A Follow-Up Study from a Multisite, Randomized Controlled Trial for Traumatized Children Receiving TF-CBT
A Follow-Up Study from a Multisite, Randomized Controlled Trial for Traumatized Children Receiving TF-CBT
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DOI：
10.1007/s10802-017-0270-0
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发表时间：
2017-11-01
影响因子：
3.6
通讯作者：
Ormhaug, Silje M.
中科院分区：
文献类型：
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作者：
Jensen, Tine K.;Holt, Tonje;Ormhaug, Silje M.
创伤-集中认知行为疗法(TF-CBT)是创伤青年的首选治疗方法，然而，后续研究很少，对共发性抑郁症的治疗效果也显示出好坏参半的结果。本研究的目的是检查TF-CBT的治疗效果在18个月的随访中是否保持不变，以及伴发抑郁的程度是否影响治疗效果。由于年轻人的心理功能需要迅速改善，我们还调查了与常规治疗(TAU)相比，TF-CBT的症状轨迹是否不同。样本包括156名青年(男15.05岁，79.50%女孩)，被随机分配到TF-CBT或TAU组。对这些年轻人进行创伤后应激症状(PTSS)、抑郁、焦虑和一般心理健康症状的评估。混合效应分析跟踪症状过程超过5个时间点。接受TF-CBT治疗的年轻人在18个月的随访中保持了他们的症状改善，所有症状测量的评分都低于临床分界点。最抑郁的年轻人的症状也有明显的下降，并在随访中保持不变。症状轨迹不同，因为TF-CBT组报告的症状缓解比TAU组更快。在TAU条件下，参与者接受的治疗次数是TF-CBT参与者的1.5倍。18个月后，两组只在一般精神健康症状上有显着差异。总之，接受TF-CBT的年轻人在创伤相关症状方面的改善比接受TAU的年轻人更有效，并且这些改善在18个月后保持不变。同样，经历严重共生抑郁症的年轻人也受益于TF-CBT。
Trauma-focused cognitive behavioral therapy (TF-CBT) is the treatment of choice for traumatized youth, however, follow-up studies are scarce, and treatment effects for co-occurring depression show mixed findings. The aims of this study were to examine whether treatment effects of TF-CBT are maintained at 18 month follow-up and whether degree of co-occurring depression influences treatment effects. As rapid improvement in psychological functioning is warranted for youth, we also investigated whether the symptom trajectory was different for TF-CBT compared to therapy as usual (TAU). The sample consisted of 156 youth (M age = 15.05, 79.50% girls) randomly assigned to TF-CBT or TAU. The youth were assessed for posttraumatic stress symptoms (PTSS), depression, anxiety and general mental health symptoms. Mixed effects analyses followed the symptom courses over 5 time points. Youth receiving TF-CBT maintained their symptom improvement at 18 months follow-up with scores below clinical cut-of on all symptom measures. The most depressed youth had also a significant decline in symptoms that were maintained at follow-up. Symptom trajectories differed as the TF-CBT group reported a more rapid symptom reduction compared to the TAU condition. In the TAU condition, participants received 1.5 times the number of treatment sessions compared to the TF-CBT participants. After 18 months the groups were significantly different on general mental health symptoms only. In conclusion, youth receiving TF-CBT experienced more efficient improvement in trauma related symptoms than youth receiving TAU and these improvements were maintained after 18 months. Also youth experiencing serious co-occurring depression benefitted from TF-CBT.