Department of Psychiatry, University of Pennsylvania, USA Yale University Child Study Center, USA.
J Child Psychol Psychiatry. 2011 Jun;52(6):676-85. doi: 10.1111/j.1469-7610.2010.02321.x. Epub 2010 Sep 24.
This pilot study evaluated the effectiveness of a four-session, caregiver-child Intervention, the Child and Family Traumatic Stress Intervention (CFTSI), to prevent the development of chronic posttraumatic stress disorder (PTSD) provided within 30 days of exposure to a potentially traumatic event (PTE).
One-hundred seventy-six 7 to 17-year-old youth were recruited through telephone screening based on report of one new distressing posttraumatic stress symptom after a PTE. Of those, 106 youth were randomly assigned to the Intervention (n = 53) or a four-session supportive Comparison condition (N = 53). Group differences in symptom severity were assessed using repeated measures with mixed effects models of intervention group, time, and the interaction of intervention and time. Logistic regression analyses were performed to assess treatment condition and any subsequent traumas experienced as predictors for full and partial PTSD diagnosis at 3-month follow-up. An exploratory chi-square analysis was performed to examine the differences in PTSD symptom criteria B, C, and D at follow-up.
At baseline, youth in both groups had similar demographics, past trauma exposures and symptom severity. At follow-up, the Intervention group demonstrated significantly fewer full and partial PTSD diagnoses than the Comparison group on a standardized diagnostic measure of PTSD. Also, there was a significant group by time interaction for Trauma Symptom Checklist for Children's Posttraumatic Stress and Anxiety Indices as the CFTSI group had significantly lower posttraumatic and anxiety scores than the Comparison group.
The results suggest that a caregiver-youth, brief preventative early intervention for youth exposed to a PTE is a promising approach to preventing chronic PTSD.
本初步研究评估了四节、照顾者-儿童干预的有效性,即儿童和家庭创伤应激干预(CFTSI),以防止创伤后应激障碍(PTSD)的发展,该干预在经历潜在创伤事件(PTE)后 30 天内提供。
通过基于 PTSD 后新出现的令人痛苦的应激症状报告的电话筛选,招募了 176 名 7 至 17 岁的青少年。其中,106 名青少年被随机分配到干预组(n = 53)或四节支持性对照条件组(n = 53)。使用混合效应模型的重复测量,评估症状严重程度的组间差异,该模型包括干预组、时间以及干预和时间的相互作用。进行逻辑回归分析,以评估治疗条件和任何随后经历的创伤作为 3 个月随访时 PTSD 完全和部分诊断的预测因素。进行探索性卡方分析,以检查 PTSD 症状标准 B、C 和 D 在随访时的差异。
在基线时,两组青少年的人口统计学特征、既往创伤暴露和症状严重程度相似。在随访时,与对照条件组相比,干预组在 PTSD 的标准化诊断测量中,完全和部分 PTSD 的诊断明显更少。此外,创伤后应激障碍检查表儿童创伤后应激和焦虑指数的组间时间交互也具有统计学意义,因为 CFTSI 组的创伤后和焦虑评分明显低于对照条件组。
结果表明,针对经历 PTE 的青少年的 caregiver-youth、简短的预防性早期干预是预防慢性 PTSD 的一种有前途的方法。