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The early course and treatment of posttraumatic stress disorder in very young children: diagnostic prevalence and predictors in hospital-attending children and a randomized controlled proof-of-concept trial of trauma-focused cognitive therapy, for 3- to 8-year-olds / C. HITCHCOCK in Journal of Child Psychology and Psychiatry, 63-1 (January 2022)
[article]
Titre : The early course and treatment of posttraumatic stress disorder in very young children: diagnostic prevalence and predictors in hospital-attending children and a randomized controlled proof-of-concept trial of trauma-focused cognitive therapy, for 3- to 8-year-olds Type de document : Texte imprimé et/ou numérique Auteurs : C. HITCHCOCK, Auteur ; B. GOODALL, Auteur ; I. M. WRIGHT, Auteur ; A. BOYLE, Auteur ; D. JOHNSTON, Auteur ; D. DUNNING, Auteur ; J. GILLARD, Auteur ; K. GRIFFITHS, Auteur ; A. HUMPHREY, Auteur ; A. MCKINNON, Auteur ; I. K. PANESAR, Auteur ; A. WERNER-SEIDLER, Auteur ; P. WATSON, Auteur ; P. SMITH, Auteur ; R. MEISER-STEDMAN, Auteur ; Tim DALGLEISH, Auteur Article en page(s) : p.58-67 Langues : Anglais (eng) Mots-clés : Adult Child Child, Preschool Cognitive Behavioral Therapy Hospitals Humans Prevalence Psychotherapy Stress Disorders, Post-Traumatic/diagnosis/epidemiology/therapy Posttraumatic stress disorder randomized control trial young children Index. décimale : PER Périodiques Résumé : BACKGROUND: The introduction of developmentally adapted criteria for posttraumatic stress disorder (PTSD) has improved the identification of ?6-year-old children with clinical needs. Across two studies, we assess predictors of the development of PTSD in young children (PTSD-YC), including the adult-led acute stress disorder (ASD) diagnosis, and provide proof of principle for cognitive-focused therapy for this age range, with the aim of increasing treatment options for children diagnosed with PTSD-YC. METHOD: Study 1 (N?=?105) assessed ASD and PTSD-YC diagnosis in 3- to 8-year-old children within one month and at around three months following attendance at an emergency room. Study 2 (N?=?37) was a preregistered (www.isrctn.com/ISRCTN35018680) randomized controlled early-phase trial comparing CBT-3M, a cognitive-focused intervention, to treatment-as-usual (TAU) delivered within the UK NHS to 3- to 8-year-olds diagnosed with PTSD-YC. RESULTS: In Study 1, the ASD diagnosis failed to identify any young children. In contrast, prevalence of acute PTSD-YC (minus the duration requirement) was 8.6% in the first month post-trauma and 10.1% at 3?months. Length of hospital stay, but no other demographic or trauma-related characteristics, predicted development of later PTSD-YC. Early (within one month) diagnosis of acute PTSD-YC had a positive predictive value of 50% for later PTSD-YC. In Study 2, most children lost their PTSD-YC diagnosis following completion of CBT-3M (84.6%) relative to TAU (6.7%) and CBT-3M was acceptable to recipient families. Effect sizes were also in favor of CBT-3M for secondary outcome measures. CONCLUSIONS: The ASD diagnosis is not fit for purpose in this age-group. There was a strong and encouraging signal of putative efficacy for young children treated using a cognitive-focused treatment for PTSD, and a larger trial of CBT-3M is now warranted. En ligne : http://dx.doi.org/10.1111/jcpp.13460 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=456
in Journal of Child Psychology and Psychiatry > 63-1 (January 2022) . - p.58-67[article] The early course and treatment of posttraumatic stress disorder in very young children: diagnostic prevalence and predictors in hospital-attending children and a randomized controlled proof-of-concept trial of trauma-focused cognitive therapy, for 3- to 8-year-olds [Texte imprimé et/ou numérique] / C. HITCHCOCK, Auteur ; B. GOODALL, Auteur ; I. M. WRIGHT, Auteur ; A. BOYLE, Auteur ; D. JOHNSTON, Auteur ; D. DUNNING, Auteur ; J. GILLARD, Auteur ; K. GRIFFITHS, Auteur ; A. HUMPHREY, Auteur ; A. MCKINNON, Auteur ; I. K. PANESAR, Auteur ; A. WERNER-SEIDLER, Auteur ; P. WATSON, Auteur ; P. SMITH, Auteur ; R. MEISER-STEDMAN, Auteur ; Tim DALGLEISH, Auteur . - p.58-67.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 63-1 (January 2022) . - p.58-67
Mots-clés : Adult Child Child, Preschool Cognitive Behavioral Therapy Hospitals Humans Prevalence Psychotherapy Stress Disorders, Post-Traumatic/diagnosis/epidemiology/therapy Posttraumatic stress disorder randomized control trial young children Index. décimale : PER Périodiques Résumé : BACKGROUND: The introduction of developmentally adapted criteria for posttraumatic stress disorder (PTSD) has improved the identification of ?6-year-old children with clinical needs. Across two studies, we assess predictors of the development of PTSD in young children (PTSD-YC), including the adult-led acute stress disorder (ASD) diagnosis, and provide proof of principle for cognitive-focused therapy for this age range, with the aim of increasing treatment options for children diagnosed with PTSD-YC. METHOD: Study 1 (N?=?105) assessed ASD and PTSD-YC diagnosis in 3- to 8-year-old children within one month and at around three months following attendance at an emergency room. Study 2 (N?=?37) was a preregistered (www.isrctn.com/ISRCTN35018680) randomized controlled early-phase trial comparing CBT-3M, a cognitive-focused intervention, to treatment-as-usual (TAU) delivered within the UK NHS to 3- to 8-year-olds diagnosed with PTSD-YC. RESULTS: In Study 1, the ASD diagnosis failed to identify any young children. In contrast, prevalence of acute PTSD-YC (minus the duration requirement) was 8.6% in the first month post-trauma and 10.1% at 3?months. Length of hospital stay, but no other demographic or trauma-related characteristics, predicted development of later PTSD-YC. Early (within one month) diagnosis of acute PTSD-YC had a positive predictive value of 50% for later PTSD-YC. In Study 2, most children lost their PTSD-YC diagnosis following completion of CBT-3M (84.6%) relative to TAU (6.7%) and CBT-3M was acceptable to recipient families. Effect sizes were also in favor of CBT-3M for secondary outcome measures. CONCLUSIONS: The ASD diagnosis is not fit for purpose in this age-group. There was a strong and encouraging signal of putative efficacy for young children treated using a cognitive-focused treatment for PTSD, and a larger trial of CBT-3M is now warranted. En ligne : http://dx.doi.org/10.1111/jcpp.13460 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=456