School of Psychology, The University of Queensland, Brisbane, QLD, Australia.
Children's Health Queensland Child and Youth Mental Health Service (CHQ CYMHS), Brisbane, QLD, Australia.
Clin Child Fam Psychol Rev. 2022 Jun;25(2):249-282. doi: 10.1007/s10567-021-00373-1. Epub 2021 Nov 15.
Exposure to a natural disaster can have a myriad of significant and adverse psychological consequences. Children have been identified as a particularly vulnerable population being uniquely susceptible to post-disaster psychological morbidity, including post-traumatic stress disorder (PTSD). Without effective intervention, the impact of natural disasters on children's developmental trajectory can be detrimental, however, research is yet to find evidence to definitively establish the comparative efficacy or unequivocal superiority of any specific psychological intervention. A scoping review was undertaken according to the Preferred Reporting Items extension for Scoping Reviews Guidelines (PRISMA-ScR), to evaluate the current research regarding psychological interventions for children (below 18 years of age) experiencing PTSD after exposure to natural disasters, a single incident trauma. Fifteen studies involving 1337 children were included in the review. Overall, psychological interventions, irrespective of type, were associated with statistically significant and sustained reductions in PTSD symptomatology across all symptom clusters. However, whilst evidence supported the general efficacy of psychological interventions in this population, the majority of studies were considered retrospective field research designed in response to the urgent need for clinical service in the aftermath of a natural disaster. Consequently, studies were largely limited by environmental and resource constraints and marked by methodological flaws resulting in diverse and highly heterogeneous data. As such, definitive conclusions regarding the treatment efficacy of specific psychological interventions, and furthermore their ameliorative contributions constituting the necessary mechanisms of change remains largely speculative. As natural disasters can have a catastrophic impact on human lives, establishing levels of evidence for the efficacy of different psychological interventions for children represents a global public health priority.
自然灾害会对人们造成各种重大的负面影响。儿童被认为是一个特别脆弱的群体，他们在灾后特别容易出现心理疾病，包括创伤后应激障碍（PTSD）。如果没有有效的干预，自然灾害对儿童发展轨迹的影响可能是有害的。然而，目前还没有研究发现任何特定心理干预措施具有明确的比较疗效或优越性。
本研究采用 PRISMA-ScR 扩展的首选报告项目进行了范围综述，以评估当前有关儿童 PTSD 的心理干预研究（年龄在 18 岁以下），这些儿童经历了单一事件创伤后自然灾害。综述共纳入了 15 项研究，涉及 1337 名儿童。总体而言，无论干预类型如何，心理干预都与 PTSD 症状的统计学显著和持续减少相关，所有症状群均如此。
然而，虽然有证据支持心理干预在这一人群中的一般疗效，但大多数研究被认为是对自然灾害后临床服务的紧急需求的回顾性现场研究。因此，这些研究主要受到环境和资源限制的限制，并存在方法学缺陷，导致数据多样化且高度异质。因此，关于特定心理干预治疗效果的明确结论，以及构成必要的变化机制的干预措施的改善作用，在很大程度上仍存在推测性。
由于自然灾害可能对人类生活造成灾难性影响，因此确定针对儿童的不同心理干预措施的疗效水平是全球公共卫生的一个优先事项。
