Psychological interventions can work wonders in children with PTSD

Psychotherapies for children and adolescents with post-traumatic stress disorder (PTSD) appears to effectively induce response even in the context of multiple trauma exposure, such as abuse or maltreatment, according to the results of a systematic review and meta-analysis.

Researchers searched multiple online databases for randomized controlled trials (RCTs) that showed whether the efficacy of psychological interventions for paediatric PTSD was diminished when patients report multiple traumas vs single-event trauma.

The inclusion criteria were as follows: (a) random allocation, (b) partial or full PTSD, (c) PTSD as the primary treatment focus, (d) sample mean age <19 years, and (e) sample size of at least 20 participants. Trauma frequency was analysed as a dichotomous (single versus ≥2 traumas) and continuous (mean number of exposures) potential moderator of efficacy.

A total of 57 RCTs, which involved 4,295 participants, met the eligibility criteria. Of the studies, 51 were included in quantitative analyses.

Pooled data showed that interventions were efficacious for single-trauma-related PTSD (Hedges’ g, 1.09, 95 percent confidence interval [CI], 0.70–1.48; k=8 trials) and multiple trauma-related PTSD (g, 1.11, 95 percent CI, 0.74–1.47; k=12).

Of note, psychotherapies performed better than active control conditions in terms of reducing multiple trauma-related PTSD. For single-event PTSD, comparison with active control conditions was not possible owing to scarcity (k=1) of available trials.

Efficacy in the trauma exposure frequency subgroups was similar in subgroup analyses.