Disorders - Post Traumatic Stress Disorder
Rodenburg, R., Benjamin, A., deRoos, C., Meijer, A. M., Stams, G. J.
The efficacy of eye movement desensitization and reprocessing (EMDR) in
children with post-traumatic stress symptoms was meta-analytically examined from the perspective of incremental efficacy. Overall post-treatment
effect size for EMDR was medium and significant (d = .56). Results indicate efficacy of EMDR when effect sizes are based on comparisons between the
EMDR and the non-established trauma treatment or the no-treatment control groups, and the incremental efficacy when effect sizes are based on
comparisons between the EMDR and the established (CBT) trauma treatment. The discussion focuses on the future replication of EMDR findings and
further research on post-traumatic stress in children. (copyright) 2009 Elsevier Ltd. All rights reserved.
Clinical
Psychology Review, 29(7) : 599-606
- 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), Eye movement desensitisation and reprocessing (EMDR)
Salloum, A., Overstreet, S.
This study evaluated a community-based grief and trauma intervention for children conducted
postdisaster. Fifty six children (7 to 12 years old) who reported moderate to severe levels of symptoms of posttraumatic stress were randomly
assigned to group or individual treatment. Treatment consisted of a manualized 10-session grief- and trauma-focused intervention and a parent
meeting. Measures of disaster-related exposure, posttraumatic stress symptoms, depression, traumatic grief, and distress were administered at
preintervention, postintervention, and 3 weeks postintervention. There was a significant decrease in all outcome measures over time, and there were
no differences in outcomes between children who participated in group intervention and those who participated in individual intervention. Results
suggest that this intervention using either treatment modality may be effective for addressing childhood grief and trauma postdisaster.
Journal of
Clinical Child & Adolescent Psychology, 37(3) : 495-507
- Year: 2008
- 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
Shooshtary, M. H., Panaghi, L., Moghadam, J. A.
Purpose: The authors
evaluated the effectiveness of cognitive behavioral therapy (CBT) among adolescents exposed to the 2004 earthquake in Bam, Iran. Methods: Four months
after the earthquake, 135 adolescents as a case group and 33 adolescents as a comparison group were evaluated with the Impact of Event Scale Revised
(IES-R). Two therapists were trained in CBT in 3-day classes according to a manual provided by mental health services. After conducting CBT in the
case group, both groups were evaluated again with IES-R. Results: The severity of posttraumatic stress symptoms significantly decreased among the
subjects given CBT in the case group. The improvement in posttraumatic stress symptoms was attributable to improvement in each of three-symptom
categories (intrusion, avoidance, and arousal) and in the total score of posttraumatic stress disorder (p < .05). Conclusions: The findings
demonstrate the efficacy of CBT in alleviating posttraumatic stress symptoms among adolescents after a catastrophic disaster. (copyright) 2008
Society for Adolescent Medicine.
Journal of Adolescent Health, 42(5) : 466-472
- Year: 2008
- 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)
Wethington, Holly R., Hahn, Robert
A., Fuqua-Whitley, Dawna S., Sipe, Theresa Ann, Crosby, Alex E., Johnson, Robert L., Liberman, Akiva M., Moscicki, Eve, Price, Leshawndra
N., Tuma, Farris K., Kalra, Geetika, Chattopadhyay, Sajal K.
Children and adolescents in the
U.S. and worldwide are commonly exposed to traumatic events, yet practitioners treating these young people to reduce subsequent psychological harm
may not be aware of-or use-interventions based on the best available evidence. This systematic review evaluated interventions commonly used to reduce
psychological harm among children and adolescents exposed to traumatic events. Guide to Community Preventive Services (Community Guide) criteria were
used to assess study design and execution. Meta-analyses were conducted, stratifying by traumatic exposures. Evaluated interventions were conducted
in high-income economies, published up to March 2007. Subjects in studies were
American Journal of Preventive Medicine, 35(3) : 287-313
- Year: 2008
- 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)
Layne, C.M., Saltzman, W.R., Poppleton, L., Burlingame, G.M., Pasa- lic, A., Durakovic, E., et al.
To evaluate the
comparative effectiveness of a classroom-based psychoeducation and skills intervention (tier 1) and a school-based trauma- and grief-focused group
treatment (tier 2) of a three-tiered mental health program for adolescents exposed to severe war-related trauma, traumatic bereavement, and postwar
adversity.\rMethod\r\rA total of 127 war-exposed and predominantly ethnic Muslim secondary school students attending 10 schools in central Bosnia who
reported severe symptoms of posttraumatic stress disorder (PTSD), depression, or maladaptive grief and significant impairment in school or
relationships were randomly assigned to one of two experimental conditions. These included either an active-treatment comparison condition (tier 1),
consisting of a classroom-based psychoeducation and skills intervention alone (n = 61, 66% girls, mean age 16.0 years, SD 1.13) or a treatment
condition composed of both the classroom-based intervention and a 17-session manual-based group therapy intervention (tier 2), trauma and grief
component therapy for adolescents (n = 66, 63% girls, mean age 15.9 years, SD 1.11). Both interventions were implemented throughout the school year.
Distressed students who were excluded from the study due to acute risk for harm (n = 9) were referred for community-based mental health services
(tier 3).\rResults\r\rProgram effectiveness was measured via reductions in symptoms of PTSD, depression, and maladaptive grief assessed at
pretreatment, posttreatment, and 4-month follow-up. Analysis of mean-level treatment effects showed significant pre- to posttreatment and
posttreatment to 4-month follow-up reductions in PTSD and depression symptoms in both the treatment and comparison conditions. Significant pre- to
posttreatment reductions in maladaptive grief reactions were found only in the treatment condition. Analyzed at the individual case level, the
percentages of students in the treatment condition who reported significant (p < .05) pre- to posttreatment reductions in PTSD symptoms (58% at
posttreatment, 81% at 4-month follow-up) compare favorably to those reported in controlled treatment efficacy trials, whereas the percentages who
reported significant reductions in depression symptoms (23% at posttreatment, 61% at follow-up) are comparable to, or higher than, those found in
community treatment settings. Lower but substantial percentages of significant symptom reduction were found for PTSD (33% at posttreatment, 48% at
follow-up) and depression symptoms (13% at posttreatment; 47% at follow-up) in students in the comparison condition. The odds of significant symptom
reduction were higher for PTSD symptoms at both posttreatment and 4-month follow-up and for maladaptive grief at posttreatment (no follow-up was
conducted on maladaptive grief). Rates of significantly worsened cases were generally rare in both the treatment and comparison conditions.
\rConclusions\r\rA three-tiered, integrative mental health program composed of schoolwide dissemination of psychoeducation and coping skills (tier
1), specialized trauma- and grief-focused intervention for severely traumatized and traumatically bereaved youths (tier 2), and referral of youths at
acute risk for community-based mental health services (tier 3) constitutes an effective and efficient method for promoting adolescent recovery in
postwar settings. J. Am. Acad. Child Adolesc. Psychiatry, 2008; 47(9): 1048 - 1062.
Journal of the American Academy of
Child & Adolescent Psychiatry, 47(9) : 1048-1062.
- Year: 2008
- Problem: Post Traumatic Stress Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Skills training, Other Psychological Interventions
Gordon, J.
S., Staples, J. K., Blyta, A., Bytyqi, M., Wilson, A. T.
Objective: To determine whether participation in a mind-body skills group program based on
psychological self-care, mind-body techniques, and self-expression decreases symptoms of posttraumatic stress disorder (PTSD). Method: Eighty-two
adolescents meeting criteria for PTSD according to the Harvard Trauma Questionnaire (which corresponds with 16 of the 17 diagnostic criteria for PTSD
in DSM-IV) were randomly assigned to a 12-session mind-body group program or a wait-list control group. The program was conducted by high school
teachers in consultation with psychiatrists and psychologists and included meditation, guided imagery, and breathing techniques; self-expression
through words, drawings, and movement; autogenic training and biofeedback; and genograms. Changes in PTSD symptoms were measured using the Harvard
Trauma Questionnaire. The study was conducted from September 2004 to May 2005 by The Center for Mind-Body Medicine at a high school in the Suhareka
region of Kosovo. Results: Students in the immediate intervention group had significantly lower PTSD symptom scores following the intervention than
those in the wait-list control group (F = 29.8, df = 1,76; p < .001). Preintervention and postintervention scores (mean [SD]) for the intervention
group were 2.5 (0.3) and 2.0 (0.3), respectively, and for the control group, 2.5 (0.3) and 2.4 (0.4), respectively. The decreased PTSD symptom scores
were maintained in the initial intervention group at 3-month follow-up. After the wait-list control group received the intervention, there was a
significant decrease (p < .001) in PTSD symptom scores compared to the preintervention scores. Conclusions: Mind-body skills groups can reduce PTSD
symptoms in war-traumatized high school students and can be effectively led by trained and supervised schoolteachers. Trial Registration:
clinicaltrials.gov Identifier: NCT00136357. copyright Copyright 2008 Physicians Postgraduate Press, Inc.
Journal of Clinical Psychiatry., 69(9) : 1469-
1476
- Year: 2008
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Biofeedback, neurofeedback, audio/video feedback, Creative expression: music, dance, drama, art, Meditation
Tol, Wietse A., Komproe, Ivan H., Susanty, Dessy, Jordans, Mark J. D., Macy, Robert D., De ong, Joop T. V. M.
Context: Objective: Design, Setting, and Participants: Intervention: Main Outcome Measures: Results: Conclusions:
Trial Registration: Little is known about the efficacy of mental health interventions for children exposed to armed conflicts in low- and middle-
income settings. Childhood mental health problems are difficult to address in situations of ongoing poverty and political instability.To assess the
efficacy of a school-based intervention designed for conflict-exposed children, implemented in a low-income setting.A cluster randomized trial
involving 495 children (81.4% inclusion rate) who were a mean (SD) age of 9.9 (1.3) years, were attending randomly selected schools in political
violence-affected communities in Poso, Indonesia, and were screened for exposure (> or = 1 events), posttraumatic stress disorder, and anxiety
symptoms compared with a wait-listed control group. Nonblinded assessment took place before, 1 week after, and 6 months after treatment between March
and December 2006.Fifteen sessions, over 5 weeks, of a manualized, school-based group intervention, including trauma-processing activities,
cooperative play, and creative-expressive elements, implemented by locally trained paraprofessionals.We assessed psychiatric symptoms using the Child
Posttraumatic Stress Scale, Depression Self-Rating Scale, the Self-Report for Anxiety Related Disorders 5-item version, and the Children's Hope
Scale, and assessed function impairment as treatment outcomes using standardized symptom checklists and locally developed rating scales.Correcting
for clustering of participants within schools, we found significantly more improvement in posttraumatic stress disorder symptoms (mean change
difference, 2.78; 95% confidence interval [CI], 1.02 to 4.53) and maintained hope (mean change difference, -2.21; 95% CI, -3.52 to -0.91) in the
treatment group than in the wait-listed group. Changes in traumatic idioms (stress-related physical symptoms) (mean change difference, 0.50; 95% CI,
-0.12 to 1.11), depressive symptoms (mean change difference, 0.70; 95% CI, -0.08 to 1.49), anxiety (mean change difference, 0.12; 95% CI, -0.31 to
0.56), and functioning (mean change difference, 0.52; 95% CI, -0.43 to 1.46) were not different between the treatment and wait-listed groups.In this
study of children in violence-affected communities, a school-based intervention reduced posttraumatic stress symptoms and helped maintain hope, but
did not reduce traumatic-stress related symptoms, depressive symptoms, anxiety symptoms, or functional impairment.isrctn.org Identifier:
ISRCTN25172408.
JAMA, 300(6) : 655-
662
- Year: 2008
- 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
Ahmad, A., Sundelin-Wahlsten, V.
Objective: To find out child-adjusted protocol for eye movement desensitization and reprocessing (EMDR). Method: Child-adjusted
modification were made in the original adult-based protocol, and within-session measurements, when EMDR was used in a randomized controlled trial
(RCT) on thirty-three 6-16-year-old children with post-traumatic stress disorder (PTSD). Results: EMDR was applicable after certain modifications
adjusted to the age and developmental level of the child. The average treatment effect size was largest on re-experiencing, and smallest on
hyperarousal scale. The age of the child yielded no significant effects on the dependent variables in the study. Conclusions: A child-adjusted
protocol for EMDR is suggested after being applied in a RCT for PTSD among traumatized and psychosocially exposed children. copyright 2007 Steinkopff
Verlag Darmstadt.
European Child & Adolescent
Psychiatry., 17(3) : 127-132
- Year: 2008
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Eye movement desensitisation and reprocessing (EMDR)
Ahmad,
A., Larsson, B., Sundelin-Wahlsten, V.
The objective of the study was to examine the efficacy of EMDR treatment for children with post-traumatic
stress disorder (PTSD) compared with untreated children in a waiting list control group (WLC) participating in a randomized controlled superiority
trial (RCT). Thirty-three 6-16-year-old children with a DSM-IV diagnosis of PTSD were randomly assigned to eight weekly EMDR sessions or the WLC
group. The Posttraumatic Stress Symptom Scale for Children (PTSS-C scale) was used in interviews with children to evaluate their symptoms and
outcome. Post-treatment scores of the EMDR group were significantly lower than the WLC indicating improvement in total PTSS-C scores, PTSD-related
symptom scale, and the subscales re-experiencing and avoidance among subjects in the EMDR group, while untreated children improved in PTSD-non-
related symptom scale. The improvement in re-experiencing symptoms proved to be the most significant between-group difference over time. The results
of the present exploratory study including a limited number of children with PTSD are encouraging and warrant further controlled studies of larger
samples of children suffering from PTSD.
Nordic Journal of Psychiatry, 61(5) : 349-354
- Year: 2007
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Eye movement desensitisation and reprocessing (EMDR)
Berger,
R., Pat-Horenczyk, R., Gelkopf, M.
A
school-based intervention for preventing and reducing children's posttraumatic stress-related symptoms, somatic complaints, functional impairment,
and anxiety due to exposure to terrorism was evaluated. In a quasi-randomized controlled trial, elementary school students were randomly assigned to
an eight-session structured program, \"Overshadowing the Threat of Terrorism\" or to a waiting list control comparison group. Two months
postintervention, the study group reported significant improvement on all measures. The authors conclude that a school-based universal intervention
may significantly reduce posttraumatic stress disorder- (PTSD-) related symptoms in children repeatedly exposed to terrorist attacks and propose that
it serve as a component of a public mental health approach dealing with children exposed to ongoing terrorism in a country ravaged by war and
terrorism. copyright 2007 International Society for Traumatic Stress Studies.
Journal of Traumatic
Stress., 20(4) : 541-551
- Year: 2007
- 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
Cohen, Judith A., Mannarino, Anthony P., Perel, James M., Staron, Virginia
Objective: To examine the potential benefits
of adding a selective serotonin reuptake inhibitor, sertraline, versus placebo, to trauma-focused cognitive-behavioral therapy (TF-CBT) for improving
posttraumatic stress disorder and related psychological symptoms in children who have experienced sexual abuse. Method: Twenty-four 10- to 17-year-
old female children and adolescents and their primary caretakers were randomly assigned to receive TF-CBT + sertraline or TF-CBT + placebo for 12
weeks. Results: Both groups experienced significant improvement in posttraumatic stress disorder and other clinical outcomes from pre- to
posttreatment with no significant group x time differences between groups except in Child Global Assessment Scale ratings, which favored the TF-CBT +
sertraline group. Conclusions: Only minimal evidence suggests a benefit to adding sertraline to TF-CBT. A drawback of adding sertraline was
determining whether TF-CBT or sertraline caused clinical improvement for children with comorbid depression. Current evidence therefore supports an
initial trial of TF-CBT or other evidence-supported psychotherapy for most children with PTSD symptoms before adding medication. (PsycINFO Database
Record (c) 2008 APA, all rights reserved) (journal abstract).
Journal of the American Academy of Child & Adolescent
Psychiatry, 46(7) : 811-819
- Year: 2007
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Psychological Interventions
(any), Trauma-focused cognitive behavioural therapy (TF-
CBT)
Resnick, Heidi, Acierno, Ron, Waldrop, Angela E., King, Lynda, King, Daniel, Danielson, Carla, Ruggiero,
Kenneth J., Kilpatrick, Dean
A randomized between-group design was used to evaluate the efficacy of a video intervention to reduce
post-traumatic stress disorder (PTSD) and other mental health problems, implemented prior to the forensic medical examination conducted within 72 h
post-sexual assault. Participants were 140 female victims of sexual assault (68 video/72 nonvideo) aged 15 years or older. Assessments were targeted
for 6 weeks (Time 1) and 6 months (Time 2) post-assault. At Time 1, the intervention was associated with lower scores on measures of PTSD and
depression among women with a prior rape history relative to scores among women with a prior rape history in the standard care condition. At Time 2,
depression scores were also lower among those with a prior rape history who were in the video relative to the standard care condition. Small effects
indicating higher PTSD and Beck Anxiety Inventory (BAI) scores among women without a prior rape history in the video condition were observed at Time
1. Accelerated longitudinal growth curve analysis indicated a videoxprior rape history interaction for PTSD, yielding four patterns of symptom
trajectory over time. Women with a prior rape history in the video condition generally maintained the lowest level of symptoms.
Behaviour Research & Therapy, 45(10) : 2432-
47
- Year: 2007
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation