Cognitive behavioral therapy for children and adolescents with post-traumatic stress disorder: meta-analysis

Xian‐Yu, Chen‐Yang; Deng, Nian‐Jia; Zhang, Jin; Li, Hao-Yang; Gao, Teng‐Yu; Zhang, Chao; Gong, Qin-Qin

doi:10.1016/j.jad.2022.04.111

Cited by 12 publications

(2 citation statements)

References 35 publications

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“…This can then help clinicians develop effective prevention and intervention strategies for children and adolescents with CM histories and for those expressing schizotypy. For example, cognitive behavioral therapy (CBT) and, more specifically, trauma-focused CBT have been shown to be effective in treating PTSD symptoms among maltreated children and adolescents (Cohen et al, 2010; Xian-Yu et al, 2022), which may help prevent or slow the development of schizotypic psychopathology. There is also evidence that CBT for patients with psychotic disorders who have CM histories improves dissociative symptoms and auditory hallucinations (Varese et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

The Indirect Effect of Peritraumatic Dissociation on the Relationship Between Childhood Maltreatment and Schizotypy

Blose

Godleski

Houston

et al. 2022

J Interpers Violence

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Schizotypy is a multidimensional personality construct that is understood as a vulnerability for schizophrenia, often manifesting as more subtle and attenuated symptoms, referred to as schizotypic psychopathology. It has many well-established environmental risk factors, including experiencing childhood maltreatment (CM), but the intermediary mechanisms that relate CM to schizotypic psychopathology are unclear. Prior studies have demonstrated that trait dissociation may indirectly affect the relationship between CM and schizotypic psychopathology. However, less is known about the importance of peritraumatic dissociative experiences during CM and how it relates to schizotypic symptom manifestations in young adulthood. Therefore, the present study explored the independent contributions of peritraumatic and trait dissociation in the relationship between CM and schizotypy. Participants ( N = 346) were undergraduate students who completed online self-report measures on CM, trait dissociation, peritraumatic dissociation experienced during CM, and schizotypic symptoms. The indirect effect of peritraumatic dissociation and trait dissociation on the relationship between CM and schizotypy was examined using mediational analyses. Correlational analyses revealed significant associations between self-reported CM, schizotypy, trait dissociation, and peritraumatic dissociation. In addition, mediational analyses indicated a significant indirect effect of peritraumatic dissociation (β = .06, 95% confidence interval (CI) [0.01, 0.12]), but not trait dissociation (β = .05, 95% CI [−0.02, 0.12]), on CM and schizotypy. These results highlight peritraumatic dissociation as an important mechanism driving the expression of schizotypic symptoms among individuals with a history of CM. Understanding how trauma sequelae lead to schizotypic psychopathology may be crucial in assessing and treating individuals with maltreatment histories or those on the psychosis spectrum.

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Section: Discussionmentioning

confidence: 99%

The Indirect Effect of Peritraumatic Dissociation on the Relationship Between Childhood Maltreatment and Schizotypy

Blose

Godleski

Houston

et al. 2022

J Interpers Violence

View full text Add to dashboard Cite

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“…First, a comprehensive summary of the field is lacking. Most previous work solely focused on a particular family of interventions for pediatric PTSD such as TF-CBT 26,50–54 , group-based interventions 55 , interventions with caregiver involvement 56 , on a specific population such as refugees 57 , children and adolescents in low and middle-income countries 29,58,59 or adolescents with interpersonal trauma-related PTSD 60 , or on short-term efficacy only 28 . To this date, only one published NMA 27 comprehensively summarized the literature across interventions and populations and included both short-term and long-term efficacy (up to 12 months posttreatment).…”

mentioning

confidence: 99%

The Efficacy of Psychological Interventions for Child and Adolescent PTSD: A Network Meta-Analysis

Hoppen,

Wessarges,

Jehn

et al. 2024

Preprint

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Pediatric post-traumatic stress disorder (PTSD) is a common and debilitating mental disorder and its effective treatment constitutes a health priority. Numerous randomized controlled trials (RCTs) have examined the efficacy of psychological interventions for pediatric PTSD. Yet, a comprehensive network meta-analysis (NMA) is lacking. The present work addresses this gap. A total of 67 RCTs met the inclusion criteria comprising 5,297 children and adolescents with full or sub-threshold PTSD. Five families of intervention were evaluated: trauma-focused cognitive behavior therapy (TF-CBT), eye movement desensitization and reprocessing (EMDR), other trauma-focused interventions, non-trauma-focused (non-TF) interventions, and multi-disciplinary treatments (MDTs). Most RCTs (73%) examined TF-CBT followed by EMDR. Other trauma-focused interventions had too few trials for analysis. At treatment endpoint, TF-CBT, EMDR, MDTs, and non-TF interventions were all effective in treating pediatric PTSD when compared to passive control conditions in random-effect NMA with large pooled effects (all Hedges' gs ≥ 0.84, all ps < .001). TF-CBT, EMDR, and MDTs also yielded significant short-term treatment effects compared to active control conditions. In a sensitivity analysis including only high-quality trials, only TF-CBT and EMDR outperformed active control conditions. And in a sensitivity analysis including only trials with ≥ 50% of participants reporting multiple-event-related PTSD, only TF-CBT yielded significant short-term effects. Results for mid-term (up to 5 months posttreatment) and long-term efficacy (beyond 5 months posttreatment) were very similar. TF-CBT consistently yielded the highest treatment effects except being second to EMDR at mid-term. The present NMA is the most comprehensive NMA of psychological interventions for pediatric PTSD to date. Results confirm that TF-CBT can effectively treat PTSD in children and adolescents both in the short and long-term and also for multiple-event-related PTSD. More long-term data and multiple-event-related PTSD data are needed for EMDR, MDTs, and non-TF interventions to draw firmer conclusions regarding their efficacy. Results for TF-CBT are encouraging for clinical practice and may help to reduce common treatment barriers.

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Psychological Interventions for Refugee Minors

Emmelkamp¹

2023

Mental Health of Refugees

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Cognitive behavioral therapy for children and adolescents with post-traumatic stress disorder: meta-analysis

Cited by 12 publications

References 35 publications

The Indirect Effect of Peritraumatic Dissociation on the Relationship Between Childhood Maltreatment and Schizotypy

The Indirect Effect of Peritraumatic Dissociation on the Relationship Between Childhood Maltreatment and Schizotypy

The Efficacy of Psychological Interventions for Child and Adolescent PTSD: A Network Meta-Analysis

Psychological Interventions for Refugee Minors

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