PTSD after childhood abuse: developmentally adapted cognitive therapy shows benefits

  • Rosner R & al.
  • JAMA Psychiatry
  • 10 Apr 2019

  • International Clinical Digest
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Takeaway

  • For adolescents with posttraumatic stress disorder (PTSD) symptoms related to abuse, developmentally adapted cognitive therapy yields better results than waitlist status.
  • The young people tolerated the intervention well in this multicenter randomized controlled trial .

Why this matters

  • Although abuse-related PTSD symptoms are relatively common, treatments targeting this population have received relatively scant attention.

Key results

  • Compared with waitlisted participants, those receiving the intervention showed more improvement in PTSD severity scores (Clinician-Administered PTSD Scale for Children and Adolescents for DSM-IV):
    • 24.7 (95% CI, 16.6-32.7) vs 47.5 (95% CI, 37.9-57.1); Hedges' g=0.90.
  • They had improved more at follow-up, too:
    • 25.9 (95% CI, 16.2-35.6) vs 47.3 (95% CI, 37.8-56.8); Hedges' g=0.80.
  • Self-reported results, secondary outcome findings followed the same pattern.
  • Younger participants seemed to gain the most benefit.

Study design

  • Trial enrolled 88 youth aged 14-21 years (44 to treatment; 44 to waitlist) seeking treatment for PTSD related to childhood abuse; 3 outpatient clinics in Germany, July 2013-June 2015.
  • Outcomes (primary was PTSD symptom severity) evaluated at baseline, 8 weeks posttreatment start, after treatment, 3 months posttreatment. 
  • Funding: German Federal Ministry of Education and Research.

Limitations

  • Small population, 85% female, excluded participants with severe, life-threatening behaviors, recent substance dependence.

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