Matulis Simone, Resick Patricia A, Rosner Rita, Steil Regina
Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Postbox 11 19 32-120, 60054, Frankfurt am Main, Germany,
Clin Child Fam Psychol Rev. 2014 Jun;17(2):173-90. doi: 10.1007/s10567-013-0156-9.
Although childhood sexual abuse and childhood physical abuse (CSA and CPA) have severe psychopathological consequences, there is little evidence supporting psychotherapeutic interventions for adolescents who have experienced CSA or CPA. To provide a treatment tailored to the specific needs of adolescents suffering from abuse-related posttraumatic stress disorder (PTSD), we modified Cognitive Processing Therapy (CPT) by adding new treatment modules and changing the therapy setting. To evaluate the feasibility and efficacy of Developmentally Adapted CPT (D-CPT), we treated 12 adolescents suffering from PTSD secondary to CSA or CPA. Patients were assessed prior to treatment (t0), post-treatment (t1), and 6 weeks after treatment (t2). Assessments included the Clinician-Administered PTSD Scale (CAPS), the UCLA PTSD Index (UCLA), the Children's Depression Inventory (CDI), the Adolescent Dissociative Experiences Scale (A-DES), and the Borderline Symptom List (BSL-23). MANOVAs revealed that posttraumatic stress measurements and associated symptom measurements significantly differed across time points. When comparing t0 with t2, Cohen's d was large with respect to the CAPS scores (d = 1.45, p < .001) and the UCLA scores (d = 1.91, p < .001). Cohen's d had a medium magnitude with respect to the CDI scores (d = .78, p < .001), the A-DES scores (d = 0.64, p < .05), and the BSL-23 scores (d = 0.74, p < .01). D-CPT has the potential to reduce PTSD symptoms and comorbid psychopathology in adolescents with histories of CSA or CPA.
尽管儿童期性虐待和儿童期身体虐待(CSA和CPA)会产生严重的精神病理学后果,但几乎没有证据支持对经历过CSA或CPA的青少年进行心理治疗干预。为了提供一种针对患有与虐待相关创伤后应激障碍(PTSD)的青少年的特定需求的治疗方法,我们通过添加新的治疗模块和改变治疗环境对认知加工疗法(CPT)进行了修改。为了评估适应性发展CPT(D-CPT)的可行性和有效性,我们对12名继发于CSA或CPA的PTSD青少年进行了治疗。在治疗前(t0)、治疗后(t1)和治疗后6周(t2)对患者进行评估。评估包括临床医生管理的PTSD量表(CAPS)、加州大学洛杉矶分校PTSD指数(UCLA)、儿童抑郁量表(CDI)、青少年解离体验量表(A-DES)和边缘症状清单(BSL-23)。多变量方差分析显示,创伤后应激测量和相关症状测量在不同时间点上有显著差异。将t0与t2进行比较时,CAPS评分(d = 1.45,p <.001)和UCLA评分(d = 1.91,p <.001)的科恩d值较大。CDI评分(d =.78,p <.001)、A-DES评分(d = 0.64,p <.05)和BSL-23评分(d = 0.74,p <.01)的科恩d值为中等大小。D-CPT有可能减轻有CSA或CPA病史的青少年的PTSD症状和共病精神病理学症状。