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The effectiveness of psychological interventions for post-traumatic stress disorder in children, adolescents and young adults: a systematic review and meta-analysis

Published online by Cambridge University Press:  22 June 2020

Rayanne John-Baptiste Bastien Open the ORCID record for Rayanne John-Baptiste Bastien [Opens in a new window] ,
Hannah E. Jongsma ,
Melissa Kabadayi  and
Jo Billings
Rayanne John-Baptiste Bastien*
Affiliation:
Division of Psychiatry, UCL, London, England
Hannah E. Jongsma
Affiliation:
Division of Psychiatry, UCL, London, England
Melissa Kabadayi
Affiliation:
Division of Psychiatry, UCL, London, England
Jo Billings
Affiliation:
Division of Psychiatry, UCL, London, England
*
Author for correspondence: Rayanne John-Baptiste Bastien, E-mail: [email protected]
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Abstract

Background

Children and adolescents display different symptoms of post-traumatic stress disorder (PTSD) than adults. Whilst evidence for the effectiveness of psychological interventions has been synthesised for adults, this is not directly applicable to younger people. Therefore, this systematic review and meta-analysis synthesised studies investigating the effectiveness of psychological interventions for PTSD in children, adolescents and young adults. It provides an update to previous reviews investigating interventions in children and adolescents, whilst investigating young adults for the first time.

Methods

We searched published and grey literature to obtain randomised control trials assessing psychological interventions for PTSD in young people published between 2011 and 2019. Quality of studies was assessed using the Cochrane Risk of Bias tool. Data were analysed using univariate random-effects meta-analysis.

Results

From 15 373 records, 27 met criteria for inclusion, and 16 were eligible for meta-analysis. There was a medium pooled effect size for all psychological interventions (d = −0.44, 95% CI −0.68 to −0.20), as well as for Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) and Eye Movement Desensitisation and Reprocessing (EMDR) (d = −0.30, 95% CI −0.58 to −0.02); d = −0.46, 95% CI −0.81 to −0.12).

Conclusions

Some, but not all, psychological interventions commonly used to treat PTSD in adults were effective in children, adolescents and young adults. Interventions specifically adapted for younger people were also effective. Our results support the National Institute for Health and Care Excellence guidelines which suggest children and adolescents be offered TF-CBT as a first-line treatment because of a larger evidence base, despite EMDR being more effective.

Keywords

AdolescentsCBTchildrencognitive behavioural therapyEMDRinterventionspost-traumatic stress disorderPTSDtherapyyouth
Type
Review Article
Information
Psychological Medicine , Volume 50 , Issue 10 , July 2020 , pp. 1598 - 1612
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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