接受创伤认知行为疗法的儿童和青少年的早期治疗反应
Early Treatment Response in Children and Adolescents Receiving CBT for Trauma.
作者信息
Wamser-Nanney Rachel, Scheeringa Michael S, Weems Carl F
机构信息
Department of Psychiatry & Behavioral Sciences, Tulane University School of Medicine and
Department of Psychiatry & Behavioral Sciences, Tulane University School of Medicine and.
出版信息
J Pediatr Psychol. 2016 Jan-Feb;41(1):128-37. doi: 10.1093/jpepsy/jsu096. Epub 2014 Oct 30.
Abstract
OBJECTIVES
To investigate the incidence and correlates of early treatment response among youth receiving cognitive behavioral therapy (CBT) for posttraumatic stress disorder (PTSD).
METHODS
56 youth who participated in a randomized controlled trial of CBT for PTSD and D-cycloserine were included. Youth with PTSD symptoms below clinical cutoff after Session 4 of a 12-session protocol were classified as early treatment responders (32% of parent reports, 44.6% of child reports). Pretreatment characteristics were examined in relation to responder status.
RESULTS
Lower levels of pretreatment PTSD, depression, and anxiety symptoms and fewer trauma types were related to child- and parent-reported responder status (d = .57, d = .52, respectively). Early treatment response was maintained at follow-up.
CONCLUSIONS
Pretreatment symptoms levels and number of traumas may play an important role in predicting early treatment response. Correlates of early treatment response may provide avenues for identifying youth who could benefit from abbreviated protocols.
摘要
目的
调查接受创伤后应激障碍（PTSD）认知行为疗法（CBT）的青少年早期治疗反应的发生率及其相关因素。
方法
纳入56名参与PTSD和D-环丝氨酸CBT随机对照试验的青少年。在一个为期12节疗程的第4节之后，PTSD症状低于临床临界值的青少年被归类为早期治疗反应者（家长报告的占32%，儿童报告的占44.6%）。研究了与反应者状态相关的治疗前特征。
结果
治疗前较低水平的PTSD、抑郁和焦虑症状以及较少的创伤类型与儿童和家长报告的反应者状态相关（效应量分别为d = 0.57和d = 0.52）。早期治疗反应在随访中得以维持。
结论
治疗前症状水平和创伤数量可能在预测早期治疗反应中起重要作用。早期治疗反应的相关因素可能为识别可从简化疗程中受益的青少年提供途径。
相似文献
1
Early Treatment Response in Children and Adolescents Receiving CBT for Trauma.
J Pediatr Psychol. 2016 Jan-Feb;41(1):128-37. doi: 10.1093/jpepsy/jsu096. Epub 2014 Oct 30.
2
Randomized placebo-controlled D-cycloserine with cognitive behavior therapy for pediatric posttraumatic stress.
J Child Adolesc Psychopharmacol. 2014 Mar;24(2):69-77. doi: 10.1089/cap.2013.0106. Epub 2014 Feb 7.
3
Effectiveness of abbreviated trauma-focused cognitive behavioural therapy for South African adolescents: a randomized controlled trial.
Eur J Psychotraumatol. 2023;14(1):2181602. doi: 10.1080/20008066.2023.2181602.
4
Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents (Review).
Evid Based Child Health. 2013 May;8(3):1004-116. doi: 10.1002/ebch.1916.
5
Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents.
Cochrane Database Syst Rev. 2012 Dec 12;12:CD006726. doi: 10.1002/14651858.CD006726.pub2.
6
Comparison of eye movement desensitization and reprocessing therapy, cognitive behavioral writing therapy, and wait-list in pediatric posttraumatic stress disorder following single-incident trauma: a multicenter randomized clinical trial.
J Child Psychol Psychiatry. 2017 Nov;58(11):1219-1228. doi: 10.1111/jcpp.12768. Epub 2017 Jun 28.
7
Psychological therapies for children and adolescents exposed to trauma.
Cochrane Database Syst Rev. 2016 Oct 11;10(10):CD012371. doi: 10.1002/14651858.CD012371.
8
Effect of Developmentally Adapted Cognitive Processing Therapy for Youth With Symptoms of Posttraumatic Stress Disorder After Childhood Sexual and Physical Abuse: A Randomized Clinical Trial.
JAMA Psychiatry. 2019 May 1;76(5):484-491. doi: 10.1001/jamapsychiatry.2018.4349.
9
Pretreatment cortisol predicts trauma-focused psychotherapy response in youth with (partial) posttraumatic stress disorder.
Psychoneuroendocrinology. 2019 Nov;109:104380. doi: 10.1016/j.psyneuen.2019.104380. Epub 2019 Jul 17.
10
A Follow-Up Study from a Multisite, Randomized Controlled Trial for Traumatized Children Receiving TF-CBT.
J Abnorm Child Psychol. 2017 Nov;45(8):1587-1597. doi: 10.1007/s10802-017-0270-0.
引用本文的文献
1
Family therapy and EMDR after child abuse and neglect: moderating effects of child attachment style and PTSD symptoms on treatment outcome.
Eur J Psychotraumatol. 2024;15(1):2416288. doi: 10.1080/20008066.2024.2416288. Epub 2024 Oct 25.
2
Promising Effect of the Children in Disaster: Evaluation and Recovery Intervention on Trauma Symptoms and Quality of Life for Children and Adolescents: A Controlled Study.
Psychiatry Investig. 2024 Feb;21(2):123-132. doi: 10.30773/pi.2023.0202. Epub 2024 Feb 8.
3
CBT+ Training Initiative in Washington State Community Mental Health: An Evaluation of Child Clinical Outcomes.
Community Ment Health J. 2024 May;60(4):649-661. doi: 10.1007/s10597-023-01194-y. Epub 2023 Oct 26.
4
Predictors of nonresponse and drop-out among children and adolescents receiving TF-CBT: investigation of client-, therapist-, and implementation factors.
BMC Health Serv Res. 2022 Sep 29;22(1):1212. doi: 10.1186/s12913-022-08497-y.
5
Predictors and moderators of treatment outcome for single incident paediatric PTSD: a multi-centre randomized clinical trial.
Eur J Psychotraumatol. 2021 Sep 30;12(1):1968138. doi: 10.1080/20008198.2021.1968138. eCollection 2021.
6
Characteristics and Service Needs of Maltreated Children Referred for Mental Health Services at a Child Advocacy Centre in Canada.
J Can Acad Child Adolesc Psychiatry. 2021 May;30(2):92-103. Epub 2021 May 1.
7
Youth Top Problems and Early Treatment Response to the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents.
Child Psychiatry Hum Dev. 2022 Jun;53(3):582-598. doi: 10.1007/s10578-021-01151-4. Epub 2021 Mar 17.
8
Challenges in recruiting and retaining adolescents with abuse-related posttraumatic stress disorder: lessons learned from a randomized controlled trial.
Child Adolesc Psychiatry Ment Health. 2020 Apr 16;14:14. doi: 10.1186/s13034-020-00320-y. eCollection 2020.
9
Lost in Transition? Evidence-Based Treatments for Adolescents and Young Adults with Posttraumatic Stress Disorder and Results of an Uncontrolled Feasibility Trial Evaluating Cognitive Processing Therapy.
Clin Child Fam Psychol Rev. 2020 Mar;23(1):122-152. doi: 10.1007/s10567-019-00305-0.
10
Examining patterns of dose response for clients who do and do not complete cognitive processing therapy.
J Anxiety Disord. 2019 Dec;68:102120. doi: 10.1016/j.janxdis.2019.102120. Epub 2019 Oct 1.
本文引用的文献
1
Development of Stepped Care Trauma-Focused Cognitive-Behavioral Therapy for Young Children.
Cogn Behav Pract. 2014 Feb 1;21(1):97-108. doi: 10.1016/j.cbpra.2013.07.004.
2
Randomized placebo-controlled D-cycloserine with cognitive behavior therapy for pediatric posttraumatic stress.
J Child Adolesc Psychopharmacol. 2014 Mar;24(2):69-77. doi: 10.1089/cap.2013.0106. Epub 2014 Feb 7.
3
Cue-centered treatment for youth exposed to interpersonal violence: a randomized controlled trial.
J Trauma Stress. 2013 Dec;26(6):654-662. doi: 10.1002/jts.21870.
4
The occasional case against broad dissemination and implementation: retaining a role for specialty care in the delivery of psychological treatments.
Am Psychol. 2014 Jan;69(1):1-18. doi: 10.1037/a0033582. Epub 2013 Aug 5.
5
Step one within stepped care trauma-focused cognitive behavioral therapy for young children: a pilot study.
Child Psychiatry Hum Dev. 2014 Feb;45(1):65-77. doi: 10.1007/s10578-013-0378-6.
6
Maternal depression and treatment gains following a cognitive behavioral intervention for posttraumatic stress in preschool children.
J Anxiety Disord. 2013 Jan;27(1):140-6. doi: 10.1016/j.janxdis.2012.11.003. Epub 2012 Dec 20.
7
Manualized therapy for PTSD: flexing the structure of cognitive processing therapy.
J Consult Clin Psychol. 2012 Dec;80(6):968-81. doi: 10.1037/a0030600. Epub 2012 Oct 29.
8
Trajectories of response to treatment for posttraumatic stress disorder.
Behav Ther. 2012 Dec;43(4):790-800. doi: 10.1016/j.beth.2012.04.003. Epub 2012 Apr 13.
9
Clinician knowledge and utilization of empirically-supported treatments for maltreated children.
Child Maltreat. 2012 Feb;17(1):11-21. doi: 10.1177/1077559511426333. Epub 2011 Nov 23.
10
A randomized trial of cognitive behaviour therapy and cognitive therapy for children with posttraumatic stress disorder following single-incident trauma.
J Abnorm Child Psychol. 2012 Apr;40(3):327-37. doi: 10.1007/s10802-011-9566-7.
Zotero 插件