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Complex PTSD as proposed for ICD-11: validation of a new disorder in children and adolescents and their response to Trauma-Focused Cognitive Behavioral Therapy / Cedric SACHSER in Journal of Child Psychology and Psychiatry, 58-2 (February 2017)
[article]
Titre : Complex PTSD as proposed for ICD-11: validation of a new disorder in children and adolescents and their response to Trauma-Focused Cognitive Behavioral Therapy Type de document : Texte imprimé et/ou numérique Auteurs : Cedric SACHSER, Auteur ; Ferdinand KELLER, Auteur ; Lutz GOLDBECK, Auteur Année de publication : 2017 Article en page(s) : p.160-168 Langues : Anglais (eng) Mots-clés : Complex posttraumatic stress disorder Trauma-Focused Cognitive Behavioral Therapy International Classification of Diseases diagnostic category Index. décimale : PER Périodiques Résumé : Background To evaluate whether the symptoms of children and adolescents with clinically significant posttraumatic stress symptoms (PTSS) form classes consistent with the diagnostic criteria of complex PTSD (CPTSD) as proposed for the ICD-11, and to relate the emerging classes with treatment outcome of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Methods Latent classes analysis (LCA) was used to explore the symptom profiles of the clinical baseline assessment of N = 155 children and adolescents participating in a randomized controlled trial of TF-CBT. The treatment outcomes of patients with posttraumatic stress disorder (PTSD) and of patients with CPTSD were compared by a t-test for depended samples and a repeated-measures ANOVA. Results The LCA revealed two distinct classes: a PTSD class characterized by elevated core symptoms of PTSD (n = 62) and low symptoms of disturbances in self-organization versus a complex PTSD class with elevated PTSD core symptoms and elevated symptoms of disturbances in self-organization (n = 93). The Group × Time interaction regarding posttraumatic stress symptoms was not significant. Pre–post effect sizes regarding posttraumatic stress symptoms were large for both groups (PTSD: d = 2.81; CPTSD: d = 1.37). For disturbances in self-organization in the CPTSD class, we found medium to large effect sizes (d = 0.40–1.16) after treatment with TF-CBT. Conclusions The results provide empirical evidence of the ICD-11 CPTSD and PTSD distinction in a clinical sample of children and adolescents. In terms of relative improvement from their respective baseline posttraumatic stress symptoms, patients with PTSD and CPTSD responded equally to TF-CBT; however, those with CPTSD ended treatment with clinically and statistically greater symptoms than those with PTSD. En ligne : http://dx.doi.org/10.1111/jcpp.12640 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=299
in Journal of Child Psychology and Psychiatry > 58-2 (February 2017) . - p.160-168[article] Complex PTSD as proposed for ICD-11: validation of a new disorder in children and adolescents and their response to Trauma-Focused Cognitive Behavioral Therapy [Texte imprimé et/ou numérique] / Cedric SACHSER, Auteur ; Ferdinand KELLER, Auteur ; Lutz GOLDBECK, Auteur . - 2017 . - p.160-168.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 58-2 (February 2017) . - p.160-168
Mots-clés : Complex posttraumatic stress disorder Trauma-Focused Cognitive Behavioral Therapy International Classification of Diseases diagnostic category Index. décimale : PER Périodiques Résumé : Background To evaluate whether the symptoms of children and adolescents with clinically significant posttraumatic stress symptoms (PTSS) form classes consistent with the diagnostic criteria of complex PTSD (CPTSD) as proposed for the ICD-11, and to relate the emerging classes with treatment outcome of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Methods Latent classes analysis (LCA) was used to explore the symptom profiles of the clinical baseline assessment of N = 155 children and adolescents participating in a randomized controlled trial of TF-CBT. The treatment outcomes of patients with posttraumatic stress disorder (PTSD) and of patients with CPTSD were compared by a t-test for depended samples and a repeated-measures ANOVA. Results The LCA revealed two distinct classes: a PTSD class characterized by elevated core symptoms of PTSD (n = 62) and low symptoms of disturbances in self-organization versus a complex PTSD class with elevated PTSD core symptoms and elevated symptoms of disturbances in self-organization (n = 93). The Group × Time interaction regarding posttraumatic stress symptoms was not significant. Pre–post effect sizes regarding posttraumatic stress symptoms were large for both groups (PTSD: d = 2.81; CPTSD: d = 1.37). For disturbances in self-organization in the CPTSD class, we found medium to large effect sizes (d = 0.40–1.16) after treatment with TF-CBT. Conclusions The results provide empirical evidence of the ICD-11 CPTSD and PTSD distinction in a clinical sample of children and adolescents. In terms of relative improvement from their respective baseline posttraumatic stress symptoms, patients with PTSD and CPTSD responded equally to TF-CBT; however, those with CPTSD ended treatment with clinically and statistically greater symptoms than those with PTSD. En ligne : http://dx.doi.org/10.1111/jcpp.12640 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=299 Moderators of treatment response to trauma-focused cognitive behavioral therapy among youth in Zambia / Jeremy C. KANE in Journal of Child Psychology and Psychiatry, 57-10 (October 2016)
[article]
Titre : Moderators of treatment response to trauma-focused cognitive behavioral therapy among youth in Zambia Type de document : Texte imprimé et/ou numérique Auteurs : Jeremy C. KANE, Auteur ; Laura K. MURRAY, Auteur ; Judith A. COHEN, Auteur ; Shannon DORSEY, Auteur ; Stephanie SKAVENSKI VAN WYK, Auteur ; Jennica GALLOWAY HENDERSON, Auteur ; Mwiya IMASIKU, Auteur ; John MAYEYA, Auteur ; Paul BOLTON, Auteur Article en page(s) : p.1194-1202 Langues : Anglais (eng) Mots-clés : Posttraumatic stress disorder orphans and vulnerable children Zambia trauma-focused cognitive behavioral therapy moderation analysis Index. décimale : PER Périodiques Résumé : Background The effectiveness of mental health interventions such as trauma-focused cognitive behavioral therapy (TF-CBT) may vary by client, caregiver, and intervention-level variables, but few randomized trials in low- and middle-income countries (LMIC) have conducted moderation analyses to investigate these characteristics. This study explores moderating factors to TF-CBT treatment response among a sample of orphans and vulnerable children (OVC) in Zambia. Methods Data were obtained from a completed randomized trial of TF-CBT among 257 OVC in Zambia. Trauma symptoms and functioning were measured at baseline and following the end of treatment. Mixed effects regression models were estimated for each moderator of interest: gender, age, number of trauma types experienced, history of sexual abuse, orphan status, primary caretaker, school status, and parental involvement in treatment. Results Treatment effectiveness was moderated by history of sexual abuse with greater reductions in both outcomes (trauma, p < .05; functioning, p < .01) for those that experienced sexual abuse. Primary caretaker was also a moderator with greater trauma reductions in those who identified their mother as the primary caretaker (p < .01), and better functioning in those that identified their father as the primary caretaker (p < .05). Nonorphans and single orphans (mother alive) showed greater reduction in functional impairment (p < .01) compared with double orphans. There was no significant moderator effect found by gender, age, number of trauma types, school status, or caregiver participation in treatment. Conclusions This study suggests that TF-CBT was effective in reducing trauma symptoms and functional impairment among trauma-affected youth overall and that it may be particularly effective for survivors of child sexual abuse and children whose primary caretaker is a biological parent. Scale-up of TF-CBT is warranted given the wide range of effectiveness and prevalence of child sexual abuse. Future randomized trials of interventions in LMIC should power for moderation analyses in the study design phase when feasible. En ligne : http://dx.doi.org/10.1111/jcpp.12623 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=295
in Journal of Child Psychology and Psychiatry > 57-10 (October 2016) . - p.1194-1202[article] Moderators of treatment response to trauma-focused cognitive behavioral therapy among youth in Zambia [Texte imprimé et/ou numérique] / Jeremy C. KANE, Auteur ; Laura K. MURRAY, Auteur ; Judith A. COHEN, Auteur ; Shannon DORSEY, Auteur ; Stephanie SKAVENSKI VAN WYK, Auteur ; Jennica GALLOWAY HENDERSON, Auteur ; Mwiya IMASIKU, Auteur ; John MAYEYA, Auteur ; Paul BOLTON, Auteur . - p.1194-1202.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 57-10 (October 2016) . - p.1194-1202
Mots-clés : Posttraumatic stress disorder orphans and vulnerable children Zambia trauma-focused cognitive behavioral therapy moderation analysis Index. décimale : PER Périodiques Résumé : Background The effectiveness of mental health interventions such as trauma-focused cognitive behavioral therapy (TF-CBT) may vary by client, caregiver, and intervention-level variables, but few randomized trials in low- and middle-income countries (LMIC) have conducted moderation analyses to investigate these characteristics. This study explores moderating factors to TF-CBT treatment response among a sample of orphans and vulnerable children (OVC) in Zambia. Methods Data were obtained from a completed randomized trial of TF-CBT among 257 OVC in Zambia. Trauma symptoms and functioning were measured at baseline and following the end of treatment. Mixed effects regression models were estimated for each moderator of interest: gender, age, number of trauma types experienced, history of sexual abuse, orphan status, primary caretaker, school status, and parental involvement in treatment. Results Treatment effectiveness was moderated by history of sexual abuse with greater reductions in both outcomes (trauma, p < .05; functioning, p < .01) for those that experienced sexual abuse. Primary caretaker was also a moderator with greater trauma reductions in those who identified their mother as the primary caretaker (p < .01), and better functioning in those that identified their father as the primary caretaker (p < .05). Nonorphans and single orphans (mother alive) showed greater reduction in functional impairment (p < .01) compared with double orphans. There was no significant moderator effect found by gender, age, number of trauma types, school status, or caregiver participation in treatment. Conclusions This study suggests that TF-CBT was effective in reducing trauma symptoms and functional impairment among trauma-affected youth overall and that it may be particularly effective for survivors of child sexual abuse and children whose primary caretaker is a biological parent. Scale-up of TF-CBT is warranted given the wide range of effectiveness and prevalence of child sexual abuse. Future randomized trials of interventions in LMIC should power for moderation analyses in the study design phase when feasible. En ligne : http://dx.doi.org/10.1111/jcpp.12623 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=295 Stepped care versus standard trauma-focused cognitive behavioral therapy for young children / Alison SALLOUM in Journal of Child Psychology and Psychiatry, 57-5 (May 2016)
[article]
Titre : Stepped care versus standard trauma-focused cognitive behavioral therapy for young children Type de document : Texte imprimé et/ou numérique Auteurs : Alison SALLOUM, Auteur ; Wei WANG, Auteur ; John ROBST, Auteur ; Tanya K. MURPHY, Auteur ; Michael S. SCHEERINGA, Auteur ; Judith A. COHEN, Auteur ; Eric A. STORCH, Auteur Article en page(s) : p.614-622 Langues : Anglais (eng) Mots-clés : Stepped care trauma-focused cognitive behavioral therapy young children posttraumatic stress disorder trauma Index. décimale : PER Périodiques Résumé : Background To compare the effectiveness and cost of stepped care trauma-focused cognitive behavioral therapy (SC-TF-CBT), a new service delivery method designed to address treatment barriers, to standard TF-CBT among young children who were experiencing posttraumatic stress symptoms (PTSS). Methods A total of 53 children (ages 3–7 years) who were experiencing PTSS were randomly assigned (2:1) to receive SC-TF-CBT or TF-CBT. Assessments by a blinded evaluator occurred at screening/baseline, after Step One for SC-TF-CBT, posttreatment, and 3-month follow-up. Trial registration: ClinicalTrials.gov: https://www.clinicaltrials.gov/ct2/show/NCT01603563. Results There were comparable improvements over time in PTSS and secondary outcomes in both conditions. Noninferiority of SC-TF-CBT compared to TF-CBT was supported for the primary outcome of PTSS, and the secondary outcomes of severity and internalizing symptoms, but not for externalizing symptoms. There were no statistical differences in comparisons of changes over time from pre- to posttreatment and pre- to 3-month follow-up for posttraumatic stress disorder diagnostic status, treatment response, or remission. Parent satisfaction was high for both conditions. Costs were 51.3% lower for children in SC-TF-CBT compared to TF-CBT. Conclusions Although future research is needed, preliminary evidence suggests that SC-TF-CBT is comparable to TF-CBT, and delivery costs are significantly less than standard care. SC-TF-CBT may be a viable service delivery system to address treatment barriers. En ligne : http://dx.doi.org/10.1111/jcpp.12471 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=288
in Journal of Child Psychology and Psychiatry > 57-5 (May 2016) . - p.614-622[article] Stepped care versus standard trauma-focused cognitive behavioral therapy for young children [Texte imprimé et/ou numérique] / Alison SALLOUM, Auteur ; Wei WANG, Auteur ; John ROBST, Auteur ; Tanya K. MURPHY, Auteur ; Michael S. SCHEERINGA, Auteur ; Judith A. COHEN, Auteur ; Eric A. STORCH, Auteur . - p.614-622.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 57-5 (May 2016) . - p.614-622
Mots-clés : Stepped care trauma-focused cognitive behavioral therapy young children posttraumatic stress disorder trauma Index. décimale : PER Périodiques Résumé : Background To compare the effectiveness and cost of stepped care trauma-focused cognitive behavioral therapy (SC-TF-CBT), a new service delivery method designed to address treatment barriers, to standard TF-CBT among young children who were experiencing posttraumatic stress symptoms (PTSS). Methods A total of 53 children (ages 3–7 years) who were experiencing PTSS were randomly assigned (2:1) to receive SC-TF-CBT or TF-CBT. Assessments by a blinded evaluator occurred at screening/baseline, after Step One for SC-TF-CBT, posttreatment, and 3-month follow-up. Trial registration: ClinicalTrials.gov: https://www.clinicaltrials.gov/ct2/show/NCT01603563. Results There were comparable improvements over time in PTSS and secondary outcomes in both conditions. Noninferiority of SC-TF-CBT compared to TF-CBT was supported for the primary outcome of PTSS, and the secondary outcomes of severity and internalizing symptoms, but not for externalizing symptoms. There were no statistical differences in comparisons of changes over time from pre- to posttreatment and pre- to 3-month follow-up for posttraumatic stress disorder diagnostic status, treatment response, or remission. Parent satisfaction was high for both conditions. Costs were 51.3% lower for children in SC-TF-CBT compared to TF-CBT. Conclusions Although future research is needed, preliminary evidence suggests that SC-TF-CBT is comparable to TF-CBT, and delivery costs are significantly less than standard care. SC-TF-CBT may be a viable service delivery system to address treatment barriers. En ligne : http://dx.doi.org/10.1111/jcpp.12471 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=288