Efficacy of psychological interventions for post-traumatic stress disorder in children and adolescents exposed to single versus multiple traumas: Meta-analysis of randomised controlled trials

Efficacy of psychological interventions for post-traumatic stress disorder in children and adolescents exposed to single versus multiple traumas: Meta-analysis of randomised controlled trials

Authors
Hoppen, T. H. Meiser-Stedman, R. Jensen, T. K. Birkeland, M. S. Morina, N.
Year
2023
Journal
The British Journal of Psychiatry
Volume
Pages
No Pagination Specified
Background Previous meta-analyses of psychotherapies for children and adolescents with post-traumatic stress disorder (PTSD) did not investigate whether treatment efficacy is diminished when patients report multiple (versus single) traumas. Aims To examine whether efficacy of psychological interventions for paediatric PTSD is diminished when patients report multiple (versus single) traumas. Method We systematically searched PsycInfo, MEDLINE, Web of Science and PTSDpubs on 21 April 2022 and included randomised controlled trials (RCTs) meeting the following criteria: (a) random allocation; (b) all participants presented with partial or full PTSD; (c) PTSD is the primary treatment focus; (d) sample mean age <19 years; (e) sample size n >= 20. Trauma frequency was analysed as a dichotomous (single versus >=2 traumas) and continuous (mean number of exposures) potential moderator of efficacy. Results Of the 57 eligible RCTs (n = 4295), 51 RCTs were included in quantitative analyses. Relative to passive control conditions, interventions were found effective for single-trauma-related PTSD (Hedges' g = 1.09; 95% CI 0.70-1.48; k = 8 trials) and multiple-trauma-related PTSD (g = 1.11; 95% CI 0.74-1.47; k = 12). Psychotherapies were also more effective than active control conditions in reducing multiple-trauma-related PTSD. Comparison with active control conditions regarding single-event PTSD was not possible owing to scarcity (k = 1) of available trials. Efficacy did not differ with trauma exposure frequency irrespective of its operationalisation and subgroup analyses (e.g. trauma-focused cognitive-behavioural therapy only). Conclusions The current evidence base suggests that psychological interventions for paediatric PTSD can effectively treat PTSD in populations reporting single and multiple traumas. Future trials for PTSD following single-event trauma need to involve active control conditions. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

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Type of intervention

Treatment and Child Welfare Interventions

Topic

Mental Health Problems and Disorders

Anxiety Problems

Trauma/ Post-traumatic Stress Disorder (PTSD)

Intervention

Psychological Treatments

Cognitive Behavioral Therapy, Behavioral Therapy and Cognitive Therapy

Age group

School Aged Children (6-12 years)

Adolescents (13-18 years)

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