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创伤后应激障碍症状青少年心理干预长期治疗效果的荟萃分析。

Meta-analysis of the Long-Term Treatment Effects of Psychological Interventions in Youth with PTSD Symptoms.

机构信息

Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Varrentrappstraße 40-42, 60486, Frankfurt, Germany.

出版信息

Clin Child Fam Psychol Rev. 2017 Dec;20(4):422-434. doi: 10.1007/s10567-017-0242-5.

Abstract

To date, the long-term effectiveness of psychological treatments in reducing post-traumatic stress disorder symptoms in children and adolescents has not been investigated extensively. This meta-analysis quantifies the long-term effects of psychological interventions in children and adolescents with PTSD symptoms and examines the period-dependent follow-up (FU) effects based on 47 studies. The mean FU effect sizes (ESs) for PTSD symptoms ranged from medium (between treatment ESs for controlled studies) to large (within treatment ESs for uncontrolled studies; pooled analysis including all studies). These effects were comparable to the post-treatment ESs, which suggests that the treatment effects remained stable. ESs did not differ depending on the length of the FU period (</>6 months). In randomized controlled trials (RCTs), as well as trials conducted with treatment as usual or active control groups, the long-term treatment effects for the reduction of PTSD symptoms were small. These results demonstrate the long-term effectiveness of psychological interventions in the treatment of PTSD in youth. However, more studies should include a FU assessment. Further research should focus on RCTs with long-term assessments, report comorbid symptoms and investigate the influence of potential moderators. Research is also warranted to determine how to improve the long-term effects of treatments for PTSD in youth.

摘要

迄今为止,尚未广泛研究心理治疗在减少儿童和青少年创伤后应激障碍症状方面的长期效果。本荟萃分析量化了心理干预对 PTSD 症状儿童和青少年的长期效果,并根据 47 项研究检查了基于时间的随访 (FU) 效果。 PTSD 症状的平均 FU 效应量 (ES) 范围从中等(对照研究的治疗 ES)到较大(未对照研究的治疗 ES;包括所有研究的汇总分析)。这些效果与治疗后 ES 相当,表明治疗效果保持稳定。ES 不取决于 FU 期的长度(</>6 个月)。在随机对照试验 (RCT) 中,以及在采用常规治疗或活性对照组进行的试验中,减少 PTSD 症状的长期治疗效果较小。这些结果表明,心理干预在治疗青少年 PTSD 方面具有长期效果。然而,应该有更多的研究包括 FU 评估。进一步的研究应侧重于长期评估的 RCT,报告共病症状,并调查潜在调节因素的影响。还需要研究如何提高青少年 PTSD 治疗的长期效果。

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