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一项针对单一创伤后创伤后应激障碍儿童的认知行为疗法和认知疗法的随机试验。

A randomized trial of cognitive behaviour therapy and cognitive therapy for children with posttraumatic stress disorder following single-incident trauma.

机构信息

School of Psychology, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.

出版信息

J Abnorm Child Psychol. 2012 Apr;40(3):327-37. doi: 10.1007/s10802-011-9566-7.

DOI:10.1007/s10802-011-9566-7
PMID:21892594
Abstract

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.

摘要

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。

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