EMDR and CBWT are brief, trauma-focused treatments that yielded equally large remission rates for PTSD and reductions in the severity of PTSD and comorbid difficulties in children and adolescents seeking treatment for PTSD tied to a single event. Further trials of both treatments with PTSD tied to multiple traumas are warranted.
Key practitioner massage:• CWBT can easily be implemented in clinical practice.• CWBT is suitable for a clinically representative group of children and adolescents with PTSD, who have experienced a wide range of single and recurrent traumatic experiences.• CWBT is a short-term potentially effective treatment.
Background
With few RCTs having compared active treatments for paediatric PTSD, little is known about whether or which baseline (i.e. pre-randomization) variables predict or moderate outcomes in the evaluated treatments.
Objective
To identify predictors and moderators of paediatric PTSD outcomes for Eye Movement Desensitization and Reprocessing Therapy (EMDR) and Cognitive Behavioural Writing Therapy (CBWT).
Method
Data were obtained as part of a multi-centre, randomized controlled trial of up to six sessions (up to 45 minutes each) of either EMDR therapy, CBWT, or wait-list, involving 101 youth (aged 8–18 years) with a PTSD diagnosis (full/subthreshold) tied to a single event. The predictive and moderating effects of the child’s baseline sociodemographic and clinical characteristics, and parent’s psychopathology were evaluated using linear mixed models (LMM) from pre- to post-treatment and from pre- to 3- and 12-month follow-ups.
Results
At post-treatment and 3-month follow-up, youth with an index trauma of sexual abuse, severe symptoms of PTSD, anxiety, depression, more comorbid disorders, negative posttraumatic beliefs, and with a parent with more severe psychopathology fared worse in both treatments. For children with more severe self-reported PTSD symptoms at baseline, the (exploratory) moderator analysis showed that the EMDR group improved more than the CBWT group, with the opposite being true for children and parents with a less severe clinical profile.
Conclusions
The most consistent finding from the predictor analyses was that parental symptomatology predicted poorer outcomes, suggesting that parents should be assessed, supported and referred for their own treatment where indicated. The effect of the significant moderator variables was time-limited, and given the large response rate (>90%) and brevity (<4 hours) of both treatments, the present findings suggest a focus on implementation and dissemination, rather than tailoring, of evidence-based trauma-focused treatments for paediatric PTSD tied to a single event.
Masters in Animal Law In recent years, the use of (wild) animals in circuses, and similar performances, has become the subject of much public and political debate throughout the world. This has led, especially over the last decade, to a number of countries adopting regulations concerning the use and displaying of (wild) animals in circuses and shows. The scope of these regulations differs however from country to country. While Bolivia, Cyprus, Greece and Malta are the only countries that have introduced a national ban on the use of all animals, most countries have only implemented restrictions on the use of all/some-wild 1 animals. This article investigates what regulations Denmark, Sweden, Norway and Finland have adopted concerning the use of (wild) animals in shows.
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