School of Psychology, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
J Abnorm Child Psychol. 2012 Apr;40(3):327-37. doi: 10.1007/s10802-011-9566-7.
The present study compared the efficacy of trauma-focused cognitive behavior therapy (CBT) with trauma-focused cognitive therapy (without exposure; CT) for children and youth with posttraumatic stress disorder (PTSD). Children and youth who had experienced single-incident trauma (N = 33; 7-17 years old) were randomly assigned to receive 9 weeks of either CBT or CT which was administered individually to children and their parents. Intent-to-treat analyses demonstrated that both interventions significantly reduced severity of PTSD, depression, and general anxiety. At posttreatment 65% of CBT and 56% of the CT group no longer met criteria for PTSD. Treatment completers showed a better response (CBT: 91%; CT: 90%), and gains were maintained at 6-month follow-up. Maternal depressive symptoms and unhelpful trauma beliefs moderated children's outcome. It is concluded that PTSD secondary to single-incident trauma can be successfully treated with trauma-focused cognitive behavioural methods and the use of exposure is not a prerequisite for good outcome.
本研究比较了创伤焦点认知行为疗法(CBT)与创伤焦点认知疗法(无暴露;CT)治疗创伤后应激障碍(PTSD)儿童和青少年的疗效。经历单一事件创伤的儿童和青少年(N=33;7-17 岁)被随机分配接受 9 周的 CBT 或 CT,CBT 和 CT 均单独对儿童及其父母进行。意向性治疗分析表明,两种干预措施均显著降低了 PTSD、抑郁和广泛性焦虑的严重程度。在治疗后,65%的 CBT 组和 56%的 CT 组不再符合 PTSD 标准。治疗完成者的反应更好(CBT:91%;CT:90%),并且在 6 个月的随访中仍保持疗效。母亲抑郁症状和无益的创伤信念会影响儿童的治疗效果。结论是,单一事件创伤引起的 PTSD 可以成功地用创伤焦点认知行为方法治疗,并且暴露的使用不是取得良好效果的先决条件。