Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Brain and Cognition Center, University of Amsterdam, Amsterdam, The Netherlands.
Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands.
Clin Psychol Rev. 2016 Jul;47:41-54. doi: 10.1016/j.cpr.2016.05.006. Epub 2016 Jun 17.
This meta-analysis aimed at determining the efficacy of psychological and psychopharmacological interventions for children and adolescents suffering from symptoms of posttraumatic stress disorder (PTSD). A search using the Medline, PsycINFO, and PILOTS databases was conducted to identify randomized controlled trials (RCTs) for pediatric PTSD. The search resulted in 41 RCTs, of which 39 were psychological interventions and two psychopharmacological interventions. Results showed that psychological interventions are effective in treating PTSD, with aggregated effect sizes of Hedge's g=0.83 when compared to waitlist and g=0.41 when compared to active control conditions at posttreatment. Trauma-focused cognitive behavior therapy was the most researched form of intervention and resulted in medium to large effect sizes when compared to waitlist (g=1.44) and active control conditions (g=0.66). Experimental conditions were also more effective than control conditions at follow-up. Interventions were further effective in reducing comorbid depression symptoms, yet the obtained effect sizes were small to medium only. The findings indicate that psychological interventions can effectively reduce PTSD symptoms in children and adolescents. There is very little evidence to support use of psychopharmacological interventions for pediatric PTSD.
本荟萃分析旨在确定心理和精神药理学干预措施对患有创伤后应激障碍(PTSD)症状的儿童和青少年的疗效。使用 Medline、PsycINFO 和 PILOTS 数据库进行了搜索,以确定儿科 PTSD 的随机对照试验(RCT)。搜索结果显示,有 41 项 RCT,其中 39 项为心理干预,2 项为精神药理学干预。结果表明,心理干预对 PTSD 有效,与等待名单相比,聚合效应大小为 Hedge's g=0.83,与活动对照组相比为 g=0.41。创伤聚焦认知行为疗法是研究最多的干预形式,与等待名单(g=1.44)和活动对照组(g=0.66)相比,其效果较大。实验条件在随访时也比对照条件更有效。干预措施还能有效减轻共病抑郁症状,但获得的效果大小仅为小到中等。研究结果表明,心理干预可有效减轻儿童和青少年的 PTSD 症状。几乎没有证据支持使用精神药理学干预儿科 PTSD。