Tutus Dunja, Pfeiffer Elisa, Plener Paul L, Rosner Rita, Bernheim Dorothee, Sachser Cedric
Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany.
Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.
J Child Adolesc Psychopharmacol. 2021 Mar;31(2):129-136. doi: 10.1089/cap.2020.0097. Epub 2020 Dec 23.
Symptoms of distress and dysfunctional posttraumatic cognitions (PTCs) have been frequently described in parents of children and adolescents with posttraumatic stress symptoms (PTSS), especially if the parents had experienced traumatic events themselves. The inclusion of non-offending parents in trauma-focused cognitive-behavioral therapy (TF-CBT) for children and adolescents may, thus, help parents to cope with the traumatic experience of their child. The aim of this study is to investigate the effects of TF-CBT on the parents, while taking their own history of traumatic experiences into account. Parents ( = 57, 84.2% mothers) of children and adolescents who received TF-CBT completed the Posttraumatic Diagnostic Scale, the Beck Depression Inventory, the State-Trait Anxiety Inventory, and the Posttraumatic Cognitions Inventory. Treatment effects and the sustainability at 6- and 12 months post-treatment were tested via repeated-measures analysis of variance, following the intention-to-treat approach. = 19 (35.2%) of the parents evaluated their child's trauma as the worst event, 18 (33.3%) rated their own experience as their worst event, and 17 (31.5%) indicated that their own worst traumatic experience was the same type as their child's trauma. Significant improvements ( < 0.001) emerged for parental PTSS [(2, 837) = 8.27; = 0.30], depression [(3, 284) = 14.73; = 0.41], anxiety symptoms [(3, 185) = 17.44; = 0.64], and dysfunctional PTCs [(2, 465) = 13.58; = 0.46]. Sustainability of these treatment gains remained at both follow-up time points ( < 0.05). There was no interaction between the time and the reference person of the traumatic index event, reported by parents. These results indicate parental benefits from participation in TF-CBT delivered to their child, until 1-year post-treatment and independently from the parental trauma history. The ongoing tendency of improvement might indicate that TF-CBT furnishes children and their parents with skills to further reduce the impact of their traumatic memories. ClinicalTrials.gov NCT01516827.
在患有创伤后应激症状（PTSS）的儿童和青少年的父母中，经常会出现痛苦症状和功能失调的创伤后认知（PTCs），尤其是当父母自身经历过创伤事件时。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）中，可能有助于父母应对孩子的创伤经历。本研究的目的是在考虑父母自身创伤经历史的情况下，调查TF-CBT对父母的影响。接受TF-CBT的儿童和青少年的父母（n = 57，84.2%为母亲）完成了创伤后诊断量表、贝克抑郁量表、状态-特质焦虑量表和创伤后认知量表。治疗效果以及治疗后6个月和12个月的可持续性通过重复测量方差分析进行测试，采用意向性治疗方法。19名（35.2%）父母将孩子的创伤评估为最糟糕的事件，18名（33.3%）将自己的经历评为最糟糕的事件，17名（31.5%）表示自己最糟糕的创伤经历与孩子的创伤类型相同。父母的PTSS（F(2, 837) = 8.27；p = 0.30）、抑郁（F(3, 284) = 14.73；p = 0.41）、焦虑症状（F(3, 185) = 17.44；p = 0.64）和功能失调的PTCs（F(2, 465) = 13.58；p = 0.46）均出现显著改善（p < 0.001）。这些治疗效果在两个随访时间点均保持稳定（p < 0.05）。父母报告的创伤指数事件的时间和参照人物之间没有交互作用。这些结果表明，父母参与为其孩子提供的TF-CBT直至治疗后1年都能从中受益，且与父母的创伤史无关。持续的改善趋势可能表明TF-CBT为儿童及其父母提供了进一步减少创伤记忆影响的技能。ClinicalTrials.gov NCT01516827。
