Centre of National Research on Disability and Rehabilitation Medicine, School of Medicine, University of Queensland, Herston QLD 4029, Australia.
BMC Psychiatry. 2010 Nov 16;10:92. doi: 10.1186/1471-244X-10-92.
Accidental injury represents the most common type of traumatic event to which a child or adolescent may be exposed, with a significant number of these children going on to experience posttraumatic stress disorder (PTSD). However, very little research has examined potential interventions for the treatment of PTSD in these children. The present trial aims to evaluate and compare child- and family-focused versions of a cognitive-behavioural early intervention for PTSD following accidental injury.
METHODS/DESIGN: The principal clinical question under investigation is the efficacy of an early, trauma-focused cognitive-behavioural intervention for the treatment of PTSD in children following accidental injury. Specifically, we compare the efficacy of two active treatments (child-focused and family-focused CBT) and a waitlist control (no therapy) to determine which is associated with greater reductions in psychological and health-related outcome measures over time. The primary outcome will be a reduction in trauma symptoms on a diagnostic interview in the active treatments compared to the waitlist control and greater reductions in the family-compared to the child-focused condition. In doing so, this project will also trial a method of stepped screening and assessment to determine those children requiring early intervention for PTSD following accidental injury.
The present trial will be one of the first controlled trials to examine a trauma-focused CBT, early intervention for children experiencing PTSD following accidental injury (as opposed to other types of traumatic events) and the first within a stepped care approach. In addition, it will provide the first evidence comparing the efficacy of child and family-focused interventions for this target group. Given the significant number of children and adolescents exposed to accidental injury, the successful implementation of this protocol has considerable implications. If efficacious, this early intervention will assist in reducing symptoms of traumatic stress as well as preventing chronic disorder and disability in children experiencing acute PTSD following accidental injury.
Controlled-trials.com: ISRCTN79049138.
意外伤害是儿童或青少年可能遭遇的最常见的创伤性事件类型，其中相当一部分儿童会发展为创伤后应激障碍（PTSD）。然而，很少有研究探讨针对这些儿童 PTSD 的潜在治疗干预措施。本试验旨在评估和比较针对意外伤害后 PTSD 的以儿童和家庭为中心的认知行为早期干预措施。
方法/设计：正在调查的主要临床问题是针对意外伤害后 PTSD 的早期、以创伤为中心的认知行为干预的疗效。具体而言，我们比较两种积极治疗（以儿童为中心和以家庭为中心的 CBT）和等待名单对照（无治疗）的疗效，以确定哪种治疗与随着时间的推移心理和健康相关结果测量的减少更相关。主要结局将是在活跃治疗中与等待名单对照相比，创伤症状在诊断访谈中的减少，以及与以儿童为中心的条件相比，家庭条件的减少。通过这样做，该项目还将试验一种逐步筛查和评估方法，以确定那些需要对意外伤害后 PTSD 进行早期干预的儿童。
本试验将是首次对照试验之一，研究针对意外伤害后经历 PTSD 的儿童的以创伤为中心的认知行为、早期干预（而不是其他类型的创伤事件），也是首次采用阶梯式护理方法。此外，它将为比较针对该目标群体的以儿童和家庭为中心的干预措施的疗效提供首次证据。鉴于大量儿童和青少年遭受意外伤害，成功实施该方案具有重要意义。如果有效，这种早期干预将有助于减轻创伤性应激症状，并预防经历急性 PTSD 的儿童出现慢性障碍和残疾。
controlled-trials.com：ISRCTN79049138。
