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识别有照顾者参与的认知行为创伤治疗对 PTSD 青少年的有效调节因素:一项荟萃分析。

Identifying effective moderators of cognitive behavioural trauma treatment with caregiver involvement for youth with PTSD: a meta-analysis.

机构信息

Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands.

Basic Trust, Specialists in Attachment and Trauma, Amsterdam, The Netherlands.

出版信息

Eur Child Adolesc Psychiatry. 2024 Jul;33(7):2067-2081. doi: 10.1007/s00787-022-02088-2. Epub 2022 Sep 30.

Abstract

Children can develop post-traumatic stress disorder (PTSD) and mental health symptoms after traumatic events. This meta-analysis evaluated the influence of moderators of cognitive behavioural trauma treatment (CBTT) with caregiver involvement in traumatized children. A total of 28 studies were included, with 23 independent samples and 332 effect sizes, representing the data of 1931 children (M age = 11.10 years, SD = 2.36). Results showed a significant medium overall effect (d = 0.55, t = 2.478, p = 0.014), indicating CBTT with caregiver involvement was effective in treating PTSD (d = 0.70), with somewhat smaller effect sizes for internalizing, externalizing, social, cognitive and total problems (0.35 < d > 0.48). The positive treatment effect was robust; we found somewhat smaller effect sizes at follow-up (d = 0.49) compared to post-test (d = 0.57) assessments. Furthermore, several sample (i.e. child's age, gender, and trauma event), programme (i.e. the duration of treatment, number of sessions), study (i.e. control condition, type of instrument, informant, type of sample), and publication (i.e. publication year and impact factor) characteristics moderated the treatment outcomes of the child. In sum, the results of our meta-analysis might help to improve the effectiveness of cognitive behavioural trauma treatment for youth with PTSD, and guide the development of innovative trauma interventions that involve caregivers. Implications for theory and practice are discussed.

摘要

儿童在经历创伤性事件后可能会发展出创伤后应激障碍(PTSD)和心理健康症状。本荟萃分析评估了有照顾者参与的认知行为创伤治疗(CBTT)对创伤后儿童的影响。共有 28 项研究被纳入,包含 23 个独立样本和 332 个效应量,代表了 1931 名儿童的数据(M 年龄=11.10 岁,SD=2.36)。结果表明,整体上存在显著的中等效应(d=0.55,t=2.478,p=0.014),表明有照顾者参与的 CBTT 对 PTSD 的治疗是有效的(d=0.70),而对内化、外化、社交、认知和总体问题的效果稍小(0.35<d<0.48)。积极的治疗效果是稳健的;与后测(d=0.57)相比,我们发现随访时的效应量稍小(d=0.49)。此外,几个样本(即儿童的年龄、性别和创伤事件)、方案(即治疗的持续时间、疗程数)、研究(即对照条件、工具类型、信息提供者、样本类型)和出版(即出版年份和影响因素)特征都对儿童的治疗结果产生了调节作用。总之,我们的荟萃分析结果可能有助于提高认知行为创伤治疗对 PTSD 青少年的有效性,并指导涉及照顾者的创新创伤干预措施的发展。讨论了理论和实践的意义。

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