Research Review: Changes in the prevalence and symptom severity of child post-traumatic stress disorder in the year following trauma - a meta-analytic study.
Research Review: Changes in the prevalence and symptom severity of child post-traumatic stress disorder in the year following trauma - a meta-analytic study.
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DOI：
10.1111/jcpp.12566
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发表时间：
2016-08
期刊：
影响因子：
--
通讯作者：
Halligan SL
中科院分区：
文献类型：
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作者：
Hiller RM;Meiser-Stedman R;Fearon P;Lobo S;McKinnon A;Fraser A;Halligan SL
了解儿童和青少年创伤后应激障碍（PTSD）的自然过程对识别和干预高危青少年具有重要意义。我们使用Meta分析方法来检查创伤后12个月内青年PTSD患病率和症状的纵向变化。我们进行了一项系统回顾，以确定在年轻人（5-18岁）中进行的PTSD纵向研究，排除治疗试验。检索得到了27项同行评议的研究和1个未发表的数据集，用于分析汇总患病率估计值、相对患病率降低和标准化平均症状变化。研究还探讨了关键的调节因素，包括年龄、样本中男孩的比例、PTSD的初始患病率和PTSD测量类型。分析表明，在创伤后的前3-6个月，PTSD患病率和症状严重程度适度下降。从创伤后1到6个月，PTSD的患病率降低了约50%。症状也显示出中度下降，特别是在创伤后的前3个月。6个月后，几乎没有证据表明患病率或症状严重程度进一步变化，这表明如果不进行干预，儿童不太可能失去PTSD诊断。 目前的研究结果提供了关键信息的可能性创伤后恢复在没有干预，并有重要的影响，我们了解儿童和青少年创伤后应激障碍。结合创伤后应激障碍筛查的时机和早期干预的潜在作用讨论了结果。研究结果特别强调了未来研究的重要性，以发展我们对什么因素阻止从“急性”创伤后时期正常恢复的理解。
Understanding the natural course of child and adolescent posttraumatic stress disorder (PTSD) has significant implications for the identification of, and intervention for, at‐risk youth. We used a meta‐analytic approach to examine longitudinal changes in youth PTSD prevalence and symptoms over the first 12 months posttrauma. We conducted a systematic review to identify longitudinal studies of PTSD in young people (5–18 years old), excluding treatment trials. The search yielded 27 peer‐reviewed studies and one unpublished dataset for analysis of pooled prevalence estimates, relative prevalence reduction and standardised mean symptom change. Key moderators were also explored, including age, proportion of boys in the sample, initial prevalence of PTSD and PTSD measurement type. Analyses demonstrated moderate declines in PTSD prevalence and symptom severity over the first 3–6 months posttrauma. From 1 to 6 months posttrauma, the prevalence of PTSD reduced by approximately 50%. Symptoms also showed moderate decline, particularly across the first 3 months posttrauma. There was little evidence of further change in prevalence or symptom severity after 6 months, suggesting that it is unlikely a child would lose a PTSD diagnosis without intervention beyond this point. The current findings provide key information about the likelihood of posttrauma recovery in the absence of intervention and have important implications for our understanding of child and adolescent PTSD. Results are discussed with reference to the timing of PTSD screening and the potential role of early interventions. Findings particularly highlight the importance of future research to develop our understanding of what factors prevent the action of normal recovery from the ‘acute’ posttrauma period.