post-traumatic stress disorder: A systematic review and meta-analysis of functional magnetic resonance imaging studies. Front Psychol. 2023;14:1074972. doi:10.3389/fpsyg.2023.1074972
26. Krüger-Gottschalk A, Kuck S, Dyer A, et al. Effectiveness in routine care: trauma-focused treatment for PTSD. Eur J Psychotraumatol. 2025;16. doi:10.1080/20008066.2025.2452680. [Epub ahead of print]
27. Melegkovits E, Blumberg J, Dixon E, et al. The effectiveness of trauma-focused psychotherapy for complex post-traumatic stress disorder: A retrospective study. Eur Psychiatry. 2022;66(1):e83. doi:10.1192/j.eurpsy.2022.2346
28. Mavranezouli I, Megnin-Viggars O, Daly C, et al. Psychological and psychosocial treatments for children and young people with post-traumatic stress disorder: a network meta-analysis. J Child Psychol Psychiatry. 2020;61(1):18-29. doi:10.1111/jcpp.13094
29. Hoppen T, Jehn M, Holling H, Mutz J, Kip A, Morina N. The efficacy and acceptability of psychological interventions for adult PTSD: A network and pairwise meta-analysis of randomized controlled trials. J Consult Clin Psychol. Published online 2023. doi:10.1037/ccp0000809. [Epub ahead of print]
30. Shea M, Krupnick J, Belsher B, Schnurr P. Non-Trauma-Focused Psychotherapies for the Treatment of PTSD: a Descriptive Review. Curr Treat Options Psychiatry. 2020;7:295-310. doi:10.1007/s40501-020-00214-y
31. Norman S. Effectiveness of currently available psychotherapies for post‐traumatic stress disorder and future directions. World Psychiatry. 2022;21(2):229-245. doi:10.1002/wps.20974
32. Mirpour B, Aghayousefi A, Bajalan L, Abdolmaleki L. P3: the introduction of traditional and modern psychotherapy in the treatment of post-traumatic stress disorder. Shefaye Khatam. 2015;3(Suppl 3):30..
33. Xiang Y, Cipriani A, Teng T, et al. Comparative efficacy and acceptability of psychotherapies for post-traumatic stress disorder in children and adolescents: a systematic review and network meta-analysis. Evid Based Ment Health. 2021;24(4):153-160. doi:10.1136/ebmental-2021-300346
34. Schnurr P. Focusing on trauma-focused psychotherapy for posttraumatic stress disorder. Curr Opin Psychol. 2017;14:56-60. doi:10.1016/j.copsyc.2016.11.005
35. Merz J, Schwarzer G, Gerger H. Comparative Efficacy and Acceptability of Pharmacological, Psychotherapeutic, and Combination Treatments in Adults With Posttraumatic Stress Disorder: A Network Meta-analysis. JAMA Psychiatry. 2019;76(9):904-913. doi:10.1001/jamapsychiatry.2019.0951
36. American Psychological Association. Summary of the clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. Am Psychol. 2019;74(5):596-607. doi:10.1037/amp0000473
37. Watts B, Schnurr P, Mayo L, Young-Xu Y, Weeks W, Friedman M. Meta-analysis of the efficacy of treatments for posttraumatic stress disorder. J Clin Psychiatry. 2013;74(6):e541-e550. doi:10.4088/JCP.12r08225
38. Hetrick S, Purcell R, Garner B, Parslow R. Combined pharmacotherapy and psychological therapies for post traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2010;(7):CD007316. doi:10.1002/14651858.CD007316.pub2
39. Bisson J, Olff M. Prevention and treatment of PTSD: the current evidence base. Eur J Psychotraumatol. 2021;12(1):1824381. doi:10.1080/20008198.2020.1824381
40. Jeffreys M, Reinfeld C, Nair P, Garcia H, Mata-Galan E, Rentz T. Evaluating treatment of posttraumatic stress disorder with cognitive processing therapy and prolonged exposure therapy in a VHA specialty clinic. J Anxiety Disord. 2014;28(1):108-114. doi:10.1016/j.janxdis.2013.04.010
41. Steenkamp M, Litz B, Hoge C, Marmar C. Psychotherapy for Military-Related PTSD: A Review of Randomized Clinical Trials. JAMA. 2015;314(5):489-500. doi:10.1001/jama.2015.8370
42. Yehuda R, Hoge C. The Meaning of Evidence-Based Treatments for Veterans With Posttraumatic Stress Disorder. JAMA Psychiatry. 2016;73(5):433-434. doi:10.1001/jamapsychiatry.2015.2878
43. Raut S, Marathe P, Van Eijk L, et al. Diverse therapeutic developments for post-traumatic stress disorder (PTSD) indicate common mechanisms of memory modulation. Pharmacol Ther. 2022;239:108195. doi:10.1016/j.pharmthera.2022.108195
44. Mavranezouli I, Megnin-Viggars O, Daly C, et al. Psychological treatments for post-traumatic stress disorder in adults: a network meta-analysis. Psychol Med. 2020;50(4):542-555. doi:10.1017/S0033291720000070
45. Henner R, Keshavan M, Hill K. Review of potential psychedelic treatments for PTSD. J Neurol Sci. 2022;439:120302. doi:10.1016/j.jns.2022.120302
46. Bisson J, Andrew M. Psychological treatment of post-traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2007;(3):CD003388. doi:10.1002/14651858.CD003388.pub3
47. Zaretsky T, Jagodnik K, Barsic R, et al. The Psychedelic Future of Post-Traumatic Stress Disorder Treatment. Curr Neuropharmacol. 2023;22:636-735. doi:10.2174/1570159x22666231027111147
48. Ot’alora GM, Grigsby J, Poulter B, et al. 3,4-Methylenedioxymethamphetamine-assisted psychotherapy for treatment of chronic posttraumatic stress disorder: A randomized phase 2 controlled trial. J Psychopharmacol. 2018;32(12):1295-1307. doi:10.1177/0269881118806297
49. Du R, Niu K, Lu G, Shang Y. Ketamine for the multivariate effect of ptsd: systematic review and meta-analysis. Preprint. Posted online June 13, 2021. doi:10.1101/2021.06.13.21258836
50. Kelmendi B, Adams T, Yarnell S, Southwick S, Abdallah C, Krystal J. PTSD: from neurobiology to pharmacological treatments. Eur J Psychotraumatol. 2016;7:31858. doi:10.3402/ejpt.v7.31858
51. Gouveia F, Davidson B, Meng Y, et al. Treating Post-traumatic Stress Disorder with Neuromodulation Therapies: Transcranial Magnetic Stimulation, Transcranial Direct Current Stimulation, and Deep Brain Stimulation. Neurotherapeutics. 2020;17:1747-1756. doi:10.1007/s13311-020-00871-0
52. Steckler T, Risbrough V. Pharmacological treatment of PTSD – Established and new approaches. Neuropharmacology. 2012;62(2):617-627. doi:10.1016/j.neuropharm.2011.06.012
53. Cukor J, Spitalnick J, Difede J, Rizzo A, Rothbaum B. Emerging treatments for PTSD. Clin Psychol Rev. 2009;29(8):715-726. doi:10.1016/j.cpr.2009.09.001
54. Reger G, Holloway K, Candy C, et al. Effectiveness of virtual reality exposure therapy for active duty soldiers in a military mental health clinic. J Trauma Stress. 2011;24(1):93-96. doi:10.1002/jts.20574
55. Norr A, Smolenski D, Katz A, et al. Virtual reality exposure versus prolonged exposure for ptsd: which treatment for whom? Depress Anxiety. 2018;35(6):523-529. doi:10.1002/da.22751
56. Rizzo A, Shilling R. Clinical virtual reality tools to advance the prevention, assessment, and treatment of ptsd. Eur J Psychotraumatol. 2017;8(sup5):1414560. doi:10.1080/20008198.2017.1414560
57. Reger G, Durham T, Tarantino K, Luxton D, Holloway K, Lee J. Deployed soldiers’ reactions to exposure and medication treatments for ptsd. Psychol Trauma. 2013;5(4):309-316. doi:10.1037/a0028409:
58. Bremner JD, Gurel NZ, Jiao Y, et al. Transcutaneous vagal nerve stimulation blocks stress-induced activation of interleukin-6 and interferon-γ in posttraumatic stress disorder: a double-blind, randomized, sham-controlled trial. Brain Behav Immun Health. 2020;9:100138. doi:10.1016/j.bbih.2020.100138
59. Powers MB, Hays SA, Rosenfield D, et al. Vagus nerve stimulation therapy for treatment-resistant PTSD. Brain Stimul. 2025;18:665-675. doi:10.1016/j.brs.2025.03.007
60. Niraj G, Karanth V, Niraj S, Charan N. Stellate ganglion block in disparate treatment-resistant mental health disorders: A case series. Scand J Pain. 2025;25(1). doi:10.1515/sjpain-2024-0071
61. Varkovitzky R, Sherrill A, Reger G. Effectiveness of the unified protocol for transdiagnostic treatment of emotional disorders among veterans with posttraumatic stress disorder: a pilot study. Behav Modif. 2017;42(2):210-230. doi:10.1177/0145445517724539
62. Belleau EL, D’Andrea W, Ford JD. Predicting differential treatment outcomes for trauma-focused versus supportive psychotherapy in PTSD. J Trauma Stress. 2020;33(3):309-317.
63. Perlick D, Sautter F, Becker-Cretu J, et al. The incorporation of emotion-regulation skills into couple- and family-based treatments for post-traumatic stress disorder. Mil Med Res. 2017;4(1):23. doi:10.1186/s40779-017-0130-9
64. Sautter F, Armelie A, Glynn S, Wielt D. The development of a couple-based treatment for ptsd in returning veterans. Prof Psychol Res Pr. 2011;42(1):63-69. doi:10.1037/a0022323
65. Busbee P, Bam M, Yang X, et al. Dysregulated TP53 Among PTSD Patients Leads to Downregulation of miRNA let-7a and Promotes an Inflammatory Th17 Phenotype. Front Immunol. 2022;12:815840. doi:10.3389/fimmu.2021.815840
66. Bam M, Yang X, Zhou J, et al. Evidence for Epigenetic Regulation of Pro-Inflammatory Cytokines, Interleukin-12 and Interferon Gamma, in Peripheral Blood Mononuclear Cells from PTSD Patients. J Neuroimmune Pharmacol. 2016;11:168-181. doi:10.1007/s11481-015-9643-8
67. Maddox SA, Kilaru V, Shin J, et al. Estrogen-dependent association of HDAC4 with fear in female mice and women with PTSD. Mol Psychiatry. 2018;23(3):658-665. doi:10.1038/mp.2017.20
68. Bonomi RE, Girgenti M, Krystal JH, Cosgrove KP. A role for histone deacetylases in the biology and treatment of post-traumatic stress disorder: what do we know and where do we go from here? Complex Psychiatry. 2022;8(1-2):13-27.
69. Whittle N, Singewald N. HDAC inhibitors as cognitive enhancers in fear, anxiety and trauma therapy: where do we stand? Biochem Soc Trans. 2014;42(2):569-581. doi:10.1042/BST20130233
70. Kothgassner O, Pellegrini M, Goreis A, et al. Hydrocortisone administration for reducing post-traumatic stress symptoms: A systematic review and meta-analysis. Psychoneuroendocrinology. 2021;126:105168. doi:10.1016/j.psyneuen.2021.105168
71. Wright L, Sijbrandij M, Sinnerton R, Lewis C, Roberts N, Bisson J. Pharmacological prevention and early treatment of post-traumatic stress disorder and acute stress disorder: a systematic review and meta-analysis. Transl Psychiatry. 2019;9(1):334. doi:10.1038/s41398-019-0673-5
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