Disorders - Post Traumatic Stress Disorder
Brillantes-Evangelista, G.
The study investigates the
effectiveness of visual arts and poetry as interventions in alleviating symptoms of depression and post-traumatic stress disorder (PTSD) among
adolescents with history of abuse. Participants were selected from five shelters within Metro Manila based on the depression and PTSD measures. They
were divided into three groups: visual arts, poetry, and control groups. Each of the intervention groups went through eight sessions of art works or
poetry with specific themes and modality. Results show that participants in the intervention groups had a general decrease of scores from pretest to
posttest on the depression and PTSD scales. On the other hand, many participants in the control group obtained higher posttest scores. Results also
indicate that the visual arts intervention was significantly effective in alleviating symptoms of PTSD but not of depression; while poetry
intervention was significantly effective in alleviating symptoms of depression it was less so in treating PTSD. Nonetheless, analysis on the
activities held suggests that the visual arts and poetry interventions helped the adolescents address their issues, make sense of their lives, and
create positive alternative stories for themselves. (copyright) 2012 Elsevier Inc.
Arts in Psychotherapy, 40(1) : 71-84
- Year: 2013
- Problem: Post Traumatic Stress Disorder, Depressive Disorders
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Creative expression: music, dance, drama, art
Parker, B., Turner, W.
Background: The sexual abuse of
children and adolescents is a significant worldwide problem. It is associated with a wide variety of negative psychological, social and physical
consequences for the victims. These effects can often be seen immediately following sexual abuse, but they may manifest later on and sometimes only
in adult life. There are a number of different interventions aimed at helping children and adolescents who have been sexually abused, and
psychoanalytic/psychodynamic psychotherapy has a long-established tradition of being used for such victims. In this review, we set out to find the
evidence for its effectiveness specifically in children and adolescents who have been sexually abused. Objectives: To assess the effectiveness of
psychoanalytic/psychodynamic psychotherapy for children and adolescents who have been sexually abused. Search methods: We searched the following
databases in May 2013: CENTRAL, Ovid MEDLINE, Embase, PsycINFO, CINAHL, Sociological Abstracts, Social Science Citation Index, Conference Proceedings
Citation Index - Social Science and Humanities, LILACS and WorldCat. We also searched three trials registers, checked the reference lists of relevant
studies and contacted known experts. Selection criteria: Randomised and quasi-randomised trials comparing psychoanalytic/psychodynamic psychotherapy
with treatment as usual or no treatment/waiting list control for children and adolescents up to age of 18 who had experienced sexual abuse at any
time prior to the intervention. Data collection and analysis: The review authors (BP and WT) independently screened search results to identify
studies that met eligibility criteria. Main results: No studies were identified that met the inclusion criteria for this review. Authors'
conclusions: There are no randomised and quasi-randomised trials that compare psychoanalytic/psychodynamic therapy with treatment as usual, no
treatment or waiting list control for children and adolescents who have been sexually abused. As a result, we cannot draw any conclusions as to the
effectiveness of psychoanalytic/psychodynamic psychotherapy for this population. This important gap emphasises the need for further research into the
effectiveness of psychoanalytic/psychodynamic psychotherapy in this population. Such research should ideally be in the form of methodologically
high-quality, large-scale randomised controlled trials. If these are not conducted, future systematic reviews on this subject may need to consider
including other lower quality evidence in order to avoid overlooking important research. Copyright © 2013 The Cochrane Collaboration.
Cochrane Database of Systematic Reviews, 2013 (7) (no
pagination)(CD008162) :
- Year: 2013
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Psychodynamic/Psychoanalysis
Hermenau, K., Hecker, T., Schaal, S., Maedl, A., Elbert, T.
Former child soldiers and ex-combatants are at high risk of developing trauma-related disorders and
appetitive aggression, which reduce successful integration into peaceful societies. In a randomized controlled clinical trial, we offered Narrative
Exposure Therapy for Forensic Offender Rehabilitation (FORNET) to 15 ex-combatants with the goal of reducing traumatic stress and appetitive
aggression compared to \"treatment as usual.\" Measures included the PTSD Symptom Scale-Interview and the Appetitive Aggression Scale assessed prior
to treatment and 2 weeks and 6 months after the treatment. We also assessed closeness to combatants as an index of reintegration. The treatment group
reported reduced PTSD symptoms and less contact with combatants. Appetitive aggression decreased substantially in both groups. The results indicate
that it is feasible to add psychological treatment to facilitate the reintegration process. We wish to thank the former combatants and former child
soldiers who participated in this study and the Congolese translators. We also want to thank the very motivated and reliable staff of the
reintegration center, especially Pascal Badibanga Zagabe, Leonce Kyakimwa, Lydie Mirimo Ajua, David Ngufu, and Matata Banyene. Furthermore, we want
to thank Charlotte Salmen for conducting the follow-up interviews and James Moran for conducting the follow-up interviews as well as proofreading the
manuscript. Sources of support: Deutsche Forschungsgemeinschaft (DFG), vivo international. Trial registration clinicaltrials.gov Identifier:
NCT01625117 (copyright) 2013 Copyright Taylor and Francis Group, LLC.
Journal of Aggression, Maltreatment &
Trauma, 22(8) : 916-934
- Year: 2013
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Narrative exposure therapy (NET)
Forman-Hoffman, Valerie L., Zolotor, Adam J., McKeeman, Joni L., Blanco,
Roberto, Knauer, Stefanie R., Lloyd, Stacey W., Fraser, Jenifer Goldman, Viswanathan, Meera
Objectives: To
assess the effectiveness of interventions targeting traumatic stress among children exposed to nonrelational traumatic events (eg, accidents, natural
disasters, war).; Methods: We assessed research on psychological and pharmacological therapy as part of an Agency for Healthcare Research and
Quality-commissioned comparative effectiveness review. We conducted focused searches of Medline, Cochrane Library, Embase, PsycINFO, Cumulative Index
to Nursing and Allied Health Literature, International Pharmaceutical Abstracts, and Web of Science. Two trained reviewers independently selected,
extracted data from, and rated the risk of bias of relevant trials and systematic reviews. We used qualitative rather than quantitative analysis
methods because of statistical heterogeneity, insufficient numbers of similar studies, and variation in outcome reporting.; Results: We found a total
of 21 trials and 1 cohort study of medium or low risk of bias from our review of 6647 unduplicated abstracts. We generally did not find studies that
attempted to replicate findings of effective interventions. In the short term, no pharmacotherapy intervention demonstrated efficacy, and only a few
psychological treatments (each with elements of cognitive behavioral therapy) showed benefit. The body of evidence provides little insight into how
interventions to treat children exposed to trauma might influence healthy long-term development.; Conclusions: Our findings serve as a call to
action: Psychotherapeutic intervention may be beneficial relative to no treatment in children exposed to traumatic events. Definitive guidance,
however, requires far more research on the comparative effectiveness of interventions targeting children exposed to nonrelational traumatic
events.;
Pediatrics, 131(3) : 526-539
- Year: 2013
- Problem: Post Traumatic Stress Disorder
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Psychological Interventions
(any)
Fraser, J. G., Lloyd, S., Murphy, R., Crowson, M., Zolotor, A. J., Coker-Schwimmer, E., Viswanathan, M.
Objective: To systematically review the comparative
effectiveness evidence for interventions to ameliorate the negative sequelae of maltreatment exposure in children ages birth to 14 years.; Methods:
We assessed the research on pharmacological and psychosocial interventions (parent-mediated approaches or trauma-focused treatments) reporting mental
and behavioral health, caregiver-child relationship, and developmental and/or school functioning outcomes. We conducted focused searches of MEDLINE
(through PubMed), Social Sciences Citation Index, PsycINFO, and the Cochrane Library (1990-2012). Reviewer pairs independently evaluated the studies
for eligibility using predetermined inclusion/exclusion criteria, evaluated studies for risk of bias, extracted data, and graded the strength of
evidence (SOE) for each comparison and each outcome based on predetermined criteria.; Results: Based on our review of 6282 unduplicated citations, we
found 17 trials eligible for inclusion. Although several interventions show promising comparative benefit for child well-being outcomes, the SOE for
all but one of these interventions was low. The results highlight numerous substantive and methodological gaps to address in the future research.;
Conclusions: It is too early to make strong treatment recommendations, as comparative research remains relatively nascent in the child maltreatment
arena. These gaps reflect, in large part, the Herculean demands on researchers involved in conducting high-quality clinical studies with this highly
vulnerable population. The National Child Traumatic Stress Network and the Developmental-Behavioral Pediatrics Research Network (DBPNet) are two
potentially powerful platforms to conduct large rigorous trials needed to move the field forward. More broadly, a paradigm shift among researchers
and funders alike is needed to galvanize the commitment and resources necessary for conducting collaborative clinical trials with this highly
vulnerable population.;
Journal of Developmental & Behavioral Pediatrics, 34(5) : 353-
368
- Year: 2013
- Problem: Post Traumatic Stress Disorder
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Psychological Interventions
(any)
Habigzang, L. F., Damasio, B. F., Koller, S. H.
This study evaluated the impact of a cognitive behavioral group therapy model in Brazilian girls who had experienced sexual abuse. The
effect of the waiting period before treatment and the enduring effectiveness of the treatment after six and 12 months were also evaluated. Forty-nine
female sexual abuse victims between the ages of 9 and 16 completed instruments measuring depression, anxiety, stress, and post-traumatic stress
disorder before, during, and after the group therapy. The group therapy had a positive impact on their psychological functioning, significantly
reducing symptoms of anxiety, stress, and post-traumatic stress disorder. The therapeutic effects lasted six to 12 months after the treatment ended.
The model proved effective for treating young female victims of sexual abuse.
Journal
of child sexual abuse, 22(2) : 173-190
- Year: 2013
- Problem: Post Traumatic Stress Disorder
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Leor, A., Dolberg,
O. T., Eshel, S. P., Yagil, Y., Schreiber, S.
To describe and evaluate the impact of an early intervention (Trauma-
Focused Early Intensive Cognitive Behavioral Intervention, TF-EICBI) in children and adolescents who were victims of suicide bombing attacks (SBAs)
in Israel. Description of an intervention and preliminary experience in its use. An acute trauma center of a Child and Adolescent Psychiatric Unit in
a Department of Psychiatry of a university-affiliated medical center. Ten children and adolescents who were victims of SBAs and underwent early
interventions (EIG) were compared to 11 adolescent victims who received no intervention (NEIG). The EIG included all the children and adolescent
survivors of various SBAs that had occurred during 1 year who presented to our hospital after the TF-EICBI was implemented (June 2001). The NEIG
comprised all adolescents girls <18 years of age at follow-up who survived one SBA (at the \"Dolphinarium\" Discotheque) before the TF-EICBI was
available. At the time of the 1-year post-SBA follow-up, all 21 subjects were assessed by the Structured Clinical Interview for Axis 1 DSMIII R
Disorders (SCID), and the Child Behavior Checklist (CBCL). One (10 percent) EI subject and four (36.4 percent) NEI subjects had post-traumatic stress
disorder. The mean CBCL total score and most of the mean CBCL behavior problem scores were significantly higher (p < 0.021) among the NEI group
members. Intervention was effective in preventing and lowering mental morbidity of children and adolescents after SBAs.
American Journal of Disaster Medicine, 8(4) : 227-234
- Year: 2013
- Problem: Post Traumatic Stress Disorder
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Trauma-focused cognitive behavioural therapy (TF-
CBT)
Gwozdziewycz, Nicolas, Mehl-Madrona, Lewis
Background: Narrative therapies, especially narrative exposure therapy, are used to treat the effects of trauma in refugees and to
prevent psychiatric illness. These methods involve helping the person to tell the story of what happened to them until it no longer elicits anxiety.;
Methods: We reviewed all quantitative studies related to narrative exposure methods for treating trauma or posttraumatic stress disorder in refugees.
We focused on studies with sufficient information to calculate effect sizes and statistical power.; Results: We found 7 quantitative studies for
which effect size and power could be calculated. The total average effect size for all interventions was 0.63 (medium). The average effect size for
studies in which interventions were administered by physicians, adequately trained graduate students, or both was 0.53. The effect size for studies
in which the counselors were themselves refugees was 1.02. The 95% confidence intervals for the effect sizes of narrative exposure therapy did not
reach below 0.; Conclusion: Studies demonstrating the effectiveness of narrative methods have adequate effect sizes and statistical power. Empowering
lay counselors to treat their fellow refugees in future studies is warranted.;
The
Permanente Journal, 17(1) : 70-76
- Year: 2013
- 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), Narrative exposure therapy (NET)
Overbeek, Mathilde M., deSchipper, J.
Clasien, Lamers-Winkelman, Francien, Schuengel, Carlo
A community-based intervention with specific factors for children and parents exposed to interparental violence (IPV) was compared
with a control intervention based on non-specific factors. We hypothesized that participation in an intervention with specific factors, focused on
IPV, parenting and coping, would be associated with better recovery. IPV exposed children and parents were group randomized over a specific factors-
and control intervention. Baseline, posttest and follow-up measurements of 155 parents and children (aged 6 - 12 years, 55.5% boys) were fitted in a
multilevel model. Outcomes were parent and teacher reported children's internalizing and externalizing problems (CBCL, TRF), child self-reported
depressive symptoms (CDI) and parent and child reported children's post-traumatic stress symptoms (TSCYC, TSCC). Based on intention-to-treat and
completer analyses, children in the specific factors intervention did not show better recovery than children in the control intervention. Children in
both interventions decreased significantly in parent-reported children's internalizing and externalizing problems and post-traumatic stress
symptoms. Children reported a decrease in their mean level of depressive and post-traumatic stress symptoms. Teachers reported a decrease in
internalizing problems, but not in externalizing problems. No association between time since exposure and level and course of symptoms was found.
Treatment differentiation was assessed and both programs were significantly different on hypothesized effective factors. Higher treatment adherence
in both programs did not result in a larger difference in recovery. IPV exposed children improve over the course and after participating in a
community-based child- and parent program, but specific factors in intervention may not carry additional benefits when implemented in community
settings.
Child Abuse & Neglect, 37 : 1202-1214
- Year: 2013
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Leenarts, L. E. W., Diehle, J., Doreleijers, T. A. H., Jansma, E. P., Lindauer, R. J. L.
This is a systematic review of evidence-
based treatments for children exposed to childhood maltreatment. Because exposure to childhood maltreatment has been associated with a broad range of
trauma-related psychopathology (e.g., PTSD, anxiety, suicidal ideation, substance abuse) and with aggressive and violent behavior, this review
describes psychotherapeutic treatments which focus on former broad range of psychopathological outcomes. A total of 26 randomized controlled clinical
trials and seven non-randomized controlled clinical trials published between 2000 and 2012 satisfied the inclusionary criteria and were included.
These studies dealt with various kinds of samples, from sexually abused and maltreated children in child psychiatric outpatient clinics or in foster
care to traumatized incarcerated boys. A total of 27 studies evaluated psychotherapeutic treatments which used trauma-focused cognitive, behavioral
or cognitive-behavioral techniques; only two studies evaluated trauma-specific treatments for children and adolescents with comorbid aggressive or
violent behavior; and four studies evaluated psychotherapeutic treatments that predominantly focused on other mental health problems than PTSD and
used non-trauma focused cognitive, behavioral or cognitive-behavioral techniques. The results of this review suggest that trauma-focused cognitive-
behavioral therapy (TF-CBT) is the best-supported treatment for children following childhood maltreatment. However, in line with increased interest
in the diagnosis of complex PTSD and given the likely relationship between childhood maltreatment and aggressive and violent behavior, the authors
suggest that clinical practice should address a phase-oriented approach. This review concludes with a discussion of future research directions and
limitations.;
European Child & Adolescent Psychiatry, 22(5) : 269-283
- Year: 2013
- 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), Cognitive & behavioural therapies (CBT), Eye movement desensitisation and reprocessing (EMDR), Trauma-focused cognitive behavioural therapy (TF-
CBT)
O'Callaghan, Paul, McMullen, John, Shannon, Ciaran, Rafferty, Harry, Black, Alastair
Objective: To assess the efficacy of trauma-focused cognitive behavioral therapy (TF-
CBT) delivered by nonclinical facilitators in reducing posttraumatic stress, depression, and anxiety and conduct problems and increasing prosocial
behavior in a group of war-affected, sexually exploited girls in a single-blind, parallel-design, randomized,+ controlled trial.; Method: Fifty-two
12- to 17-year-old, war-affected girls exposed to rape and inappropriate sexual touch in the Democratic Republic of Congo were screened for trauma,
depression and anxiety, conduct problems, and prosocial behavior. They were then randomized to a 15 session, group-based, culturally modified TF-CBT
(n = 24) group or a wait-list control group (n = 28). Primary analysis, by intention-to-treat, involving all randomly assigned participants occurred
at pre- and postintervention and at 3-month follow-up (intervention group only).; Results: Compared to the wait list control, the TF-CBT group
experienced significantly greater reductions in trauma symptoms (F(1,49) = 52.708, p<0·001, ?(p)2 = 0.518). In addition, the TF-CBT group showed a
highly significant improvement in symptoms of depression and anxiety, conduct problems, and prosocial behavior. At 3-months follow-up the effect size
(Cohen's d) for the TF-CBT group was 2.04 (trauma symptoms), 2.45 (depression and anxiety), 0.95 (conduct problems), and-1.57 (prosocial behavior).;
Conclusions: A group-based, culturally modified, TF-CBT intervention delivered by nonclinically trained Congolese facilitators resulted in a large,
statistically significant reduction in posttraumatic stress symptoms and psychosocial difficulties among war-affected girls exposed to rape or sexual
violence. Clinical trial registration information-An RCT of TF-CBT with sexually-exploited, war-affected girls in the DRC;
http://clinicaltrials.gov/; NCT01483261.; Copyright © 2013 American Academy of Child & Adolescent Psychiatry. Published by Elsevier Inc. All rights
reserved.
Journal of the
American Academy of Child & Adolescent Psychiatry, 52(4) : 359-369
- Year: 2013
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Trauma-focused cognitive behavioural therapy (TF-
CBT)
McMullen, John., O'Callaghan, Paul., Shannon, Ciaran., Black,
Alastair., Eakin, John.
Background: The Democratic Republic of Congo (DRC) has been home to the world's deadliest conflict since World War II and is reported to have
the largest number of child soldiers in the world. Despite evidence of the debilitating impact of war, no group-based mental health or psychosocial
intervention has been evaluated in a randomised controlled trial for psychologically distressed former child soldiers.; Method: A randomised
controlled trial involving 50 boys, aged 13-17, including former child soldiers (n = 39) and other war-affected boys (n = 11). They were randomly
assigned to an intervention group, or wait-list control group. The intervention group received a 15-session, group-based, culturally adapted Trauma-
Focused Cognitive-Behavioural Therapy (TF-CBT) intervention. Assessment interviews were completed at baseline, postintervention and 3-month follow-up
(intervention group).; Results: Analysis of Covariance (ANCOVA) demonstrated that, in comparison to the wait-list control group, the TF-CBT
intervention group had highly significant reductions in posttraumatic stress symptoms, overall psychosocial distress, depression or anxiety-like
symptoms, conduct problems and a significant increase in prosocial behaviour (p < .001 for all). Effect sizes were higher when former child soldier
scores were separated for sub-analysis. Three-month follow-up of the intervention group found that treatment gains were maintained.; Conclusions: A
culturally modified, group-based TF-CBT intervention was effective in reducing posttraumatic stress and psychosocial distress in former child
soldiers and other war-affected boys.; © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent
Mental Health.
Journal of
Child Psychology & Psychiatry & Allied Disciplines, 54(11) : 1231-1241
- Year: 2013
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Trauma-focused cognitive behavioural therapy (TF-
CBT)