Cognitive‐Behavioral Psychotherapy for Children and Adolescents With Posttraumatic Stress Disorder After a Single‐Incident Stressor

March, John S.; Amaya-Jackson, Lisa; Murray, Mary Cathryn; Schulte, Ann C.

doi:10.1097/00004583-199806000-00008

Cited by 289 publications

(167 citation statements)

References 25 publications

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“…Prior studies report treatment lengths from 10 (Smith et al, 2007) to 18 sessions (March, Amaya-Jackson, Murray, & Schulte, 1998), while the current treatment needed only a mean of fi ve sessions. This is possibly due to the focus of the treatment on the most important elements of treatment (exposure, cognitive-restructuring and social sharing), while other non-effective elements (such as relaxation techniques, or affect modulation; Bisson et al, 2007) often included in other trauma-focused CBT manuals (e.g.…”

Section: Strengthsmentioning

confidence: 82%

Treatment of post‐traumatic stress disorder in children using cognitive behavioural writing therapy

Oord

Lucassen²,

Emmerik

et al. 2009

Clin Psychology and Psychoth

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Section: Strengthsmentioning

confidence: 82%

Treatment of post‐traumatic stress disorder in children using cognitive behavioural writing therapy

Oord

Lucassen²,

Emmerik

et al. 2009

Clin Psychology and Psychoth

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“…However, a cognitive-behavioral approach was previously described as helpful. 15 The efficacy of this approach was further suggested by our own experience, as described.…”

Section: Discussionmentioning

confidence: 96%

“…However, our intervention strategy was informed by cognitive-behavioral approaches that are used in the treatment of victims of other forms of trauma. 15 Patients described in the case reports were not enrolled in the survey.…”

Section: Case Studiesmentioning

confidence: 99%

A Pilot Study of Posttraumatic Stress and Nonadherence in Pediatric Liver Transplant Recipients

et al. 2000

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ABSTRACT. Background. Symptoms of posttraumatic stress disorder (PTSD) were described in survivors of life-threatening diseases, the trauma being the experiences associated with the disease or its treatment. Their prevalence in liver transplant recipients is unknown. Based on clinical observations, we hypothesize that a significant proportion of pediatric liver transplant recipients suffers from PTSD symptoms. We further hypothesize that nonadherence (noncompliance) to medical management may, in some cases, be associated with these symptoms. Traumatized patients, according to this hypothesis, will avoid taking their medications, because these serve as painful reminders of the disease.Objectives. To determine the prevalence of PTSD symptoms in a sample of pediatric liver transplant recipients. To determine whether symptoms of PTSD are associated with nonadherence in these patients. To describe the clinical presentation of PTSD and the management of severe nonadherence in patients who suffer from this disorder.Methods. Nineteen pediatric liver transplant recipients and their caretakers were interviewed, using the UCLA Post Traumatic Stress Disorder Reaction Index (PTSRI). Data were obtained on a few demographic parameters and perception of disease threat. Adherence was evaluated by 2 methods: 1) a clinician panel (taking into account the clinical sequelae of severe nonadherence); and 2) computation of the standard deviations (SDs) of consecutive determinations of blood levels of Tacrolimus (a higher SD means higher variability between individual measures and is therefore an indicator of nonadherence). As an illustration of the general phenomenon, we describe 3 cases of liver transplant recipients who were nonadherent and who suffered from PTSD.Results. Six of 19 patients had positive scores on all 3 components of the PTSRI (PTSD patients). Three of these, and none of the others, were considered significantly nonadherent by the panel. Therefore, nonadherence was significantly associated with the existence of symptoms from all 3 domains of PTSD (Fisher's exact test) in our sample. In particular, a high avoidance score on the PTSRI was highly correlated with panel-determined nonadherence. Further, SD of medication levels were significantly higher in PTSD patients, compared with the rest of our sample. No significant differences were found in perception of disease threat or demographic variables between PTSD patients and the rest of our sample. The 3 cases that we describe became adherent to their medications when symptoms of PTSD subsided during the course of therapy.Conclusions. Clinically significant nonadherence, determined by 2 different methods, was associated with the full spectrum of PTSD symptoms in this sample. It was especially associated with a high avoidance score, which suggests that avoidance of reminders of the disease (eg, medications) may be a mechanism of nonadherence. Screening for and management of these symptoms, therefore, may improve adherence. This novel concept may be applicable to other pati...

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“…Arguably the most rigorous studies (usually random assignment to welldefined manualized treatment versus comparison treatment or waitlist control) have focused on trauma-focused CBT in sexually abused children (34), although CBT treatments have been extended to children exposed to other types of trauma (35,36). These studies have added to the growing evidence supporting the efficacy of trauma-focused CBT on measures of PTSD, depression, and behavior problems in children with PTSD (37).…”

Section: Psychotherapymentioning

confidence: 99%

Posttraumatic Stress Disorder in Children

Eth¹,

Pynoos²

2017

The SAGE Encyclopedia of Marriage, Family, and Couples Counseling

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In the past ten years, there has been increasing recognition that children who have been exposed to traumatic events can, like traumaexposed adults, develop post-traumatic stress disorder (PTSD) Post-traumatic stress disorder (PTSD) first appeared in the DSM-III in 1980. The impetus for the development of this diagnostic category arose primarily from the need to account for the characteristic array of symptoms displayed by Vietnam veterans in the United States, and as such PTSD was conceptualized around traumatized adults. However, since that time there has been increasing recognition that children, too, can develop severe and debilitating reactions to traumatization.Studies indicate that children can develop PTSD after exposure to a range of traumatic stressors, including violent crime, sexual abuse, natural disasters, and war. Where relatively standardized assessment methods have been used, the incidence of PTSD among child survivors of specific disasters ranges from 30 to 60% (1,2). As yet there are no epidemiological studies of the prevalence of PTSD among children in the general population; however, community studies in the United States have consistently indicated that around 40% of high school students have experienced some form of domestic or community violence, and between 3 and 6% have PTSD (3,4).High rates of trauma exposure and evidence of PTSD among child populations suggest that mental health practitioners worldwide need to be able to recognize those posttraumatic reactions in children that require intervention, and offer timeous and effective treatments. This is particularly critical given the substantial challenges that post-traumatic stress poses to the healthy physical, cognitive and emotional development of children and adolescents (5). DIAGNOSIS AND ASSESSMENTThe DSM-IV-TR describes three symptom clusters in PTSD: persistent re-experiencing of the trauma (e.g., intrusive memories and flashback experiences, often triggered by exposure to traumatic reminders, and recurring traumarelated nightmares); avoidance of traumatic reminders (including places, people, and conversations) and a general numbing of emotional responsiveness; and chronic physiological hyperarousal, including sleep disturbances, poor concentration, and hypervigilance to threat. The DSM notes that, in children, re-experiencing may occur through repetitive play involving trauma-related themes, rather than through memories, and nightmares may have generalized, rather than trauma-specific, content. Following a traumatic experience, it is normal and expectable for children and adults to exhibit some intrusive, avoidance and hyperarousal symptoms, which remit spontaneously within a few days or weeks. In order to meet the PTSD diagnosis, at least one re-experiencing symptom, three avoidance/numbing symptoms and two hyperarousal symptoms should be present for at least one month, and must cause significant distress or functional impairment. When symptom duration is less than one month, a diagnosis of acute stress disorder (ASD) is made.

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Cognitive‐Behavioral Psychotherapy for Children and Adolescents With Posttraumatic Stress Disorder After a Single‐Incident Stressor

Cited by 289 publications

References 25 publications

Treatment of post‐traumatic stress disorder in children using cognitive behavioural writing therapy

Treatment of post‐traumatic stress disorder in children using cognitive behavioural writing therapy

A Pilot Study of Posttraumatic Stress and Nonadherence in Pediatric Liver Transplant Recipients

Posttraumatic Stress Disorder in Children

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