Pfefferbaum Betty, Jacobs Anne K, Nitiéma Pascal, Everly George S
1Terrorism and Disaster Center,Department of Psychiatry and Behavioral Sciences,College of Medicine,University of Oklahoma Health Sciences Center,Oklahoma City,Oklahoma USA.
2Department of Psychiatry and Behavioral Sciences,Johns Hopkins School of Medicine,Johns Hopkins Bloomberg School of Public Health,Baltimore,Maryland USA.
Prehosp Disaster Med. 2015 Jun;30(3):306-15. doi: 10.1017/S1049023X15004665. Epub 2015 Apr 14.
Debriefing, a controversial crisis intervention delivered in the early aftermath of a disaster, has not been well evaluated for use with children and adolescents. This report constitutes a review of the child debriefing evidence base.
A systematic search of selected bibliographic databases (EBM Reviews, EMBASE, ERIC, Medline, Ovid, PILOTS, PubMed, and PsycINFO) was conducted in the spring of 2014 using search terms related to psychological debriefing. The search was limited to English language sources and studies of youth, aged 0 to 18 years. No time limit was placed on date of publication. The search yielded 713 references. Titles and abstracts were reviewed to select publications describing scientific studies and clinical reports. Reference sections of these publications, and of other literature known to the authors that was not generated by the search, were used to locate additional materials. Review of these materials generated 187 publications for more thorough examination; this assessment yielded a total of 91 references on debriefing in children and adolescents. Only 15 publications on debriefing in children and adolescents described empirical studies. Due to a lack of statistical analysis of effectiveness data with youth, and some articles describing the same study, only seven empirical studies described in nine papers were identified for analysis for this review. These studies were evaluated using criteria for assessment of methodological rigor in debriefing studies.
Children and adolescents included in the seven empirical debriefing studies were survivors of motor-vehicle accidents, a maritime disaster, hostage taking, war, or peer suicides. The nine papers describing the seven studies were characterized by inconsistency in describing the interventions and populations and by a lack of information on intervention fidelity. Few of the studies used randomized design or blinded assessment. The results described in the reviewed studies were mixed in regard to debriefing's effect on posttraumatic stress, depression, anxiety, and other outcomes. Even in studies in which debriefing appeared promising, the research was compromised by potentially confounding interventions.
The results highlight the small empirical evidence base for drawing conclusions about the use of debriefing with children and adolescents, and they call for further dialogue regarding challenges in evaluating debriefing and other crisis interventions in children.
心理汇报是一种在灾难发生后早期实施的、颇具争议的危机干预措施，其在儿童和青少年中的应用尚未得到充分评估。本报告对儿童心理汇报的证据基础进行了综述。
2014年春季，使用与心理汇报相关的检索词，对选定的书目数据库（循证医学评价、荷兰医学文摘数据库、教育资源信息中心、医学期刊数据库、Ovid、心理学文摘数据库、医学期刊全文数据库和心理学文摘数据库）进行了系统检索。检索仅限于英文文献来源以及针对0至18岁青少年的研究。对出版日期未设时间限制。检索共得到713条参考文献。对标题和摘要进行了审查，以挑选出描述科学研究和临床报告的出版物。这些出版物的参考文献部分，以及作者所知的非检索所得的其他文献，被用于查找更多资料。对这些资料的审查产生了187份出版物以供更深入的研究；此次评估共得到91篇关于儿童和青少年心理汇报的参考文献。只有15篇关于儿童和青少年心理汇报的出版物描述了实证研究。由于缺乏对青少年有效性数据的统计分析，且一些文章描述的是同一研究，因此本综述仅确定了9篇论文中描述的7项实证研究以供分析。这些研究使用了心理汇报研究中方法严谨性评估的标准进行评估。
7项实证心理汇报研究中的儿童和青少年是机动车事故、海难、人质劫持、战争或同伴自杀的幸存者。描述这7项研究的9篇论文的特点是，在描述干预措施和研究对象方面存在不一致，且缺乏关于干预保真度的信息。很少有研究采用随机设计或盲法评估。综述研究中描述的结果在心理汇报对创伤后应激、抑郁、焦虑和其他结果的影响方面参差不齐。即使在心理汇报似乎有前景的研究中，该研究也因潜在的混杂干预而受到影响。
结果凸显了关于儿童和青少年心理汇报应用结论的实证证据基础薄弱，呼吁就评估儿童心理汇报及其他危机干预措施中的挑战展开进一步对话。
