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Randomized Controlled Trial of Group Cognitive Behavioural Therapy for Post-Traumatic Stress Disorder in Children and Adolescents Exposed to Tsunami in Thailand

Published online by Cambridge University Press:  08 April 2014

Nuttorn Pityaratstian ,
Vinadda Piyasil ,
Panom Ketumarn ,
Nanthawat Sitdhiraksa ,
Sirirat Ularntinon  and
Pornjira Pariwatcharakul
Nuttorn Pityaratstian*
Affiliation:
Chulalongkorn University, Bangkok, Thailand
Vinadda Piyasil
Affiliation:
Queen Sirikit National Institute of Child Health, Bangkok, Thailand
Panom Ketumarn
Affiliation:
Siriraj Hospital, Mahidol University, Bangkok, Thailand
Nanthawat Sitdhiraksa
Affiliation:
Siriraj Hospital, Mahidol University, Bangkok, Thailand
Sirirat Ularntinon
Affiliation:
Queen Sirikit National Institute of Child Health. Bangkok, Thailand
Pornjira Pariwatcharakul
Affiliation:
Siriraj Hospital, Mahidol University, Bangkok, Thailand
*
Reprint requests to Nuttorn Pityaratstian, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand. E-mail: [email protected]
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Abstract

Background: 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.

Keywords

Post-traumatic stress disordercognitive behavioural therapydisastertsunami
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 43 , Issue 5 , September 2015 , pp. 549 - 561
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2014 

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References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev. ed.). Washington, DC: APA.Google Scholar
Bolton, D., O'Ryan, D., Udwin, O., Boyle, S. and Yule, W. (2000). The long-term psychological effects of a disaster experienced in adolescence: II: general psychopathology. Journal of Child Psychology and Psychiatry, 41, 513–523.CrossRefGoogle ScholarPubMed
Breslau, N., Davis, G. C., Andreski, P. and Peterson, E. (1991). Traumatic events and posttraumatic stress disorder in an urban population of young adults. Archives of General Psychiatry, 48, 216–222.Google Scholar
Chemtob, C. M., Nakashima, J. P. and Hamada, R. S. (2002). Psychosocial intervention for postdisaster trauma symptoms in elementary school children: a controlled community field study. Archives of Pediatrics and Adolescent Medicine, 156, 211–216.Google Scholar
Clark, D. B., Lesnick, L. and Hegedus, A. M. (1997). Traumas and other adverse life events in adolescents with alcohol abuse and dependence. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1744–1751.Google Scholar
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Hillside, NJ: Erlbaum.Google Scholar
Cohen, J. A., Deblinger, E., Mannarino, A. P. and Steer, R. A. (2004). A multisite, randomized controlled trial for children with sexual abuse-related PTSD symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 393–402.Google Scholar
Deblinger, E., McLeer, S. V. and Henry, D. (1990). Cognitive behavioral treatment for sexually abused children suffering post-traumatic stress: preliminary findings. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 747–752.Google Scholar
Deblinger, E., Steer, R. A. and Lippmann, J. (1999). Two-year follow-up study of cognitive behavioral therapy for sexually abused children suffering post-traumatic stress symptoms. Child Abuse and Neglect, 23, 1371–1378.CrossRefGoogle ScholarPubMed
Ehlers, A., Clark, D. M., Hackmann, A., McManus, F., Fennell, M., Herbert, C., et al. (2003). A randomized controlled trial of cognitive therapy, a self-help booklet, and repeated assessments as early interventions for posttraumatic stress disorder. Archives of General Psychiatry, 60, 1024–1032.CrossRefGoogle ScholarPubMed
Friedberg, R. and McClure, J. (2005). Adolescents. In Kazantzis, N., Deane, F., Ronan, K. and L'Abate, L. (Eds.), Using Homework Assignments in Cognitive Behavior Therapy (pp. 95–116). New York: Routledge.Google Scholar
Giannopoulou, I., Dikaiakou, A. and Yule, W. (2006). Cognitive-behavioural group intervention for PTSD symptoms in children following the Athens 1999 earthquake: a pilot study. Clinical Child Psychology and Psychiatry, 11, 543–553.CrossRefGoogle ScholarPubMed
Goenjian, A. K., Walling, D., Steinberg, A. M., Karayan, I., Najarian, L. M. and Pynoos, R. (2005). A prospective study of posttraumatic stress and depressive reactions among treated and untreated adolescents 5 years after a catastrophic disaster. American Journal of Psychiatry, 162, 2302–2308.CrossRefGoogle ScholarPubMed
Hardy, E. and Stallard, P. (2008). A pilot study to explore the effect of symptom monitoring in children and adolescents with posttraumatic stress reactions following road traffic accidents. Behavioural and Cognitive Psychotherapy, 36, 431–435.Google Scholar
Hudson, J. and Kendall, P. (2005). Children. In Kazantzis, N., Deane, F., Ronan, K. and L'Abate, L. (Eds.), Using Homework Assignments in Cognitive Behavior Therapy (pp. 75–94). New York: Routledge.Google Scholar
Jensen, T. K., Dyb, G. and Nygaard, E. (2009). A longitudinal study of posttraumatic stress reactions in Norwegian children and adolescents exposed to the 2004 tsunami. Archives of Pediatrics and Adolescent Medicine, 163, 856–861.Google Scholar
John, P. B., Russell, S. and Russell, P. S. (2007). The prevalence of posttraumatic stress disorder among children and adolescents affected by tsunami disaster in Tamil Nadu. Disaster Management and Response, 5, 3–7.CrossRefGoogle ScholarPubMed
Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M. and Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048–1060.Google Scholar
Kristensen, P., Weisaeth, L. and Heir, T. (2009). Psychiatric disorders among disaster bereaved: an interview study of individuals directly or not directly exposed to the 2004 tsunami. Depression and Anxiety, 26, 1127–1133.Google Scholar
Manassis, K., Wilansky-Traynor, P., Farzan, N., Kleiman, V., Parker, K. and Sanford, M. (2010). The feelings club: randomized controlled evaluation of school-based CBT for anxious or depressive symptoms. Depression and Anxiety. 27, 945–952.Google Scholar
March, J. S., Amaya-Jackson, L., Murray, M. C. and Schulte, A. (1998). Cognitive-behavioral psychotherapy for children and adolescents with posttraumatic stress disorder after a single-incident stressor. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 585–593.CrossRefGoogle ScholarPubMed
Meiser-Stedman, R., Yule, W., Smith, P., Glucksman, E. and Dalgleish, T. (2005). Acute stress disorder and posttraumatic stress disorder in children and adolescents involved in assaults or motor vehicle accidents. American Journal of Psychiatry, 162, 1381–1383.CrossRefGoogle ScholarPubMed
Neuner, F., Schauer, E., Catani, C., Ruf, M. and Elbert, T. (2006). Post-tsunami stress: a study of posttraumatic stress disorder in children living in three severely affected regions in Sri Lanka. Journal of Traumatic Stress, 19, 339–347.CrossRefGoogle Scholar
Perrin, S., Meiser-Stedman, R. and Smith, P. (2005). The Children's Revised Impact of Event Scale (CRIES): validity as a screening instrument for PTSD. Behavioural and Cognitive Psychotherapy, 33, 487–498.Google Scholar
Pityaratstian, N., Ketumarn, P., Piyasilpa, V., Sitdhiraksa, N. and Ularntinon, S. (2010). Recovery and beyond: working with young tsunami victims in Thailand. Seishin Shinkeigaku Zasshi, 112, 153–158.Google ScholarPubMed
Piyasil, V., Ketuman, P., Plubrukarn, R., Jotipanut, V., Tanprasert, S., Aowjinda, S., et al. (2007). Post traumatic stress disorder in children after tsunami disaster in Thailand: 2 years follow-up. Journal of the Medical Association of Thailand, 90, 2370–2376.Google Scholar
Pynoos, R. S., Frederick, C., Nader, K., Arroyo, W., Steinberg, A., Eth, S., et al. (1987). Life threat and posttraumatic stress in school-age children. Archives of General Psychiatry, 44, 1057–1063.Google Scholar
Smith, P., Dyregrov, A. and Yule, W. (1999). Children and Disaster: teaching recovery techniques. Bergen: Children and War Foundation.Google Scholar
Smith, P., Yule, W., Perrin, S., Tranah, T., Dalgleish, T. and Clark, D. M. (2007). Cognitive-behavioral therapy for PTSD in children and adolescents: a preliminary randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 1051–1061.CrossRefGoogle ScholarPubMed
Stein, B. D., Jaycox, L. H., Kataoka, S. H., Wong, M., Tu, W., Elliott, M. N., et al. (2003). A mental health intervention for schoolchildren exposed to violence: a randomized controlled trial. Journal of the American Medical Association, 290, 603–611.CrossRefGoogle ScholarPubMed
Thienkrua, W., Cardozo, B. L., Chakkraband, M. L., Guadamuz, T. E., Pengjuntr, W., Tantipiwatanaskul, P., et al. (2006). Symptoms of posttraumatic stress disorder and depression among children in tsunami-affected areas in southern Thailand. Journal of the American Medical Association, 296, 549–559.Google Scholar
Ularntinon, S., Piyasil, V., Ketumarn, P., Sitdhiraksa, N., Pityaratstian, N., Lerthattasilp, T., et al. (2008). Assessment of psychopathological consequences in children at 3 years after tsunami disaster. Journal of the Medical Association of Thailand, 91 Suppl 3, S69–75.Google Scholar
Yule, W., Dyregrov, A., Raundalen, M. and Smith, P. (2013). Children and war: the work of the Children and War Foundation. European Journal of Psychotraumatology, 4. doi: 10.3402/ejpt.v4i0.18424Google Scholar
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