Tutus Dunja, Keller Ferdinand, Sachser Cedric, Pfeiffer Elisa, Goldbeck Lutz
Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm , Ulm, Germany .
J Child Adolesc Psychopharmacol. 2017 Mar;27(2):200-205. doi: 10.1089/cap.2016.0136. Epub 2017 Jan 4.
Depressive symptoms are frequently described in parents whose children have been exposed to traumatic events. Hence, including nonoffending parents in trauma-focused cognitive-behavioral therapy (TF-CBT) for children and adolescents may help both children and their parents to cope with the trauma. Up to now, three randomized controlled trials have investigated parental depressive symptoms after TF-CBT. Given the ambiguous results, further effectiveness trials are needed to investigate parental benefit from TF-CBT. The aim of this study is to determine whether TF-CBT is superior to waitlist (WL) regarding change in parental depressive symptoms.
Parents, N = 84, whose children (age 6-17 years) were randomly assigned to either 12 sessions of TF-CBT (n = 40) or to WL condition (n = 44) completed the Beck Depression Inventory-Second Edition (BDI-II) for pre-post comparison. The group difference was tested through repeated-measures analyses of variance (ANOVA). The change in parental depressive symptoms was additionally categorized using the reliable change index.
Repeated-measures ANOVA indicated a significant time effect F(1, 82) = 2.55, p = 0.02, and no significant time-group interaction F(1, 82) = 1.09, p = 0.30, suggesting a similar reduction in parental depressive symptoms in both groups. Across both conditions, most of the parents remained unchanged (n = 62), some of them improved (n = 17), and a few deteriorated (n = 5). There was no significant difference between the conditions (χ(2) = 1.74; p = 0.42).
Contrary to findings of several previous studies, our results suggest no superiority of TF-CBT in comparison with WL regarding change in depressive symptoms in parents. This might be due to different types of the child's trauma. Parental benefit from TF-CBT was found in samples of sexually abused, but not in children and adolescents exposed to diverse trauma types.
在孩子遭受创伤性事件的父母中,抑郁症状屡见不鲜。因此,将未犯罪的父母纳入针对儿童和青少年的创伤聚焦认知行为疗法(TF-CBT),可能有助于孩子及其父母应对创伤。到目前为止,已有三项随机对照试验对TF-CBT后父母的抑郁症状进行了研究。鉴于结果不明确,需要进一步开展有效性试验,以探究父母从TF-CBT中获得的益处。本研究的目的是确定在父母抑郁症状的改善方面,TF-CBT是否优于等待名单(WL)。
84名孩子(年龄6至17岁)被随机分配至12节TF-CBT课程组(n = 4)或等待名单组(n = 44)的父母,完成了贝克抑郁量表第二版(BDI-II),用于前后比较。通过重复测量方差分析(ANOVA)检验组间差异。此外,使用可靠变化指数对父母抑郁症状的变化进行分类。
重复测量方差分析显示出显著的时间效应F(1, 82) = 2.55,p = 0.02,且无显著的时间-组间交互作用F(1, 82) = 1.09,p = 0.30,这表明两组父母的抑郁症状减轻程度相似。在两种情况下,大多数父母症状未变(n = 62),一些父母症状改善(n = 17),少数父母症状恶化(n = 5)。两种情况之间无显著差异(χ(2) = 1.74;p = 0.42)。
与之前多项研究的结果相反,我们的研究结果表明,在父母抑郁症状的改善方面,TF-CBT与WL相比并无优势。这可能是由于孩子创伤类型不同所致。在遭受性虐待的样本中发现父母能从TF-CBT中获益,但在遭受多种创伤类型的儿童和青少年样本中未发现此情况。