Disorders - Post Traumatic Stress Disorder
Mannarino, A. P., Cohen, J. A., Deblinger, E., Runyon, M. K., Steer, R. A.
This study presents the findings from 6- and 12-month follow-up assessments of 158 children ages 4-11 years who had experienced sexual abuse and who had been treated with Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) with or without the inclusion of the trauma narrative (TN) treatment module and in 8 or 16 treatment sessions. Follow-up results indicated that the overall significant improvements across 14 outcome measures that had been reported at posttreatment were sustained 6 and 12 months after treatment and on two of these measures (child self-reported anxiety and parental emotional distress) there were additional improvements at the 12-month follow-up. Higher levels of child internalizing and depressive symptoms at pretreatment were predictive of the small minority of children who continued to meet full criteria for posttraumatic stress disorder at the 12-month follow-up. These results are discussed in the context of the extant TF-CBT treatment literature. (copyright) The Author(s) 2012.
Child Maltreatment, 17(3) : 231-241
- Year: 2012
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Narrative exposure therapy (NET)
, Trauma-focused cognitive behavioural therapy (TF-CBT)
Macdonald, G., Higgins, J. P., Ramchandani, P., Valentine, J. C., Bronger, L. P., Klein, P., O'Daniel, R., Pickering, M., Rademaker, B., Richardson, G., Taylor, M.
Despite differences in how it is defined, there is a general consensus amongst clinicians and researchers that the sexual abuse of children and adolescents ('child sexual abuse') is a substantial social problem worldwide. The effects of sexual abuse manifest in a wide range of symptoms, including fear, anxiety, post-traumatic stress disorder and various externalising and internalising behaviour problems, such as inappropriate sexual behaviours. Child sexual abuse is associated with increased risk of psychological problems in adulthood. Cognitive-behavioural approaches are used to help children and their non-offending or 'safe' parent to manage the sequelae of childhood sexual abuse. This review updates the first Cochrane review of cognitive-behavioural approaches interventions for children who have been sexually abused, which was first published in 2006. To assess the efficacy of cognitive-behavioural approaches (CBT) in addressing the immediate and longer-term sequelae of sexual abuse on children and young people up to 18 years of age. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2011 Issue 4); MEDLINE (1950 to November Week 3 2011); EMBASE (1980 to Week 47 2011); CINAHL (1937 to 2 December 2011); PsycINFO (1887 to November Week 5 2011); LILACS (1982 to 2 December 2011) and OpenGrey, previously OpenSIGLE (1980 to 2 December 2011). For this update we also searched ClinicalTrials.gov and the International Clinical Trials Registry Platform (ICTRP). We included randomised or quasi-randomised controlled trials of CBT used with children and adolescents up to age 18 years who had experienced being sexually abused, compared with treatment as usual, with or without placebo control. At least two review authors independently assessed the eligibility of titles and abstracts identified in the search. Two review authors independently extracted data from included studies and entered these into Review Manager 5 software. We synthesised and presented data in both written and graphical form (forest plots). We included 10 trials, involving 847 participants. All studies examined CBT programmes provided to children or children and a non-offending parent. Control groups included wait list controls (n = 1) or treatment as usual (n = 9). Treatment as usual was, for the most part, supportive, unstructured psychotherapy. Generally the reporting of studies was poor. Only four studies were judged 'low risk of bias' with regards to sequence generation and only one study was judged 'low risk of bias' in relation to allocation concealment. All studies were judged 'high risk of bias' in relation to the blinding of outcome assessors or personnel; most studies did not report on these, or other issues of bias. Most studies reported results for study completers rather than for those recruited.Depression, post-traumatic stress disorder (PTSD), anxiety and child behaviour problems were the primary outcomes. Data suggest that CBT may have a positive impact on the sequelae of child sexual abuse, but most results were not statistically significant. Strongest evidence for positive effects of CBT appears to be in reducing PTSD and anxiety symptoms, but even in these areas effects tend to be 'moderate' at best. Meta-analysis of data from five studies suggested an average decrease of 1.9 points on the Child Depression Inventory immediately after intervention (95% confidence interval (CI) decrease of 4.0 to increase of 0.4; I(2) = 53%; P value for heterogeneity = 0.08), representing a small to moderate effect size. Data from six studies yielded an average decrease of 0.44 standard deviations on a variety of child post-traumatic stress disorder scales (95% CI 0.16 to 0.73; I(2) = 46%; P value for heterogeneity = 0.10). Combined data from five studies yielded an average decrease of 0.23 standard deviations on various child anxiety scales (95% CI 0.3 to 0.4; I(2) = 0%; P value for heterogeneity = 0.84). No study reported adverse effects. The conclusions of this updated review remain the same as those when it was first published. The eview confirms the potential of CBT to address the adverse consequences of child sexual abuse, but highlights the limitations of the evidence base and the need for more carefully conducted and better reported trials.
Cochrane Database of Systematic Reviews, 5 : CD001930
- Year: 2012
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Qouta, Samir R., Palosaari, Esa, Diab, Marwan
We examined the effectiveness of a psychosocial intervention in reducing mental health symptoms among war‐affected children, and the role of peritraumatic dissociation in moderating the intervention impact on posttraumatic stress symptoms (PTSS). School classes were randomized into intervention (n = 242) and waitlist control (n = 240) conditions in Gaza, Palestine. The intervention group participated in 16 extracurriculum sessions of teaching recovery techniques (TRT) and the controls received normal school‐provided support. Participants were 10‐ to 13‐year‐old Palestinian girls (49.4%) and boys (50.6%). Data on PTSS, depressive symptoms, and psychological distress were collected at baseline (T1), postintervention (T2), and 6‐month follow‐up (T3). Peritraumatic dissociation was assessed only at baseline. Regression analyses that took regression to the mean and cluster sampling into account were applied. The results on intervention effectiveness were specific to gender and peritraumatic dissociation. At T2, the intervention significantly reduced the proportion of clinical PTSS among boys, and both the symptom level (R² = .24), and proportion of clinical PTSS among girls who had a low level of peritraumatic dissociation. The results have implications for risk‐specific tailoring of psychosocial interventions in war conditions. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Journal of Traumatic Stress, 25(3) : 288-298
- Year: 2012
- Problem: Post Traumatic Stress Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Gillies, D., Taylor, F., Gray, C., O'Brien, L., D'Abrew, N.
Post-traumatic stress disorder (PTSD) is highly prevalent in children and adolescents who have experienced trauma and has high personal and health costs. Although a wide range of psychological therapies have been used in the treatment of PTSD there are no systematic reviews of these therapies in children and adolescents. To examine the effectiveness of psychological therapies in treating children and adolescents who have been diagnosed with PTSD. We searched the Cochrane Depression, Anxiety and Neurosis Review Group's Specialised Register (CCDANCTR) to December 2011. The CCDANCTR includes relevant randomised controlled trials from the following bibliographic databases: CENTRAL (the Cochrane Central Register of Controlled Trials) (all years), EMBASE (1974 -), MEDLINE (1950 -) and PsycINFO (1967 -). We also checked reference lists of relevant studies and reviews. We applied no date or language restrictions. All randomised controlled trials of psychological therapies compared to a control, pharmacological therapy or other treatments in children or adolescents exposed to a traumatic event or diagnosed with PTSD. Two members of the review group independently extracted data. If differences were identified, they were resolved by consensus, or referral to the review team.We calculated the odds ratio (OR) for binary outcomes, the standardised mean difference (SMD) for continuous outcomes, and 95% confidence intervals (CI) for both, using a fixed-effect model. If heterogeneity was found we used a random-effects model. Fourteen studies including 758 participants were included in this review. The types of trauma participants had been exposed to included sexual abuse, civil violence, natural disaster, domestic violence and motor vehicle accidents. Most participants were clients of a trauma-related support service.The psychological therapies used in these studies were cognitive behavioural therapy (CBT), exposure-based, psychodynamic, narrative, supportive counselling, and eye movement desensitisation and reprocessing (EMDR). Most compared a psychological therapy to a control group. No study compared psychological therapies to pharmacological therapies alone or as an adjunct to a psychological therapy.Across all psychological therapies, improvement was significantly better (three studies, n = 80, OR 4.21, 95% CI 1.12 to 15.85) and symptoms of PTSD (seven studies, n = 271, SMD -0.90, 95% CI -1.24 to -0.42), anxiety (three studies, n = 91, SMD -0.57, 95% CI -1.00 to -0.13) and depression (five studies, n = 156, SMD -0.74, 95% CI -1.11 to -0.36) were significantly lower within a month of completing psychological therapy compared to a control group.
Cochrane Database of Systematic Reviews, 12 : CD006726
- Year: 2012
- Problem: Post Traumatic Stress Disorder
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
Greyber, Laura R., Dulmus, Catherine N., Cristalli, Maria E.
This article examines the methodological rigor of randomized controlled trials (RCTs) of eye movement desensitization reprocessing (EMDR) conducted specifically with children and adolescents who had a diagnosis of posttraumatic stress disorder and history of trauma. A thorough search for RCTs of EMDR with children and adolescents that were published between 1998 and 2010 was conducted utilizing several databases. A total of five studies were identified. Following an extensive review of the literature, it became apparent that the number of RCTs conducted with EMDR with children and adolescents was negligible, though initial results suggest that it is a promising practice. Although current EMDR studies have been conducted with children and adolescents, and have indicated that EMDR is a promising practice, the state of knowledge at this point is insufficient. EMDR tends to produce less positive results when compared to other trauma-focused interventions, although some research indicates the opposite. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)
Child & Adolescent Social Work Journal, 29(5) : 409-425
- Year: 2012
- Problem: Post Traumatic Stress Disorder
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Eye movement desensitisation and reprocessing (EMDR)
Lange-Nielsen, Ida Ingridsdatter, Kolltveit, Silje, Mousa Thabet, Abdel Aziz, Dyregrov, Atle, Pallesen, Ståle, Johnsen, Tom Backer, Laberg, Jon Christian
This study evaluates the effect of a short-term group intervention titled Writing for Recovery in Gaza. Adolescents (N = 139) aged 12 - 17 were randomly assigned to an intervention or to a waiting list group. Levels of distress were assessed at baseline and at posttest. A follow-up assessment was conducted 5 months after both groups had received the intervention. Results at posttest showed a reduction in posttraumatic stress symptoms in both groups, an increase in depression in the intervention group, and no change in anxiety symptoms. At follow-up, a significant decline in depression scores was evident. Overall, no evidence for improvements due to the intervention was found. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)
Journal of Loss & Trauma, 17(5) : 403-422
- Year: 2012
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Creative expression: music, dance, drama, art
Hasanovic, M., Husanovic, J., Srabovic, S., Haskic, E., Lukic, D., Jaganjac, A.
Aim: To estimate whether psychosocial support of the School Project UHD nullPrijateljice-Friendsnull positively affect on reducing of posttraumatic sequel in Bosnia-Herzegovina among school adolescents, after the war period 1992-1995. Methods: The stratified sample of 507 students, aged of 13.7(plus or minus)1.0 (10 to16) years, in primary and secondary schools, involved in psychosocial support, compared with 78 randomly selected peers from the same schools, not involved in this project. Data were collected in February 2010 and in May 2010. The Children Depression Inventory and DSM III R questionnaire for posttraumatic stress disorder (PTSD) were utilized. Results: All adolescents reported experience of (mean(plus or minus)standard deviation=5.4(plus or minus)2.7) without significant differences between observed and control group (F=0.001, P=0.980, ANOVA). Symptoms of PTSD and depressiveness among students involved in the School Project, significantly reduced from (mean(plus or minus)standard deviation=6.5(plus or minus)3.3 to 4.9(plus or minus)3.5; 7.1(plus or minus)4.5 to 5.8(plus or minus)5.2, respectively) (t=8.524, P< 0.001; t=4.792, P< 0.001, respectively, Pared Samples Test). In the control group severity of PTSD symptoms reduced from 6.6(plus or minus)3.4 to 6.5(plus or minus)3.6 (t=0.354, P=0.723, Pared Samples Test), while depressiveness increased from 8.7(plus or minus)6.9 to 11.8(plus or minus)6.9 (t= - 3.387, P=0.001, Pared Samples Test). Conclusions: Adolescents in this study reported surviving of multiple traumas. Psychosocial support within the School Project resulted with significant reduction of PTSD symptoms severity and severity of depressiveness amongst involved students compared to controls. Schools and other institutions ought to envisage as many as possible projects to be implemented in schools and out-of-schools in order to assist youth to easier overcome consequences of no favorable war in their development.
European Psychiatry, 27 :
- Year: 2012
- Problem: Post Traumatic Stress Disorder, Depressive Disorders
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Hirai, M., Skidmore, S. T., Clum, G. A., Dolma, S.
This study compared the efficacy of 2 online expressive writing protocols for a traumatic/stressful life event in a Hispanic student sample. Participants who had reported a traumatic event were randomly assigned to either the emotion-focused group or the fact-focused group. The emotion-focused group focused their written accounts on emotions and feelings as well as facts about a stressful/traumatic experience, whereas the fact-focused group focused on facts of a stressful/traumatic event. Both groups completed 3 online writing sessions scheduled for 3 consecutive days, a 1-week online follow-up assessment, and a 5-week online follow-up assessment. Both groups statistically significantly reduced trauma symptoms over time with the emotion-focused group demonstrating statistically significantly greater trauma symptom reductions than the fact-focused group at the 5-week follow-up assessment. (copyright) 2012.
Behavior Therapy, 43(4) : 812-824
- Year: 2012
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Service Delivery & Improvement, Creative expression: music, dance, drama, art
, Technology, interventions delivered using technology (e.g. online, SMS)
Kalantari, M., Yule, W., Dyregrov, A., Neshatdoost, H., Ahmadi, S. J.
Effective evidence-based intervention for traumatic bereavement is one of the current major research issues in the field of Post Traumatic Stress Disorder (PTSD) in children and adolescents. The "Writing for Recovery" group intervention is a new treatment approach developed by the Children and War Foundation for traumatized and bereaved children and adolescents after disasters. The purpose of this project was an empirical examination of this intervention with 12- to 18-year-old war bereaved Afghani refugees. Eighty-eight war bereaved Afghani refugees were screened using the Traumatic Grief Inventory for Children (TGIC). From those with the highest total score, 61 were randomly assigned to either an experimental (n = 29) or control group (n = 32). The experimental group received six sessions of group training on 3 consecutive days in their school. The difference of TGIC scores between the experimental group in pretest and posttest was significant (p = 0.001). Results of analysis of covariance also showed a significant effect of Writing for Recovery on the experimental group (p < 0.001). It is concluded that "Writing for Recovery" is an effective group intervention for bereaved children and adolescents after disasters. (copyright) 2012, Baywood Publishing Co., Inc.
Omega, 65(2) : 139-150
- Year: 2012
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Creative expression: music, dance, drama, art
Berger, R., Gelkopf, M., Heineberg, Y.
Purpose: For the past 8 years, the residents of Sderot - a town in southern Israel - have been exposed to ongoing and intense war-related threat due to daily rocket attacks and mortar shelling from the adjacent Gaza region. This study first evaluates the prevalence of posttraumatic symptomatology in a sample of seventh- and eighth-grade students, and then assesses the efficacy of a universal teacher-delivered skill-oriented and present-focused intervention in preventing and reducing adolescents' posttraumatic stress-related symptoms. Method: In a quasi-randomized controlled trial, 154 seventh- and eighth-grade students with significant levels of war-related exposure were assigned to participate in either a manualized active 16-session intervention (Extended Enhancing Resiliency Amongst Students Experiencing Stress, ERASE-Stress) or a waiting-list control group. They were assessed using self-report measures before and after the intervention on posttraumatic stress-related symptoms, somatic complaints, functional impairment, and anxiety. Results: At baseline, 43.5% were found to have a likely diagnosis of posttraumatic stress disorder. A month after the intervention ended, students in the active intervention showed statistically significant reduction on all outcome measures compared with those in the waiting-list control group. Conclusions: Extended ERASE-Stress - a universal teacher-delivered skill-oriented program not targeting traumatic memories and involving trained and supervised homeroom teachers - may help students suffering from significant war-related posttraumatic symptoms reduce their level of symptomatology and can serve as an important and effective component of a community mental health policy for communities affected by chronic trauma, such as war and terrorism. (copyright) 2012 Society for Adolescent Health and Medicine.
Journal of Adolescent Health, 51(5) : 453-461
- Year: 2012
- Problem: Post Traumatic Stress Disorder
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Skills training, Other Psychological Interventions
Ford, J. D., Steinberg, K. L., Hawke, J., Levine, J., Zhang, W.
Posttraumatic stress disorder (PTSD) is prevalent in youth involved in delinquency, but it is often not effectively treated. A randomized clinical trial was conducted comparing the outcomes of an emotion regulation therapy (Trauma Affect Regulation: Guide for Education and Therapy, or TARGET) with a relational supportive therapy (Enhanced Treatment as Usual, or ETAU) with 59 delinquent girls (age 13-17 years) who met criteria for full or partial PTSD. Mixed model regression analyses demonstrated generally large effects for pre-post change in PTSD symptoms for both therapies but not in emotion regulation. Both therapies had small to medium effect size changes in anxiety, anger, depression, and posttraumatic cognitions. Treatment null Time interactions showed small to medium effects favoring TARGET for change in PTSD (intrusive reexperiencing and avoidance) and anxiety symptoms, posttraumatic cognitions, and emotion regulation, and favoring ETAU for change in hope and anger. Results provide preliminary support for TARGET as a potentially efficacious therapy for PTSD with delinquent girls. Relational therapies such as ETAU also may be beneficial for delinquent girls with PTSD, particularly to enhance optimism and self-efficacy and reduce anger. (copyright) Taylor and Francis Group, LLC.
Journal of Clinical Child & Adolescent Psychology, 41(1) : 27-37
- Year: 2012
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Supportive therapy, Other Psychological Interventions
Cary, Colleen E., McMillen, J. Curtis
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is one of the most widely disseminated mental health interventions for children and youth. The purpose of this study is to systematically review the evidence of TF-CBT's ability to reduce symptoms of post-traumatic stress, depression and behavior problems in children and youth who have survived trauma. A search was conducted to locate studies that evaluated TF-CBT or interventions highly similar to TF-CBT. Ten studies (twelve articles) were selected for inclusion in three sets of meta-analyses. Findings were consistent amongst meta-analyses; pooled estimates were similar whether we were analyzing the effects of interventions that were highly similar to TF-CBT, or if we were exclusively analyzing the effects of the branded intervention. Results show that there is a significant difference between the TFCBT condition and comparison conditions in its ability to reduce symptoms of PTSD (g = .671), depression (g = .378) and behavior problems (g = .247) immediately after treatment completion. This difference held for PTSD at twelve months after treatment completion (.389) but did not hold for depression or behavior problems. There was not a significant difference between the TF-CBT condition and alternative active control conditions immediately after treatment completion. Therefore, TF-CBT is an effective intervention for the treatment of PTSD in youth. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Children & Youth Services Review, 34(4) : 748-757
- Year: 2012
- Problem: Post Traumatic Stress Disorder
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Trauma-focused cognitive behavioural therapy (TF-CBT)