Systematic Review and Meta-analysis: Group-Based Interventions for Treating Posttraumatic Stress Symptoms in Children and Adolescents.

Autor:	Davis RS; University of Bath, United Kingdom., Meiser-Stedman R; University of East Anglia, Norwich, United Kingdom., Afzal N; University of Bath, United Kingdom., Devaney J; School of Social and Political Science, University of Edinburgh, United Kingdom., Halligan SL; University of Bath, United Kingdom; University of Cape Town, South Africa., Lofthouse K; University of East Anglia, Norwich, United Kingdom., Smith P; Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom., Stallard P; University of Bath, United Kingdom., Ye S; University of Bath, United Kingdom., Hiller RM; Division of Psychology and Language Sciences, University College London, United Kingdom; Anna Freud National Centre for Children & Families, United Kingdom. Electronic address: r.hiller@ucl.ac.uk.
Jazyk:	angličtina
Zdroj:	Journal of the American Academy of Child and Adolescent Psychiatry [J Am Acad Child Adolesc Psychiatry] 2023 Nov; Vol. 62 (11), pp. 1217-1232. Date of Electronic Publication: 2023 Mar 20.
DOI:	10.1016/j.jaac.2023.02.013
Abstrakt:	Objective: Trauma exposure in childhood is common and can lead to a range of negative mental health outcomes, including posttraumatic stress disorder (PTSD). In many settings, resources to address this distress are scarce. Group-based interventions require minimal resources and training, can be delivered by non-mental health specialists, and target larger numbers of children and adolescents. This meta-analysis sought to establish whether such an approach is an effective method for targeting PTSD symptoms and to identify potential moderators of effectiveness. Method: PubMed, PsycNET, and PTSDPubs were searched for randomized controlled trials that used a group-based PTSD intervention with children and adolescents aged 6 to 18 years. Data were extracted for PTSD symptoms and depression symptoms. A random-effects meta-analysis was conducted to obtain between-group pooled effect size estimates. This study was registered on PROSPERO (CRD42020187214). Results: The initial search identified 9,650 studies, of which 42 were eligible for inclusion (N = 5,998). Children randomized to a group-based intervention had significantly lower PTSD symptoms after treatment compared with a control group, with a medium pooled effect (g = -0.55, 95% CI [-0.76, -0.35]). Group interventions were superior when compared with either active or passive controls, at follow-up, and for depression symptoms. There was a large amount of heterogeneity, but no evidence that this was explained by whether the intervention was delivered in a low- and middle-income or high-income country, included caregivers, or was universal or targeted. Conclusion: Group PTSD interventions, particularly cognitive-behavioral therapy-based interventions, are effective at targeting posttrauma distress in children and adolescents. There was evidence of effectiveness when delivered in highly complex and resource-scarce settings and to a range of trauma-exposed groups, including groups exposed to war/conflict, natural disasters, and abuse. (Copyright © 2023 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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