Disorders - Post Traumatic Stress Disorder
John-Baptiste-Bastien, R., Jongsma, H. E., Kabadayi, M., Billings, J.
BACKGROUND: Children and adolescents display different symptoms of post-traumatic stress disorder (PTSD) than adults. Whilst
evidence for the effectiveness of psychological interventions has been synthesised for adults, this is not directly applicable to younger people.
Therefore, this systematic review and meta-analysis synthesised studies investigating the effectiveness of psychological interventions for PTSD in
children, adolescents and young adults. It provides an update to previous reviews investigating interventions in children and adolescents, whilst
investigating young adults for the first time. METHOD(S): We searched published and grey literature to obtain randomised control trials assessing
psychological interventions for PTSD in young people published between 2011 and 2019. Quality of studies was assessed using the Cochrane Risk of Bias
tool. Data were analysed using univariate random-effects meta-analysis. RESULT(S): From 15 373 records, 27 met criteria for inclusion, and 16 were
eligible for meta-analysis. There was a medium pooled effect size for all psychological interventions (d = -0.44, 95% CI -0.68 to -0.20), as well as
for Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) and Eye Movement Desensitisation and Reprocessing (EMDR) (d = -0.30, 95% CI -0.58 to -
0.02); d = -0.46, 95% CI -0.81 to -0.12). CONCLUSION(S): Some, but not all, psychological interventions commonly used to treat PTSD in adults were
effective in children, adolescents and young adults. Interventions specifically adapted for younger people were also effective. Our results support
the National Institute for Health and Care Excellence guidelines which suggest children and adolescents be offered TF-CBT as a first-line treatment
because of a larger evidence base, despite EMDR being more effective.
Psychological medicine, 50(10) : 1598-
1612
- Year: 2020
- Problem: Post Traumatic Stress Disorder
- Type: Systematic reviews
-
Stage: 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)
Hirai, M., Dolma, S., Vernon, L. L., Clum, G. A.
Objective: Although expressive writing (EW) appears efficacious for treating a range of
posttraumatic stress (PTS) symptoms including diagnosed PTSD, little is known about its efficacy when offered online and for ethnic/cultural minority
populations such as Hispanic individuals. The current study examined the longitudinal effects of two online EW tasks for treating PTS symptoms in a
Hispanic student sample. Design(s): Seventy-one participants who had experienced a traumatic event were randomly assigned to either an emotion-
focused (EM) writing group or a fact-focused (FC) writing group and completed online writing sessions for three consecutive days. Participants
completed online assessments at 1-week, 1-month, and 3-month follow-ups. The PTSD Checklist-DSM-5 version was used to assess PTS symptoms. Result(s):
Both groups reported statistically significant reductions in severity of PTS symptoms at 1-week follow-up with the EM group demonstrating
statistically significantly greater symptom reductions than the FC group. Differential longitudinal effects over the 3-month follow-up periods were
found for some PTS domains, with the EM group showing superior improvements relative to the FC group. Conclusion(s): EW delivered online can be
useful for Hispanic individuals with PTS symptoms following traumatic life events. Further, the current findings align with an inhibitory learning
model for explaining EW's mechanism of action.
Psychology & health, 35(12) : 1459-
1476
- Year: 2020
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Creative expression: music, dance, drama, art
Carrion, V. G.
Objectives: Cue-centered therapy (CCT) is a manualized treatment designed to reduce posttraumatic stress symptoms in children
exposed to chronic violence. The purpose of this study is threefold: 1) conduct a randomized trial contrasting CCT to trauma-focused CBT (TF-CBT) and
treatment as usual (TAU); 2) conduct a longitudinal assessment with evaluations before treatment (T1), midtreatment (T2), and posttreatment (T3), and
at 3-month follow-up; and 3) assess for symptomatic improvements, supplementing clinical measures with functional near-infrared spectroscopy (fNIRS)
evaluations. Method(s): This community-based study enrolled 73 children (27 males; 46 females) aged 7-17 years (M = 12.9, SD = 3.1) exposed to
chronic violence who endorsed posttraumatic symptoms on the University of California, Los Angeles PTSD Reaction Index (UCLA-RI). Subjects were
randomized to 1 of 3 treatment conditions: CCT (n = 25), TF-CBT (n = 22), or TAU (n = 26). Measures included the Behavior Rating Inventory of
Executive Function (BRIEF), the Multiaxial Anxiety Scale for Children (MASC), and the Children's Depression Inventory (CDI). A total of 53 subjects
have at least 2 evaluation times, and 17 of these subjects have T3 data and were included in these preliminary analyses. Result(s): There were no
statistically significant differences in baseline variables across groups. Dependent sample t-tests indicated significant pre-post differences
between total scores on the UCLA-RI for CCT (t(5) = 3.4; p = 0.01; D = 1.39) and TF-CBT (t(6) = 2.85; p = 0.02; D = 1.08), but not for TAU (t(5) =
0.5; p = 0.6). Pre (M = 59.6, SD = 14.6) and post (M = 52.3, SD = 12.9) differences were also significant (t(7) = 3.0; p = 0.01; D = 0.52) on MASC
total scores for TF-CBT. Although the total score on the MASC dropped between pre (M = 56.5, SD = 7.0) and post (M = 46.2, SD = 9.8) for CCT, the
result was not significant (t(6) = 2.1; p = 0.07; D = 1.2). There were no significant pre-post differences across groups on the CDI or BRIEF.
Conclusion(s): These data indicate that both CCT and TF-CBT improve posttraumatic and anxiety symptoms in children with a history of interpersonal
violence. The significance of effect sizes will be discussed. fNIRS results on executive function will supplement BRIEF results. PTSD, P, IMAGS
Copyright © 2020
Journal of the American Academy of Child and Adolescent Psychiatry, 59 (10
Supplement) : S323
- Year: 2020
- 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), Other Psychological Interventions, Trauma-focused cognitive behavioural therapy (TF-
CBT)
Bennett, R. S., Denne, M., McGuire,
R., Hiller, R. M.
Child maltreatment is associated with elevated risk of post-traumatic stress disorder
(PTSD), which can often present alongside comorbidities. While evidence-based treatments for PTSD in young people already exist, there remains
ongoing clinical and academic debate about the suitability of these approaches, particularly cognitive-behavioral approaches, for young people who
have been exposed to more complex traumatic experiences, such as maltreatment. We conducted an updated systematic review of the evidence-base for
psychological treatments for PTSD, specifically for maltreated young people. Fifteen randomized controlled trials and five non-randomized controlled
clinical trials satisfied the inclusion criteria. Trials included treatments ranging from trauma-focused CBT to creative-based therapies. Trauma-
focused CBT remained the best supported treatment for children and adolescents following child maltreatment, with new evidence that symptom
improvements are maintained at longer-term follow up. The evidence for other therapies remained limited, and there were concerns regarding
methodological quality. Implications for treatment decision-making are discussed.
Child
maltreatment, : 1077559520961176
- Year: 2020
- Problem: Post Traumatic Stress Disorder
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Exposure therapy, Exposure
and response prevention, Other Psychological Interventions, Trauma-focused cognitive behavioural therapy (TF-
CBT), Creative expression: music, dance, drama, art, Other complementary & alternative
interventions
Barron, I., Freitas, F., Bosch, C. A.
The study aimed to evaluate Teaching Recovery
Techniques (TRT) delivered to Brazilian youth who experienced drug violence in one Favela. Thirty children, 8 to 14 years, were randomly assigned to
TRT (n = 14) or to a treatment as usual group (n = 16) involving boxing/martial arts. Youth received five 90-min sessions over successive weeks.
Standardized measures assessed Posttraumatic Stress and Depression at 2 weeks pre and post-test. An exploratory assessment of posttraumatic growth
was also utilized. An interview with group leaders explored perceptions of delivering TRT within the favela. Medium effect sizes were found for PTSD
and Depression, and a small effect size for posttraumatic growth. Group leaders emphasized understanding the favela context for program adaptation.
In conclusion, TRT was found to be effective for children with PTSD and Depression who experienced drug violence in a Brazilian favela. TRT is
recommended for future delivery. Larger scale RCTs are needed in Brazilian favelas. Copyright © 2020, Springer Nature Switzerland AG.
Journal of Child and Adolescent
Trauma., :
- Year: 2020
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Ali, A. S. S.
A.
Background: The number of individuals displaced from their original countries due to civil wars, hunger, disasters, and international wars
is increasing worldwide day by day. These refugees are more vulnerable to Post-Traumatic Stress Disorder (PTSD). Objective(s): The present study
aimed to examine the effectiveness of the intervention program in improving the well-being and reducing Post-Traumatic Stress Disorder (PTSD) among a
sample of Syrian refugee women in Jordan who had been displaced due to civil wars in Syria. Method(s): The study recruited 40 Syrian refugee females
in Jordan who were psychologically challenged, with high PTSD symptoms (assessed by PCL) and a psychological well-being impairment (assessed by PWD).
The culture of Jordanian society discriminates and affects the Syrian refugee women, rendering them vulnerable to PTSD. Quasi-experimental design was
used, wherein the participants were randomly distributed in experimental and control groups (n=20/group). The control group members did not receive
any services related to psychological support or psychiatric medications, while the experimental group underwent a counseling program. Result(s): The
present study demonstrated that the intervention program improves the well-being and reduces PTSD among the Syrian refugee women who constituted the
experimental group. The intervention program and the PTSD manifestation were not affected by age. The present study recommended that the program be
applied to the refugees in Jordan to improve the well-being of the women in the residential areas. Conclusion(s): Furthermore, an intervention on the
Jordanian cultural impact on the refugee camps was also essential if the condition for the female refugees worsened. Lastly, the effect of Jordanian
culture on Syrian refugees should be investigated since the literature presented a negative impact. Copyright © 2020 Ahmad Sa'ad Saleh Alsheikh
Ali.
Clinical Practice and Epidemiology in Mental Health, 16(Supplement 1) : 134-
141
- Year: 2020
- 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
Pfefferbaum, B., Nitiema, P., Newman, E., Patel, A.
Numerous interventions to address posttraumatic stress (PTS) in youth exposed to mass
trauma have been delivered and evaluated. It remains unclear, however, which interventions work for whom and under what conditions. This report
describes a meta-analysis of the effect of youth mass-trauma interventions on PTS to determine if interventions were superior to inactive controls
and describes a moderator analysis to examine whether the type of event, population characteristics, or income level of the country where the
intervention was delivered may have affected the observed effect sizes. A comprehensive literature search identified randomized controlled trials
(RCTs) of youth mass-trauma interventions relative to inactive controls. The search identified 2,232 references, of which 25 RCTs examining 27 trials
(N = 4,662 participants) were included in this meta-analysis. Intervention effects were computed as Hedge's g estimates and combined using a random
effects model. Moderator analyses were conducted to explain the observed heterogeneity among effect sizes using the following independent variables:
disaster type (political violence versus natural disaster); sample type (targeted versus non-targeted); and income level of the country where the
intervention was delivered (high- versus middle- versus low-income). The correlation between the estimates of the intervention effects on PTS and on
functional impairment was estimated. The overall treatment effect size was converted into a number needed to treat (NNT) for a practical
interpretation. The overall intervention effect was statistically significant (g = 0.57; P < .0001), indicating that interventions had a medium
beneficial effect on PTS. None of the hypothesized moderators explained the heterogeneity among the intervention effects. Estimates of the
intervention effects on PTS and on functional impairment were positively correlated (Spearman's r = 0.90; P < .0001), indicating a concomitant
improvement in both outcomes. These findings confirm that interventions can alleviate PTS and enhance functioning in children exposed to mass trauma.
This study extends prior research by demonstrating improvement in PTS with interventions delivered to targeted and non-targeted populations,
regardless of the country income level. Intervention populations and available resources should be considered when interpreting the results of
intervention studies to inform recommendations for practice.
Prehospital and disaster medicine, 34(5) : 540-
551
- Year: 2019
- Problem: Post Traumatic Stress Disorder
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any)
Barron, I. G., Bourgaize, C., Lempertz, D., Swinden, C., Darker-Smith, S.
There is currently a limited number of studies into the efficacy of eye movement
desensitization reprocessing (EMDR) therapy with children and adolescents with posttraumatic stress disorder (PTSD). The current study utilizes a
systematic narrative review of methodologies and findings of previous literature reviews and meta-analyses as well as analyzing randomized control
trials (RCTs) conducted from 2002 to 2018. Following initial scoping of the extent of studies, two systematic literature searches were conducted,
firstly for literature reviews and secondly for recent RCTs. Nine databases were utilized. Eight reviews and seven RCTs were identified and analyzed
for quality of methodology and outcome as measured by impact on PTSD symptoms. EMDR was found to be efficacious in reducing children's PTSD symptoms
compared to waitlist conditions, with similar outcomes to cognitive behavior therapy (CBT). EMDR was effective with both single-event trauma as well
as cumulative trauma such as sexual abuse. EMDR was equally effective with girls and boys as well as children from different cultures. EMDR achieved
medium to large effect sizes. Reductions in PTSD were maintained at 2-, 3-, 6-, and 12-month follow-up. In conclusion, EMDR was consistently found to
be an efficacious treatment for children with PTSD. Recommendations are made for future practice and research. (PsycInfo Database Record (c) 2020
APA, all rights reserved)
Journal of EMDR Practice and Research, 13(4) : 270-
283
- Year: 2019
- 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)
Jones, M. G., Rice, S. M., Cotton, S. M.
Introduction As interest in Animal-Assisted Interventions (AAI) grows, there is
increasing need to differentiate informal activities from formal and professionally directed therapies, including mental health focussed Canine-
Assisted Psychotherapy (CAP). There have been no reviews focusing exclusively on CAP and the distinct developmental period of adolescence. The aims
of this study were to identify the characteristics of CAP interventions, their impacts and their acceptability, tolerability and feasibility for
adolescents with mental health disorders. Method A systematic review identified studies incorporating canines into mental health treatments for
adolescents aged 10-19 years. Studies reporting qualitative or quantitative psychological or psychosocial outcomes were included. Results Seven
studies were scrutinised. Intervention characteristics varied, including a range of formats, settings, locations, doses, and facilitators.
Information on the role of the canines in sessions was sparse. CAP had a positive impact on primary diagnoses and symptomatology, conferring
additional benefits to standard treatments for internalising disorders, post-traumatic stress disorder, and equivalent effects for anxiety, anger and
externalising disorders. CAP was associated with positive impacts on secondary factors including increased engagement and socialisation behaviours,
and reductions in disruptive behaviours within treatment sessions. Global functioning also improved. There was insufficient evidence that CAP
improved factors associated with self-esteem, subjective wellbeing, or coping. Good attendance and retention rates indicated high levels of
acceptability. Moderate to high tolerability was also indicated. Feasibility may be limited by additional training and logistical requirements.
Recommendations We recommend the development of theoretically informed, standardised (manualised) intervention protocols that may subsequently form
the basis of efficacy and effectiveness testing. Such protocols should clearly describe canine-participant-facilitator interactions via a for-malised
nomenclature; spontaneous (animal-led), adjunctive (facilitator-led), and experiential (participant-led). Conclusions There is emerging evidence to
suggest that CAP improves the efficacy of mental health treatments in self-selected adolescent populations via reductions in primary symptomatology,
and via secondary factors that improve therapeutic processes and quality, such as engagement and retention. Copyright © 2019 Jones et al. This is an
open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are credited.
PLoS ONE, 14 (1) (no
pagination)(e0210761) :
- Year: 2019
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Other complementary & alternative
interventions
Strohm,
M., Siegesleitner, M., Kunze, A. E., Ehring, T., Wittekind, C. E.
Imagery rescripting (ImRs) has been shown to be a promising intervention for
aversive emotional memories, but research on underlying mechanisms is only in its beginnings. Previous analogue studies on ImRs were mainly based on
the trauma film paradigm, but the personal relevance of film-induced memories is limited. Therefore, the present study aimed to investigate the
effects of ImRs on personally relevant autobiographical memories. Sixty-five participants who had experienced a distressing life-event were randomly
assigned to ImRs or no-intervention control (NIC). ImRs led to less intrusive memories than NIC during the 1-week follow-up period, but was not
superior in reducing overall event-related stress symptoms. When retrieving the memory after 1 week, ImRs participants reported greater reductions in
sadness and distress, and higher feelings of mastery. Findings underline the potential of the paradigm used in this study to test memory processes
involved in ImRs. Limitations and modifications of the paradigm are discussed. Copyright © 2019, Springer Science+Business Media, LLC, part of
Springer Nature.
Cognitive Therapy and Research., 43 : 1005 - 1017
- Year: 2019
- 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
Norton, C. L., Tucker, A., Farnham-Stratton, M., Borroel, F., Pelletier, A.
Child abuse is epidemic in the United States and has dire long-term consequences. Innovative
interventions are needed to address the negative cognitive, affective and behavioral effects of child abuse. This mixed-method study examined if
adventure therapy is 1) an effective mental health intervention for child and adolescent survivors of abuse and neglect, and 2) an effective
intervention for families affected by abuse and neglect. The effectiveness of the adventure therapy intervention was measured by a reduction in child
trauma symptoms and improved family functioning, as reported via the Trauma Symptom Checklist for Children (TSCC), the Family Assessment Device
(FAD), as well as qualitative data gathered via family focus groups. Findings showed that trauma-informed adventure therapy with youth and families
affected by abuse reduces trauma symptomology in youth and improves family functioning, particularly in the areas of communication, closeness and
problem-solving skills. Copyright © 2017, Springer International Publishing.
Journal of Child and Adolescent Trauma, 12(1) : 85-
95
- Year: 2019
- Problem: Post Traumatic Stress Disorder
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Other Psychological Interventions, Physical activity, exercise, Other complementary & alternative
interventions
Vinke, Y. D., Truijens, F., van-Polanen Petel, E., van-Emmerik, A.
A. P.
OBJECTIVE: This online study
examined the effects of a single imaginal exposure-writing assignment on posttraumatic stress (PTS) and comorbid depressive symptoms. METHOD(S):
Forty-six participants with PTS were allocated to either a single imaginal exposure-writing assignment, a nontrauma writing assignment, or to a
nonwriting control condition, and were reassessed 2 and 5 weeks after baseline. Of the 49 participants, 36 were female, with an average age of 23.
Participation was conducted through Qualtrics. Effects were assessed with the Posttraumatic Diagnostic Scale (PDS) and the Beck Depression
Inventory-II (BDI-II). RESULT(S): PTS and depressive symptoms decreased over time regardless of the study condition. CONCLUSION(S): We found no
support for the efficacy of a single imaginal exposure-writing assignment in reducing PTS or comorbid depressive symptoms. Suggestions are given for
future studies that attempt to identify a minimal dose of imaginal exposure writing for PTS. Copyright © 2019 Wiley Periodicals, Inc.
Journal of clinical
psychology., :
- Year: 2019
- Problem: Post Traumatic Stress Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions, Self-help