a Department of Psychology , University of Oslo , Oslo , Norway.
b Norwegian Centre for Violence and Traumatic Stress Studies , Oslo , Norway.
Psychother Res. 2019 Jan;29(1):99-111. doi: 10.1080/10503307.2017.1303208. Epub 2017 Apr 4.
To understand the meaning of trauma narration, we examined changes in the trauma narratives of youth receiving trauma-focused cognitive behavioral therapy (TF-CBT) and explored the relationship between changes in narratives and in posttraumatic stress.
The sample consisted of 12 non-responders and 12 maximum-responders to treatment (M = 14.3, SD = 2.35, range = 10-17; 75% girls). The youth were assessed with the Clinical-Administered PTSD-Scale for Children and Adolescents both pre- and post-treatment. Their first and last narratives were coded according to a standardized coding manual.
For the group as a whole there was an increase in organized thoughts and reports of internal events (e.g., descriptions of thoughts and feelings), while narrative fragmentation decreased. There were no significant narrative changes in external events (e.g., descriptions of actions and dialogues). Max-responders differed significantly from non-responders in developing more organized thoughts. We did not find a significant relationship between changes in narratives and changes in posttraumatic stress symptoms (PTSS).
Youth receiving TF-CBT develop narratives that contain more organized thoughts and a greater internal focus, which are both thought to be helpful for traumatized youth. However, more coherent and organized trauma narratives were not related to reductions in PTSS. Clinical or methodological significance of this article: This study suggests that trauma-focused cognitive behavioral therapy contributes to more organized and coherent trauma narratives for traumatized youth. Although, this may be important and contribute to meaning making, therapist should be aware that this may not be sufficient in reducing posttraumatic stress symptoms in youth.
为了理解创伤叙述的意义，我们研究了接受创伤聚焦认知行为疗法（TF-CBT）的年轻人的创伤叙述的变化，并探讨了叙述变化与创伤后应激之间的关系。
该样本包括 12 名非反应者和 12 名治疗最大反应者（M = 14.3，SD = 2.35，范围 = 10-17；75%为女孩）。在治疗前后，青少年都用儿童和青少年临床管理创伤后应激障碍量表进行评估。他们的第一和最后一个叙述都根据一个标准化的编码手册进行编码。
对于整个群体，思维的组织性和内部事件的报告（例如，思想和感受的描述）增加，而叙述的碎片化减少。外部事件（例如，动作和对话的描述）没有明显的叙述变化。最大反应者与非反应者在思维的组织性方面有显著差异。我们没有发现叙述变化与创伤后应激症状（PTSS）变化之间存在显著关系。
接受 TF-CBT 的年轻人发展出包含更多组织性思维和更大内部焦点的叙述，这两者都被认为对创伤后的年轻人有帮助。然而，更连贯和有组织的创伤叙述与 PTSD 症状的减少无关。
这项研究表明，创伤聚焦认知行为疗法有助于创伤后年轻人更有组织和连贯的创伤叙述。尽管这可能很重要，并有助于意义的形成，但治疗师应该意识到，这可能不足以减少青少年的创伤后应激症状。
