Cognitive-Behavioral Therapy for PTSD in Children and Adolescents: A Preliminary Randomized Controlled Trial

Kings College London, Institute of Psychiatry, UK.
Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 7.26). 09/2007; 46(8):1051-61. DOI: 10.1097/CHI.0b013e318067e288
Source: PubMed

ABSTRACT To evaluate the efficacy of individual trauma-focused cognitive-behavioral therapy (CBT) for treating posttraumatic stress disorder (PTSD) in children and young people.
Following a 4-week symptom-monitoring baseline period, 24 children and young people (8-18 years old) who met full DSM-IV PTSD diagnostic criteria after experiencing single-incident traumatic events (motor vehicle accidents, interpersonal violence, or witnessing violence) were randomly allocated to a 10-week course of individual CBT or to placement on a waitlist (WL) for 10 weeks.
Compared to the WL group, participants who received CBT showed significantly greater improvement in symptoms of PTSD, depression, and anxiety, with significantly better functioning. After CBT, 92% of participants no longer met criteria for PTSD; after WL, 42% of participants no longer met criteria. CBT gains were maintained at 6-month follow-up. Effects of CBT were partially mediated by changes in maladaptive cognitions, as predicted by cognitive models of PTSD.
Individual trauma-focused CBT is an effective treatment for PTSD in children and young people.

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Available from: Sean Perrin, Sep 26, 2015
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    • "The current study did not take into account the comorbidity of PTSD of the participants such as depression and other anxiety disorders. Previous controlled studies that demonstrated the efficacy of CBT in young participants also showed the improvement in depression (Smith et al., 2007; Stein et al., 2003) and anxiety (March, Amaya-Jackson, Murray and Schulte, 1998; Smith et al., 2007). There was a suggestion from the previous research that depression and anxiety often developed secondarily to PTSD and successful treatment of PTSD should lead to improvement in other emotional symptoms. "
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    ABSTRACT: Post-traumatic stress disorder (PTSD) is a common and debilitating consequence of natural disaster in children and adolescents. Accumulating data show that cognitive behavioural therapy (CBT) is an effective treatment for PTSD. However, application of CBT in a large-scale disaster in a setting with limited resources, such as when the tsunami hit several Asian countries in 2004, poses a major problem. Aims: This randomized controlled trial aimed to test for the efficacy of the modified version of CBT for children and adolescents with PSTD. Method: Thirty-six children (aged 10–15 years) who had been diagnosed with PSTD 4 years after the tsunami were randomly allocated to either CBT or wait list. CBT was delivered in 3-day, 2-hour-daily, group format followed by 1-month posttreatment self-monitoring and daily homework. Results: Compared to the wait list, participants who received CBT demonstrated significantly greater improvement in symptoms of PTSD at 1-month follow-up, although no significant improvement was observed when the measures were done immediately posttreatment. Conclusions: Brief, group CBT is an effective treatment for PTSD in children and adolescents when delivered in conjunction with posttreatment self-monitoring and daily homework.
    Behavioural and Cognitive Psychotherapy 09/2015; 43(05):549-561. DOI:10.1017/S1352465813001197 · 1.69 Impact Factor
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    • "Treatment with medication is not usually recommended for children and young people with PTSD (The National Institute of Mental Health (NIMH)). Individual trauma-focused CBT is an effective treatment for PTSD in children and young people (Smith et al., 2007). "
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    ABSTRACT: Post-traumatic stress disorder (PTSD) is a complex mental disorder with psychological and emotional components, caused by exposure to single or repeated extreme traumatic events found in war, terrorist attacks, natural or man-caused disasters, and by violent personal assaults and accidents. Recently, research attention has been focused on the types of memory processes involved in PTSD and hypothesized neurobiological processes. Complicating this exploration, and the treatment of PTSD, are underlying comorbid disorders, such as depression, anxiety, and substance use disorders. Treatment of PTSD has undergone. Despite clinical studies and improved understanding of the mechanisms of cellular damage, prevention and treatment strategies for patients with PTSD remain unsatisfactory. Posttraumatic stress disorder is a prevalent mental health problem associated with substantial psychiatric morbidity. Three major treatment approaches are currently available for PTSD patients: cognitive behavioral therapy, pharmacotherapy, and more traditional individual and group dynamic psychotherapy. To develop an improved plan for treating and impeding progression of PTSD, it is important to identify underlying biochemical changes that may play key role in the initiation and progression of these disorders.
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    • "In the field of treatment outcome, Smith et al. (2007) found a strong significant correlation between changes in PTSD symptoms and changes on the CPTCI, indicating that the CPTCI is able to measure treatment effects. This was supported by Nixon, Sterk and Pearce (2012) who found a significant reduction on the CPTCI from pre-to posttrauma therapy. "
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    ABSTRACT: With the inclusion of trauma-related cognitions in the DSM-5 criteria for posttraumatic stress disorder (PTSD), the assessment of these cognitions has become essential. Therefore, valid tools for the assessment of these cognitions are warranted. The current study aimed at validating the Dutch version of the Child Posttraumatic Cognitions Inventory (CPTCI). We included children aged 8-19 years in our study and assessed the factor structure, reliability and validity of the CPTCI in a clinical sample (n=184) and a school sample (n=318). Our results supported the two-factor structure of the CPTCI and showed good internal consistency for the total scale and the two subscales. We found significant positive correlations between the CPTCI and measures of PTSD, depression, and anxiety disorder. The CPTCI correlated negatively with a measure of quality of life. Furthermore, we found significantly higher scores in the clinical sample than in the school sample. For children who received treatment, we found that a decrease in CPTCI scores was accompanied by a decrease in posttraumatic stress symptoms and comorbid problems indicating that the CPTCI is able to detect treatment effects. Overall, our results suggest that the Dutch CPTCI is a reliable and valid instrument.
    European Journal of Psychotraumatology 02/2015; 6:26362. DOI:10.3402/ejpt.v6.26362 · 2.40 Impact Factor
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