Disorders - Post Traumatic Stress Disorder
Trask, E. V.
The present meta-analysis examined the effects of psychosocial treatments at reducing deleterious outcomes of sexual abuse. The meta-analysis included a total of 35 published and unpublished studies written in English, focusing on youth under the age of 18, and evaluating the effectiveness of treatments for the most common negative outcomes of sexual abuse: PTSD symptoms, externalizing problems, and internalizing problems. Results revealed medium effect sizes for PTSD symptoms, externalizing problems, and internalizing problems following treatment for sexual abuse. This study also examined the potential moderating effects of treatment (e.g., modality, duration, and inclusion of caregiver) and participant (e.g., age, gender, and ethnicity) characteristics. Results indicated that longer interventions were associated with greater treatment gains while group and individual treatments were equally effective. These findings shed new light on treatment effectiveness and provide useful information regarding the conditions under which treatment may be most effective. Future directions for research in this area are discussed. (copyright) 2010 Elsevier Ltd.
Aggression & Violent Behavior, 16(1) : 6-19
- Year: 2011
- 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)
Stoddard, Frederick J., Jr., Luthra, Rohini, Sorrentino, Erica A., Saxe, Glenn N., Drake, Jennifer, Chang, Yuchiao, Levine, John B., Chedekel, David S., Sheridan, Robert L.
Background: This study evaluated the potential benefits of a centrally acting selective serotonin reuptake inhibitor, sertraline, versus placebo for prevention of symptoms of posttraumatic stress disorder (PTSD) and depression in burned children. This is the first controlled investigation based on our review of the early use of a medication to prevent PTSD in children. Methods: Twenty-six children aged 6–20 were assessed in a 24-week double-blind placebo-controlled design. Each child received either flexibly dosed sertraline between 25–150 mg/day or placebo. At each reassessment, information was collected in compliance with the study medication, parental assessment of the child’s symptomatology and functioning, and the child’s self-report of symptomatology. The protocol was approved by the Human Studies Committees of Massachusetts General Hospital and Shriners Hospitals for Children. Results: The final sample was 17 subjects who received sertraline versus 9 placebo control subjects matched for age, severity of injury, and type of hospitalization. There was no significant difference in change from baseline with child-reported symptoms; however, the sertraline group demonstrated a greater decrease in parent-reported symptoms over 8 weeks (−4.1 vs. −0.5, p = 0.005), over 12 weeks (−4.4 vs. −1.2, p = .008), and over 24 weeks (−4.0 vs. −0.2, p = 0.017). Conclusions: Sertraline was a safe drug, and it was somewhat more effective in preventing PTSD symptoms than placebo according to parent report but not child report. Based on this study, sertraline may prevent the emergence of PTSD symptoms in children. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Journal of Child & Adolescent Psychopharmacology, 21(5) : 469-477
- Year: 2011
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs)
Taylor, Marcus K., Stanfill, Katherine E., Padilla, Genieleah A., Markham, Amanda E., Ward, Michael D., Koehler, Matthew M., Anglero, Antonio, Adams, Barry D.
In this randomized, controlled field study, we examined the effects of a brief psychological skills training (PST) intervention on stress responses during military survival school. A second purpose was to build upon prior research in this unique environment by extending the follow-up window to 3 months. Baseline subjective distress (dissociative) symptoms were measured in 65 male military subjects, who were then randomized either to PST or a control group that received no training beyond the normal survival school curriculum. PST received training in arousal control, mental imagery, goal setting, and positive self-talk in two separate 40-minute sessions before stressful field exercises. Stress symptoms were then assessed during a mock-captivity phase of training, as well as 24 hours, 1 month, and 3 months after completion of training. Repeated-measures analyses of variance with follow-up paired t tests examined differences between groups and across time. Survival training precipitated remarkable increases in subjective distress, but few substantive group differences emerged. This study extends prior work quantifying the human stress response to intense military training.
Military Medicine, 176(12) : 1362-1368
- Year: 2011
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Skills training
Wolmer, Leo, Hamiel, Daniel, Laor, Nathaniel
Objective: The psychological outcomes that the exposure to mass trauma has on children have been amply documented in the past decades. The objective of this study is to describe the effects of a universal, teacher-based preventive intervention implemented with Israeli students before the rocket attacks that occurred during Operation Cast Lead, compared with a nonintervention but exposed control group. Method: The study sample consisted of 1,488 students studying in fourth and fifth grades in a city in southern Israel who were exposed to continuous rocket attacks during Operation Cast Lead. The intervention group included about half (53.5%) of the children who studied in six schools where the teacher-led intervention was implemented 3 months before the traumatic exposure. The control group (46.5% of the sample) included six schools matched by exposure in which the preventive intervention was not implemented. Children filled out the UCLA-PTSD Reaction Index and the Stress/Mood Scale 3 months after the end of the rocket attacks. Results: The intervention group displayed significantly lower symptoms of posttrauma and stress/mood than the control group (p < .001). Control children had 57% more detected cases of postraumatic stress disorder (PTSD) than participant children. This difference was significantly more pronounced among boys (10.2% versus 4.4%) and less among girls (12.5% versusl0.1%). Conclusions: The teacherbased, resilience-focused intervention is a universal, cost-effective approach to enhance the preparedness of communities of children to mass trauma and to prevent the development of PTSD after exposure. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Journal of the American Academy of Child & Adolescent Psychiatry, 50(4) : 340-348
- Year: 2011
- Problem: Post Traumatic Stress Disorder
- Type: Controlled clinical trials
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Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Rolfsnes, Erika S.
This is a review and meta-analysis of school-based intervention programs targeted at reducing symptoms of posttraumatic stress disorder (PTSD). Nineteen studies conducted in 9 different countries satisfied the inclusionary criteria. The studies dealt with various kinds of type I and type II trauma exposure. Sixteen studies used cognitive–behavioral therapy methods; the others used play/art, eye movement desensitization and reprocessing, and mind-body techniques. The overall effect size for the 19 studies was d=0.68 (SD=0.41), indicating a medium-large effect in relation to reducing symptoms of PTSD. The authors’ findings suggest that intervention provided within the school setting can be effective in helping children and adolescents following traumatic events. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Journal of Traumatic Stress, 24(2) : 155-165
- Year: 2011
- Problem: Post Traumatic Stress Disorder
- Type: Systematic reviews
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Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
Sloan, Denise M., Marx, Brian P., Greenberg, Eva M.
This study examined the efficacy of the written emotional disclosure (WED) procedure with a sample of young adults who met diagnostic criteria for posttraumatic stress disorder (PTSD). Participants were randomly assigned to either WED or a control writing condition and were assessed at baseline and one month following the writing sessions. During each writing session, participants’ heart rate was recorded; participants also provided self-report ratings of emotional responding. Findings indicated no significant group differences for PTSD and depression symptom severity at follow-up assessment. Relative to control participants, WED participants displayed significantly greater heart rate activity and reported greater emotional responding during the first writing session; however, no reduction in emotional responding occurred for either condition from the first to the last writing session. Taken together, these findings indicate that WED may not be an efficacious intervention for PTSD. Suggestions are made for future work in this area. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Behaviour Research & Therapy, 49(4) : 299-304
- Year: 2011
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
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Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Creative expression: music, dance, drama, art
Robjant, Katy, Fazel, Mina
Individuals who have experienced multiple traumatic events over long periods as a result of war, conflict and organised violence, may represent a unique group amongst PTSD patients in terms of psychological and neurobiological sequelae. Narrative Exposure Therapy (NET) is a short-term therapy for individuals who have PTSD symptoms as a result of these types of traumatic experiences. Originally developed for use in low-income countries, it has since been used to treat asylum seekers and refugees in high-income settings. The treatment involves emotional exposure to the memories of traumatic events and the reorganisation of these memories into a coherent chronological narrative. This review of all the currently available literature investigates the effectiveness of NET in treatment trials of adults and also of KIDNET, an adapted version for children. Results from treatment trials in adults have demonstrated the superiority of NET in reducing PTSD symptoms compared with other therapeutic approaches. Most trials demonstrated that further improvements had been made at follow-up suggesting sustained change. Treatment trials of KIDNET have shown its effectiveness in reducing PTSD amongst children. Emerging evidence suggests that NET is an effective treatment for PTSD in individuals who have been traumatised by conflict and organised violence, even in settings that remain volatile and insecure.
Copyright © 2010 Elsevier Ltd. All rights reserved.
Clinical Psychology Review, 30(8) : 1030-1039
- Year: 2010
- Problem: Post Traumatic Stress Disorder
- Type: Systematic reviews
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Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Narrative exposure therapy (NET)
Shechtman, Z., Mor, M.
The study was conducted in Israel following the 2006 Lebanon war. The purpose was to examine the impact of counseling groups employing an expressivesupportive modality on children and adolescents with war-related or divorce/ loss-related trauma symptoms. The 164 children were placed into 18 small groups for 10 weekly sessions. The children were screened for traumatic stress symptoms and then randomly divided into experimental and control (wait-list) conditions. All participants completed the measures of the dependent variables (trauma symptoms, anxiety), a social support measure, and group-process measures (group relationships, group cohesion, and catharsis). Results indicated a significantly sharper reduction in trauma symptoms and anxiety in the experimental group than in the control group, regardless of type of trauma. A reduction in anxiety was predicted by gains in social support and group cohesiveness.
International Journal of Group Psychotherapy, 60(2) : 221-244
- Year: 2010
- Problem: Post Traumatic Stress Disorder
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Ruf, M., Schauer, M., Neuner, F., Catani, C., Schauer, E., Elbert, T.
The authors examined the effectiveness of narrative exposure therapy for children (KIDNET) in treating posttraumatic stress disorder (PTSD) in refugee children living in exile. Twenty-six children traumatized by organized violence were randomly assigned to KIDNET or to a waiting list. Significant treatment by time interactions on all PTSD-relevant variables indicated that the KIDNET group, but not the controls, showed a clinically significant improvement in symptoms and functioning. Success of the KIDNET group remained stable at 12-month follow-up. This study confirms previous findings that, if left untreated, PTSD in children may persist for an extended period. However, it also shows that it is possible to effectively treat chronic PTSD and restore functioning in traumatized refugee children in only 8 treatment sessions.
Journal of Traumatic Stress, 23(4) : 437-445
- Year: 2010
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Narrative exposure therapy (NET)
Strawn, J. R., Keeshin, B. R., DelBello, M. P., Geracioti Jr, T. D., Putnam, F. W.
Objective: Despite the high prevalence and significant morbidity associated with posttraumatic stress disorder (PTSD) in children and adolescents, there are limited and conflicting data to guide psychopharmacologic interventions. With these considerations in mind, we sought to summarize the current evidence for psychopharmacologic interventions in youth with PTSD. Data Sources/Study Selection: We conducted a literature review of the National Library of Medicine to identify publications of pharmacologic treatments for youth with PTSD or posttraumatic stress symptoms. The search was limited to articles written in English and published between 1966 and 2009. In addition, we manually searched each citation for additional references and the following journals: Journal of the American Academy of Child and Adolescent Psychiatry and the Journal of Child and Adolescent Psychopharmacology. Data Extraction: All articles were manually reviewed and evaluated. Thereafter, each agent or class of medication was categorized by level of evidence. Data Synthesis: Three double-blind, randomized controlled trials of selective serotonin reuptake inhibitors (SSRIs) and 1 double-blind randomized controlled trial of imipramine in children and adolescents with PTSD or acute stress disorder were identified. Additionally, several open-label studies and case series involving other classes of medications (eg, antiadrenergics, other antidepressants, and second-generation antipsychotics) were reviewed. Conclusions: The extant data do not support the use of SSRIs as first-line treatments for PTSD in children and adolescents. There is limited evidence that the brief use of antiadrenergic agents, second-generation antipsychotics, and several mood stabilizers may attenuate some PTSD symptoms in youth. However, controlled trials of these agents in children and adolescents with PTSD are needed. (copyright) Copyright 2010 Physicians Postgraduate Press, Inc.
Journal of Clinical Psychiatry, 71(7) : 932-941
- Year: 2010
- Problem: Post Traumatic Stress Disorder
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
Robb, A. S., Cueva, J. E., Sporn, J., Yang, R., Vanderburg, D. G.
Objective: The aim of this study was to evaluate the safety and efficacy of sertraline in children and adolescents who met Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for posttraumatic stress disorder (PTSD). Method: Children and adolescents (6-17 years old) meeting DSM-IV criteria for PTSD were randomized to 10 weeks of double-blind treatment with sertraline (50-200mg/day) or placebo. The primary efficacy measure was the University of California, Los Angeles Post-Traumatic Stress Disorder Index for DSM-IV (UCLA PTSD-I). Results: A total of 131 patients met entry criteria and were randomized to sertraline (n=67; female, 59.7%; mean age, 10.8; mean UCLA PTSD-I score, 43.8(plus or minus)8.5) or placebo (n=62; female, 61.3%; mean age, 11.2; mean UCLA PTSD-I score, 42.1(plus or minus)8.8). There was no difference between sertraline and placebo in least squares (LS) mean change in the UCLA PTSD-I score, either on a completer analysis (-20.4(plus or minus)2.1 vs.-22.8(plus or minus)2.1; p=0.373) or on an last observation carried forward (LOCF) end point analysis (-17.7(plus or minus)1.9 vs.-20.8(plus or minus)2.1; p=0.201). Attrition was higher on sertraline (29.9%) compared to placebo (17.7%). Discontinuation due to adverse events occurred in a 7.5% treated with sertraline and 3.2% treated with placebo. Conclusions: Sertraline was a generally safe treatment in children and adolescents with PTSD, but did not demonstrate efficacy when compared to placebo during 10 weeks of treatment. (copyright) Copyright 2010, Mary Ann Liebert, Inc.
Journal of Child & Adolescent Psychopharmacology, 20(6) : 463-471
- Year: 2010
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs)
Nugent, N. R., Christopher, N. C., Crow, J. P., Browne, L., Ostrowski, S., Delahanty, D. L.
Initial research supports the use of propranolol to prevent posttraumatic stress disorder (PTSD); research has not examined pharmacological prevention for children. Twenty-nine injury patients (ages 10-18 years old) at risk for PTSD were randomized to a double-blind 10-day trial of propranolol or placebo initiated within 12 hours postadmission. Six-week PTSD symptoms and heart rate were assessed. Although intent-to-treat analyses revealed no group differences, findings supported a significant interaction between gender and treatment in medication-adherent participants, Delta R(2) = .21. Whereas girls receiving propranolol reported more PTSD symptoms relative to girls receiving placebo, Delta R(2) = .44, boys receiving propranolol showed a nonsignificant trend toward fewer PTSD symptoms than boys receiving placebo, Delta R(2) = .32. Findings inform gender differences regarding pharmacological PTSD prevention in youth.
Journal of Traumatic Stress, 23(2) : 282-287
- Year: 2010
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions (any)
, Other biological interventions