Disorders - Post Traumatic Stress Disorder
Huemer, J., Erhart, F., Steiner, H.
PTSD in children and adolescents differs from the adult disease.
Therapeutic approaches involve both psychotherapy and psychopharmacotherapy. OBJECTIVES: The current paper aims at reviewing studies on
psychopharmacological treatment of childhood and adolescent PTSD. Additionally, developmental frameworks for PTSD diagnosis and research along with
an experimental model of quenching and kindling in the context of stress exposure are presented. We conducted an extensive literature search of
reviews on psychopharmacotherapy as well as studies on psychopharmacological treatment for PTSD among children and adolescents. We used the database
PubMed and focused on the time period of the last 10 years up to January 2009. Pertinent earlier papers were also included.There are a limited number
of studies specifically assessing the psychopharmacological treatment of PTSD in children and adolescents. The vast majority of them lack
verification in RCTs. Only the use of imipramine, divalproex sodium and sertraline were already evaluated in RCTs. Future studies should take into
account developmental approaches to the diagnosis and treatment of PTSD in children and adolescents. In this context, different underlying
neurobiological patterns, which are reflected in distinct clinical symptomatology, require a precise investigation and a symptom-orientated
psychopharmacological approach.
Child Psychiatry & Human Development, 41(6) : 624-
640
- 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)
Gilboa-Schechtman, E., Foa, E. B., Shafran, N., Aderka, I. M., Powers, M.
B., Rachamim, L., Rosenbach, L., Yadin, E., Apter, A.
Objective To examine the efficacy and maintenance of developmentally adapted prolonged exposure therapy for adolescents (PE-A)
compared with active control time-limited dynamic therapy (TLDP-A) for decreasing posttraumatic and depressive symptoms in adolescent victims of
single-event traumas. Method Thirty-eight adolescents (12 to 18 years old) were randomly assigned to receive PE-A or TLDP-A. Results Both treatments
resulted in decreased posttraumatic stress disorder and depression and increased functioning. PE-A exhibited a greater decrease of posttraumatic
stress disorder and depression symptom severity and a greater increase in global functioning than did TDLP-A. After treatment, 68.4% of adolescents
beginning treatment with PE-A and 36.8% of those beginning treatment with TLDP-A no longer met diagnostic criteria for posttraumatic stress disorder.
Treatment gains were maintained at 6- and 17-month follow-ups. Conclusions Brief individual therapy is effective in decreasing posttraumatic distress
and behavioral trauma-focused components enhance efficacy. Clinical trial registry information Prolonged Exposure Therapy Versus Active Psychotherapy
in Treating Post-Traumatic Stress Disorder in Adolescents, URL: http://clinicaltrials.gov, unique identifier: NCT00183690. (copyright) 2010 American
Academy of Child and Adolescent Psychiatry.
Journal of the American Academy of Child & Adolescent Psychiatry, 49(10) : 1034-
1042
- Year: 2010
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Exposure therapy, Exposure
and response prevention, Psychodynamic/Psychoanalysis
Kemp, M., Drummond,
P., McDermott, B.
The present study investigated the efficacy of four EMDR sessions in comparison to
a six-week wait-list control condition in the treatment of 27 children (aged 6 to 12 years) suffering from persistent PTSD symptoms after a motor
vehicle accident. An effect for EMDR was identified on primary outcome and process measures including the Child Post-Traumatic Stress-Reaction Index,
clinician rated diagnostic criteria for PTSD, Subjective Units of Disturbance and Validity of Cognition scales. All participants initially met two or
more PTSD criteria. After EMDR treatment, this decreased to 25% in the EMDR group but remained at 100% in the wait-list group. Parent ratings of
their child's PTSD symptoms showed no improvement, nor did a range of non-trauma child self-report and parent-reported symptoms. Treatment gains
were maintained at three and 12 month follow-up. These findings support the use of EMDR for treating symptoms of PTSD in children, although further
replication and comparison studies are required.
Clinical Child Psychology & Psychiatry, 15(1) : 5-
25
- Year: 2010
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Eye movement desensitisation and reprocessing (EMDR)
Cohen, J. A., Bukstein, O., Walter, H., Benson, R. S., Chrisman, A., Farchione, T. R., Hamilton, J., et-al
This Practice Parameter reviews the evidence from
research and clinical experience and highlights significant advances in the assessment and treatment of posttraumatic stress disorder since the
previous Parameter was published in 1998. It highlights the importance of early identification of posttraumatic stress disorder, the importance of
gathering information from parents and children, and the assessment and treatment of comorbid disorders. It presents evidence to support trauma-
focused psychotherapy, medications, and a combination of interventions in a multimodal approach. (copyright) 2010 American Academy of Child and
Adolescent Psychiatry.
Journal of the American Academy of Child & Adolescent Psychiatry, 49(4) : 414-
430
- 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), Psychological Interventions
(any)
Catani, C., Mahendran, K., Ruf, M., Schauer, E., Elbert, T., Neuner, F.
Background: The North-Eastern part of Sri Lanka had already been affected by civil war when the 2004 Tsunami wave hit
the region, leading to high rates of posttraumatic stress disorder (PTSD) in children. In the acute aftermath of the Tsunami we tested the efficacy
of two pragmatic short-term interventions when applied by trained local counselors. Methods: A randomized treatment comparison was implemented in a
refugee camp in a severely affected community. 31 children who presented with a preliminary diagnosis of PTSD were randomly assigned either to six
sessions Narrative Exposure Therapy for children (KIDNET) or six sessions of meditation-relaxation (MED-RELAX). Outcome measures included severity of
PTSD symptoms, level of functioning and physical health. Results: In both treatment conditions, PTSD symptoms and impairment in functioning were
significantly reduced at one month post-test and remained stable over time. At 6 months follow-up, recovery rates were 81% for the children in the
KIDNET group and 71% for those in the MED-RELAX group. There was no significant difference between the two therapy groups in any outcome measure.
Conclusion: As recovery rates inthe treatment groups exceeded the expected rates of natural recovery, the study provides preliminary evidence for the
effectiveness of NET as well as meditation-relaxation techniques when carried out by trained local counselors for the treatment of PTSD in children
in the direct aftermath of mass disasters. (copyright) 2009 Catani et al; licensee BioMed Central Ltd.
BMC
Psychiatry, 9 :
- Year: 2009
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Narrative exposure therapy (NET), Meditation, Relaxation
Berger, R., Gelkopf, M.
Background: On December 26, 2004, a tsunami hit the southern
coast of Sri Lanka, leaving thousands dead and injured. Previous research has found significant mental health problems among children exposed to
major disasters. School-based universal interventions have shown promise in alleviating distress and posttraumatic symptomatology in children and
adolescents. This study evaluated the efficacy of a school-based intervention in reducing stress-related symptomatology among Sri Lankan children
exposed to the tsunami. Methods: In a quasi-randomized controlled trial 166 elementary school students (ages 9-15) with significant levels of tsunami
exposure and previous traumatic background were randomly assigned to a 12-session structured program 'ERASE Stress Sri Lanka' (ES-SL) or to a
waiting list (WL) religious class control group. Students were assessed 1 week prior and 3 months after the intervention on measures of posttraumatic
symptomatology [including posttraumatic stress disorder (PTSD) and severity of posttraumatic symptomatology], depression, functional problems,
somatic problems and hope. Results: This study shows a significant reduction on all outcome variables. PTSD severity, functional problems, somatic
complaints, depression and hope scores were all significantly improved in the ES-SL group compared to the WL group. No new cases of PTSD were
observed in the experimental group. Conclusion: This study adds to the growing body of evidence suggesting the efficacy of school-based universal
approaches in helping children in regions touched by war, terror and disaster and suggests the need to adopt a two-stage approach toward dealing with
trauma-exposed students, namely, starting with a universal intervention followed by targeted specialized interventions for those still suffering from
posttraumatic distress. Copyright (copyright) 2009 S. Karger AG.
Psychotherapy & Psychosomatics, 78(6) : 364-
371
- Year: 2009
- Problem: Post Traumatic Stress Disorder
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Psychoeducation, Skills training, Other Psychological Interventions, Physical activity, exercise, Other complementary & alternative
interventions
Hasanovic, M., Srabovic, S., Rasidovic, M., Sehovic, M., Hasanbasic, E., Husanovic, J., Hodzic, R.
Background: The 1992-1995 war in Bosnia and Herzegovina (BH) has had a
tremendous impact on civilians; thousands of inhabitants were left with numerous traumatic experiences. Many children suffered or witnessed
horrifying acts of violence and aggression. Although young trauma victims are often resilient, many experience mental health difficulties, including
PTSD. The aim of the study was to estimate whether psychosocial support given by the School Project of Humanitarian Association of \" Prijateljice\"
reduced posttraumatic consequences in students in primary and secondary schools in Bosnia and Herzegovina after 1992-1995 war. Subjects and methods:
A stratified sample of 336 students in primary and secondary schools located in two entities of North-East Bosnia and Herzegovina, involved in
psychosocial support, was compared with 72 voluntarily selected same-age students from the same schools who were not involved in this project. Data
were collected on two occasions, beginning of December 2005 and end of May 2006, by using a self-evaluation survey method for measuring symptoms of
posttraumatic stress disorder (PTSD) according to DSM IV. The Index of Children Post-traumatic reactions were used. Results: The severity of PTSD
symptoms among students involved in the School Project decreased from (mean(plus or minus)standard deviation=35.3(plus or minus)10.2 to 26.7(plus or
minus)8.7) (t=13.1, P<0.001, Paired sample test), whereas in the group with no psychosocial assistance this reduction was from (29.7(plus or
minus)10.9 to 28.1(plus or minus)1.8) (t=0.9, P=0.396, Paired sample test). Conclusion: This study suggests that work with students by giving them
psychosocial support within the School Project resulted in significant reduction of PTSD symptoms' severity. (copyright) Medicinska naklada.
Psychiatria Danubina, 21(4) : 463-
473
- Year: 2009
- 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
Gelkopf, M., Berger, R.
BACKGROUND: Since September 2000 Israeli children have been exposed to a large number of terrorist attacks. A universal, school-based
intervention for dealing with the threat of terrorism as well as with terror-related symptoms, ERASE-Stress (ES), was evaluated in a male religious
middle school in southern Israel. The program was administered by the homeroom teachers as part of the school curriculum. It consists of 12 classroom
sessions each lasting 90 minutes, and included psycho-educational material, skill training and resiliency strategies delivered to the students by
homeroom teachers. METHODS: One hundred and fourteen 7th and 8th grade students were randomly assigned to the ES intervention or were part of a
waiting list (WL). They were assessed on measures of posttraumatic symptomatology, depression, somatic symptoms and functional problems before and 3
months after the intervention or the WL period. RESULTS: Three months after the program ended, students in the experimental group showed significant
reduction in all measures compared to the waiting-list control group. CONCLUSIONS: The ERASE-Stress program may help students suffering from terror-
related posttraumatic symptoms and mitigate the negative effects of future traumatic experiences. Furthermore, a school-based universal program such
as the ERASE-Stress may potentially serve as an important and effective component of a community mental health policy for communities affected by
terrorism.
Journal of Child Psychology &
Psychiatry & Allied Disciplines, 50(8) : 962-971
- Year: 2009
- Problem: Post Traumatic Stress Disorder
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Skills training, Other Psychological Interventions
Jordans, M. J. D., Tol, W. A., Komproe, I. H., DeJong, J. V. T. M.
Background: There is a growing body of literature on interventions addressing psychosocial wellbeing and mental health of children
affected by violence in low- and middle-income countries. Method: This systematic review of PubMed, PsychINFO, and PILOTS identified 500 publications
(1991-2008) on interventions. Results: Sixty-six publications (12 treatment outcome studies and 54 intervention descriptions, covering a range of
treatment modalities) met inclusion criteria. Most interventions are evaluated positively, while some studies lack evidence for efficacy and
effectiveness. Conclusions: Scarcity of rigorous studies, diversity of interventions, and mixed results of evaluations demonstrate a need to identify
evidence-based interventions. The literature presents consensus on a number of treatment-related issues, yet the application remains limited across
interventions. (copyright) 2009 The Author. Journal compilation (copyright) 2009 Association for Child and Adolescent Mental Health.
Child & Adolescent Mental Health, 14(1) : 2-14
- Year: 2009
- 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)
Lesmana, C. B. J., Suryani, L. K., Jensen, G. D., Tiliopoulos, N.
The aim of this study was to
assess the effectiveness of a spiritual-hypnosis assisted therapy (SHAT) for treatment of posttraumatic stress disorder (PTSD) in children. All
children, age 6-12 years (N=226; 52.7% females), who experienced the terrorist bomb blasts in Bali in 2002, and subsequently were diagnosed with PTSD
were studied, through a longitudinal, quasi-experimental (pre-post test), single-blind, randomized control design. Of them, 48 received group SHAT
(treatment group), and 178 did not receive any therapy (control group). Statistically significant results showed that SHAT produced a 77.1%
improvement rate, at a two-year follow up, compared to 24% in the control group, while at the same time, the mean PTSD symptom score differences were
significantly lower in the former group. We conclude that the method of spiritual-hypnosis is highly effective, economic, and easily implemented, and
has a potential for therapy of PTSD in other cultures or other catastrophic life-threatening events. Copyright (copyright) 2009 by the American
Society of Clinical Hypnosis.
American Journal of Clinical Hypnosis, 52(1) : 23-
34
- Year: 2009
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Other Psychological Interventions, Other complementary & alternative
interventions
McClatchey, Irene Searles, Vonk, M. Elizabeth, Palardy, Gregory
Objective: This study
examined the efficacy of a short-term, camp-based, trauma-focused grief intervention in reducing traumatic grief and posttraumatic stress disorder
symptoms in parentally bereaved children. Method: For this nonequivalent comparison group study, 100 children were split into two groups, with one
group serving as the immediate treatment group and the second group serving as the delayed treatment group. Results: The results were analyzed using
chi-square, independent samples t tests, multiple and logistic regression and showed this short-term intervention to be followed by reduced traumatic
grief and posttraumatic stress disorder symptoms. Conclusions: The results are discussed in relation to current research on and practice with
bereaved children as well as implications for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (journal abstract)
Research on Social Work Practice, 19(1) : 19-
30
- Year: 2009
- 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)
Schaal, Susanne, Elbert, Thomas, Neuner, Frank
Background: The aim of the present
study was to evaluate the efficacy of treatment modules for trauma spectrum disorders in a sample of Rwandan genocide orphans. Methods: Twenty-six
orphans (originally 27) who presented with posttraumatic stress disorder (PTSD) at first assessment continued to meet a PTSD DSM-IV diagnosis 6
months after their initial assessment. They were offered participation in a controlled treatment trial. A group adaptation of interpersonal
psychotherapy (IPT, n = 14) was compared to individual narrative exposure therapy (NET, n = 12). The last NET session involved guided mourning. Each
treatment program consisted of 4 weekly sessions. Main outcome measures were diagnostic status and symptoms of PTSD and depression assessed before
treatment, at 3 months post-test and at 6 months follow-up using the Clinician-Administered PTSD Scale, Mini-International Neuropsychiatric
Interview, and Hamilton Rating Scale. Results: At post-test, there were no significant group differences between NET and IPT on any of the examined
outcome measures. At 6-month follow-up, only 25% of NET, but 71% of IPT participants still fulfilled PTSD criteria. There was a significant time x
treatment interaction in the severity of PTSD [Wilks’ Λ = 0.75, F(2,23) = 3.93; p ! 0.05] and depression symptoms [Wilks’ Λ= 0.23, F(2,23) =
3.40; p = 0.05]. At follow-up, NET participants were significantly more improved than IPT participants with respect to both the severity of symptoms
of PTSD and depression. Conclusions: Individual NET in combination with group-based mourning comprises an effective treatment for traumatized
survivors who have to bear the loss of loved ones and have been suffering from symptoms of PTSD and depression. (PsycINFO Database Record (c) 2010
APA, all rights reserved) (journal abstract)
Psychotherapy & Psychosomatics, 78(5) : 298-
306
- Year: 2009
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Interpersonal therapy (IPT), Narrative exposure therapy (NET)