Nexhmedin Morina, PhD, Department of Psychology, University of Münster, Münster, Germany; Mina Malek, MS, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands; Angela Nickerson, PhD, Richard A. Bryant, PhD, School of Psychology, University of New South Wales, NSW, Sydney, Australia
Nexhmedin Morina, PhD, Department of Psychology, University of Münster, Münster, Germany; Mina Malek, MS, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands; Angela Nickerson, PhD, Richard A. Bryant, PhD, School of Psychology, University of New South Wales, NSW, Sydney, Australia.
Br J Psychiatry. 2017 Apr;210(4):247-254. doi: 10.1192/bjp.bp.115.180265. Epub 2017 Feb 2.
The majority of survivors of mass violence live in low- and middle-income countries (LMICs).To synthesise empirical findings for psychological interventions for children and adolescents with post-traumatic stress disorder (PTSD) and/or depression in LMICs affected by mass violence.Randomised controlled trials with children and adolescents with symptoms of PTSD and/or depression in LMICs were identified. Overall, 21 812 records were found through July 2016 in the Medline, PsycINFO and PILOTS databases; 21 met the inclusion criteria and were reviewed according to recommended guidelines.Twenty-one studies were included. Active treatments for PTSD yielded large pre-treatment to post-treatment changes ( = 1.15) and a medium controlled effect size ( = 0.57). Effect sizes were similar at follow-up. Active treatments for depression produced small to medium effect sizes. Finally, after adjustment for publication bias, the imputed uncontrolled and controlled effect sizes for PTSD were medium and small respectively.Psychological interventions may be effective in treating paediatric PTSD in LMICs. It appears that more targeted approaches are needed for depressive responses.
大多数大规模暴力事件的幸存者生活在中低收入国家(LMICs)。为了综合大规模暴力事件影响下的中低收入国家儿童和青少年创伤后应激障碍(PTSD)和/或抑郁症的心理干预的实证研究结果。确定了针对中低收入国家有 PTSD 和/或抑郁症症状的儿童和青少年的随机对照试验。总的来说,2016 年 7 月前在 Medline、PsycINFO 和 PILOTS 数据库中发现了 21812 条记录;21 项符合纳入标准,并根据建议的指南进行了审查。共纳入 21 项研究。针对 PTSD 的积极治疗在治疗前到治疗后发生了较大的变化( = 1.15),并且具有中等的对照效果大小( = 0.57)。在随访时,效果大小相似。针对抑郁症的积极治疗产生了小到中等的效果大小。最后,在调整发表偏倚后,PTSD 的未对照和对照的推断效果大小分别为中等和小。心理干预可能对治疗中低收入国家的儿童 PTSD 有效。似乎需要针对抑郁反应采取更有针对性的方法。
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