Teculeasa Flavia, Golu Florinda, Gorbănescu Adrian
Faculty of Psychology and Educational Sciences, University of Bucharest, 90 Panduri Street, 50663 Bucharest, Romania.
J Child Adolesc Trauma. 2023 Jun 30;16(4):917-932. doi: 10.1007/s40653-023-00563-9. eCollection 2023 Dec.
Due to prevalent exposure to trauma in the biological family, children in foster care often experience post-traumatic stress symptoms, difficulties in forming secure attachments with the caregivers, and can present a complex range of symptoms and impairments across several areas of development. Therefore, there is an increased necessity for interventions on the effects of trauma exposure in foster care. This is the first meta-analysis to investigate the effectiveness of interventions on the effects of trauma exposure in foster care against control groups. Twelve randomized controlled trials on interventions for children with trauma-related diagnoses or with other mental health problems that are a result of complex trauma were included. A random-effects model was used for pooling the effect sizes, which were calculated for trauma-related outcomes at posttreatment and follow-up. Several potential moderator variables were analyzed. The results showed that participants receiving the intervention on trauma-related problems reported significantly better outcomes than those in the control conditions at posttreatment, after the exclusion of one outlier (g = 0.39; 95% CI [0.18 to 0.62]). The effect size was smaller at follow-up (g = 0.24; 95% CI [0.03 to 0.46]), but significant. Clinical diversity, methodological diversity, as well as other limitations were identified and discussed. Overall, the findings highlight the potential of interventions for trauma-related problems in foster care. These findings bring important contributions to the child welfare system in their efforts to develop and adapt suitable interventions for children with mental health problems due to trauma.
The online version contains supplementary material available at 10.1007/s40653-023-00563-9.
由于在原生家庭中普遍遭受创伤,寄养儿童经常出现创伤后应激症状,难以与照顾者建立安全的依恋关系,并且可能在多个发展领域呈现出一系列复杂的症状和损害。因此,针对寄养中创伤暴露影响的干预措施变得越发必要。这是第一项对寄养中创伤暴露影响的干预措施与对照组进行效果比较的荟萃分析。纳入了12项针对有创伤相关诊断或因复杂创伤导致其他心理健康问题儿童的干预随机对照试验。采用随机效应模型合并效应量,效应量针对治疗后和随访时的创伤相关结果进行计算。分析了几个潜在的调节变量。结果显示,在排除一个异常值后,接受创伤相关问题干预的参与者在治疗后报告的结果显著优于对照组(g = 0.39;95%置信区间[0.18至0.62])。随访时效应量较小(g = 0.24;95%置信区间[0.03至0.46]),但仍具有显著性。确定并讨论了临床多样性、方法学多样性以及其他局限性。总体而言,研究结果凸显了针对寄养中创伤相关问题干预措施的潜力。这些发现为儿童福利系统在努力为因创伤导致心理健康问题的儿童制定和调整合适干预措施方面做出了重要贡献。
在线版本包含可在10.1007/s40653-023-00563-9获取的补充材料。