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[创伤优先——针对患有创伤相关障碍的儿童和青少年的门诊认知行为干预:一项试点研究]

[Trauma First - an Outpatient, Cognitive-Behavioural Intervention for Children and Adolescents With Trauma-Related Disorders: a Pilot Study].

作者信息

Sierau Susan, Knabe Alena, Ahrens-Eipper Sabine, Nelius Katrin, Glaesmer Heide

机构信息

1 Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig, Leipzig.

2 Gemeinschaftspraxis für Psychotherapie, Halle/Saale.

出版信息

Z Kinder Jugendpsychiatr Psychother. 2019 Jul;47(4):289-298. doi: 10.1024/1422-4917/a000568. Epub 2018 Jan 22.

Abstract

Trauma First - an Outpatient, Cognitive-Behavioural Intervention for Children and Adolescents With Trauma-Related Disorders: a Pilot Study Although traumatic experiences are one of the most important causes for psychiatric disorders in childhood and adulthood, trauma-specific intervention approaches are rarely applied in German outpatient clinics. The aim of the present pilot study was to evaluate a manualized, outpatient, cognitive-behavioural intervention programme ("Trauma First") for children and youths with trauma and stress-related disorders. We hypothesized that there would be specific improvements in PTSD symptoms as well as in depression, anxiety, and behavioural problems following the structured intervention programme. The pilot study consisted of a pre-post-test design without a control group. Symptom severity of 33 children and youths (age: 10-15 years; 54.5 % female) with traumatic experiences was assessed by self-ratings and parent-ratings before and after the treatment. After the treatment, improvements were found in children's PTSD symptoms, depression, anxiety, and behavioural problems (Cohen's d: 0.51-1.49). A trend was found showing improvement of children's life satisfaction. Effect sizes were comparable with results from meta-analyses. The pilot study provided first evidence for the effectiveness of "Trauma First" under ecologically valid conditions. This study is a first step in the evaluation process of psychotherapeutic effectiveness, which should be continued by conducting a randomized-controlled study design.

摘要

创伤优先——针对患有创伤相关障碍的儿童和青少年的门诊认知行为干预:一项试点研究 尽管创伤经历是儿童期和成年期精神疾病的最重要病因之一,但在德国门诊诊所中,针对创伤的特定干预方法很少应用。本试点研究的目的是评估一项针对患有创伤和应激相关障碍的儿童和青少年的手册化门诊认知行为干预计划(“创伤优先”)。我们假设,在结构化干预计划之后,创伤后应激障碍(PTSD)症状以及抑郁、焦虑和行为问题会有特定改善。 该试点研究采用了无对照组的前后测设计。通过自我评定和家长评定对33名有创伤经历的儿童和青少年(年龄:10 - 15岁;54.5%为女性)治疗前后的症状严重程度进行了评估。 治疗后,发现儿童的PTSD症状、抑郁、焦虑和行为问题有所改善(科恩d值:0.51 - 1.49)。发现有儿童生活满意度提高的趋势。效应量与元分析结果相当。 该试点研究为“创伤优先”在生态有效条件下的有效性提供了初步证据。这项研究是心理治疗效果评估过程的第一步,应通过进行随机对照研究设计继续开展。

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