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儿童创伤后应激障碍的心理治疗干预:最新进展

Psychotherapeutic interventions for childhood posttraumatic stress disorder: an update.

作者信息

Rossouw Jaco, Sharp Tamsin, Halligan Sarah, Seedat Soraya

机构信息

Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University.

Department of Psychology, University of Bath, Bath, UK.

出版信息

Curr Opin Psychiatry. 2022 Nov 1;35(6):417-424. doi: 10.1097/YCO.0000000000000821. Epub 2022 Aug 29.

Abstract

PURPOSE OF THE REVIEW

We review treatment outcome studies and systematic reviews for childhood and adolescent posttraumatic stress disorder (PTSD) between January 2020 and August 2022, including studies involving younger children and different treatment delivery methods and models. We address predictors, moderators, treatment engagement, and attrition.

RECENT FINDINGS

Recent randomised controlled trials corroborate earlier trials documenting trauma-focused cognitive behaviour therapy (TF-CBT) as a highly efficacious treatment for PTSD. Evidence for treatment effects in complex PTSD in youth is still sparse. Research on moderators and predictors of treatment continues to be hampered by multiple factors, including a lack of sufficiently large homogeneous trauma samples.

SUMMARY

TF-CBT is a very effective treatment for children and adolescents with PTSD. Further work is needed to (i) demonstrate that task-shifting models utilising lay community health counsellors and peer counsellors can effectively and cost-effectively close the mental health treatment gap that exists world-wide in children and adolescents diagnosed with PTSD, but particularly within low- and middle income countries, and (ii) better understand moderators and predictors of treatment which remains a priority.

摘要

综述目的

我们回顾了2020年1月至2022年8月期间关于儿童和青少年创伤后应激障碍(PTSD)的治疗结果研究和系统评价,包括涉及年幼儿童以及不同治疗实施方法和模式的研究。我们探讨了预测因素、调节因素、治疗参与度和脱落率。

最新发现

近期的随机对照试验证实了早期试验的结果,即创伤聚焦认知行为疗法(TF-CBT)是治疗PTSD的一种高效疗法。关于青少年复杂性PTSD治疗效果的证据仍然稀少。包括缺乏足够大的同质创伤样本在内的多种因素,继续阻碍着对治疗调节因素和预测因素的研究。

总结

TF-CBT是治疗患有PTSD的儿童和青少年的一种非常有效的疗法。需要进一步开展工作,以(i)证明利用非专业社区健康顾问和同伴顾问的任务转移模式能够有效且经济高效地缩小全球范围内被诊断患有PTSD的儿童和青少年,尤其是低收入和中等收入国家儿童和青少年中存在的心理健康治疗差距,以及(ii)更好地理解治疗的调节因素和预测因素,这仍然是一个优先事项。

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