针对难民儿童的创伤聚焦治疗的有效性:一项系统评价和荟萃分析。
Effectiveness of trauma-focused treatments for refugee children: a systematic review and meta-analyses.
作者信息
Velu Merel E, Kuiper Rebecca M, Schok Michaela, Sleijpen Marieke, de Roos Carlijn, Mooren Trudy
机构信息
ARQ Centrum'45, Partner in ARQ National Psychotrauma Centre, Diemen, The Netherlands.
Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands.
出版信息
Eur J Psychotraumatol. 2025 Dec;16(1):2494362. doi: 10.1080/20008066.2025.2494362. Epub 2025 May 19.
Prevalence of posttraumatic stress disorder (PTSD) in refugees is higher compared to the general population, and barriers in accessing mental health care are often experienced. With staggering numbers of people seeking refuge around the world, and 40% being 18 years or younger, effective trauma-focused therapies for refugee children with PTSD are highly needed. A systematic review and meta-analyses were conducted to provide an overview of, and to analyse, intervention studies using PTSD measures in young refugees, assessing treatment effectiveness and addressing efforts to mitigate barriers to mental health care. Eleven databases were searched for studies evaluating trauma-focused treatments (TFT) for refugee children (0-18). Meta-analyses were conducted for all included studies grouped together; and second, per intervention type, using posttreatment measures and follow-up measures. Pooled between-group effect sizes (ESs) and pre-post ESs, using a random-effects model were calculated. A total of 47 studies was retrieved, with 32 included in the meta-analyses. The narrative review highlighted positive outcomes in reducing posttraumatic stress symptoms for CBT-based interventions, EMDR therapy, KIDNET, and other treatments such as art therapy. Meta-analyses revealed medium pooled pre-post ESs for CBT-based interventions (ES = -.55) and large for EMDR therapy (ES = -1.63). RCT and CT studies using follow-up measures showed promising outcomes for KIDNET (ES = -.49). High heterogeneity of the included studies limited interpretation of several other combined effects. Results should be interpreted with caution due to the generally low quality of the included studies. All studies addressed efforts to minimize treatment barriers. More high-quality studies are urgently needed to inform treatment recommendations. Evidence-based therapies, such as CBT-based interventions, EMDR therapy, and KIDNET, demonstrate promising findings but need further replication. Strategies to overcome barriers to treatment may be necessary to reach this population.
与普通人群相比,难民中创伤后应激障碍(PTSD)的患病率更高,而且他们在获得心理健康护理方面往往面临障碍。全球有大量人口寻求庇护,其中40%为18岁及以下儿童,因此迫切需要针对患有PTSD的难民儿童的有效创伤聚焦疗法。本研究进行了系统评价和荟萃分析,以概述和分析使用PTSD测量方法的年轻难民干预研究,评估治疗效果,并探讨减轻心理健康护理障碍的措施。检索了11个数据库,以查找评估针对难民儿童(0 - 18岁)的创伤聚焦治疗(TFT)的研究。对所有纳入研究进行汇总荟萃分析;其次,按干预类型,使用治疗后测量和随访测量进行荟萃分析。使用随机效应模型计算合并组间效应量(ESs)和前后ESs。共检索到47项研究,其中32项纳入荟萃分析。叙述性综述强调了基于认知行为疗法(CBT)的干预、眼动脱敏再处理疗法(EMDR)、儿童创伤网络疗法(KIDNET)以及艺术疗法等其他治疗在减轻创伤后应激症状方面的积极结果。荟萃分析显示,基于CBT的干预的合并前后ESs为中等(ES = -0.55),EMDR疗法的为大(ES = -1.63)。使用随访测量的随机对照试验(RCT)和对照试验(CT)研究显示KIDNET有良好结果(ES = -0.49)。纳入研究的高度异质性限制了对其他几种合并效应的解释。由于纳入研究的总体质量普遍较低,结果应谨慎解释。所有研究都探讨了尽量减少治疗障碍的措施。迫切需要更多高质量研究为治疗建议提供依据。基于证据的疗法,如基于CBT的干预、EMDR疗法和KIDNET,显示出有前景的结果,但需要进一步重复验证。可能需要采取克服治疗障碍的策略才能惠及这一人群。
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