Effectiveness of abbreviated trauma-focused cognitive behavioural therapy for South African adolescents: a randomized controlled trial.
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| Title: | Effectiveness of abbreviated trauma-focused cognitive behavioural therapy for South African adolescents: a randomized controlled trial. |
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| Alternate Title: | Eficacia de la terapia cognitiva conductual abreviada centrada en el trauma para adolescentes sudafricanos: un ensayo controlado aleatorizado. 简化版聚焦创伤的认知行为疗法对南非青少年的有效性：一项随机对照试验 |
| Authors: | Kaminer, Debra (AUTHOR), Simmons, Candice (AUTHOR), Seedat, Soraya (AUTHOR), Skavenski, Stephanie (AUTHOR), Murray, Laura (AUTHOR), Kidd, Martin (AUTHOR), Cohen, Judith A. (AUTHOR) |
| Source: | European Journal of Psychotraumatology. 2023, Vol. 14 Issue 1, p1-11. 11p. |
| Subjects: | Post-traumatic stress disorder, Exposure therapy, Behavior therapy, South Africans, Child mental health services, Mental health services, Cognitive therapy |
| Geographic Terms: | South Africa |
| Abstract (English): | Background: In low- and middle- income countries (LMICs) trauma exposure among youth is high, but mental health services are critically under-resourced. In such contexts, abbreviated trauma treatments are needed. Objective: To evaluate the efficacy of an abbreviated eight-session version of Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) for improving posttraumatic stress disorder (PTSD) and depression symptoms in a sample of South African adolescents. Method: 75 trauma-exposed adolescents (21 males, 54 females; mean age = 14.92, range = 11–19) with posttraumatic stress disorder (PTSD) symptoms were randomly assigned to eight sessions of TF-CBT or to usual services. At baseline, post-treatment and three-month follow-up, participants completed the Child PTSD Symptom Scale for DSM 5 (CPSS-5) and the Beck Depression Inventory II (BDI-II). The trial is registered on the Pan African Trial Registry (PACTR202011506380839).6. Results: 95% of TF-CBT participants completed treatment while only 47% of TAU participants accessed treatment. Intention-to-treat analyses found that the TF-CBT group had a significantly greater reduction in CPSS-5 PTSD symptom severity at post-treatment (Cohen's d = 0. 60, p <.01) and three-month follow-up (Cohen's d = 0.62, p <. 01), and a greater reduction in the proportion of participants meeting the CPSS-5 clinical cut-off for PTSD at both time points (p =.02 and p =.03, respectively). There was also a significantly greater reduction in depression symptom severity in the TF-CBT group at post-treatment (Cohen's d = 0.51, p =.03) and three-month follow-up (Cohen's d = 0.41, p =.05), and a greater reduction in the proportion of TF-CBT participants meeting the BDI clinical cut-off for depression at both time points (p =.02 and p =.03, respectively). Conclusion: The findings provide preliminary evidence of the efficacy of an abbreviated eight-session version of TF-CBT for reducing PTSD and depression symptoms in a LMIC sample of adolescents with multiple trauma exposure. Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) is one of the leading evidence-based treatments for child and adolescent posttraumatic stress, but an abbreviated version has not been evaluated in low- and middle-income countries (LMICs). At post-treatment and three-month follow-up, eight sessions of TF-CBT were more effective than treatment-as-usual in reducing posttraumatic stress and depression symptoms in an LMIC sample of South African adolescents exposed to multiple traumas. Effect sizes were similar to those reported for standard length TF-CBT, indicating that abbreviated TF-CBT may be a suitable option for resource-constrained child and adolescent mental health services in LMICs. [ABSTRACT FROM AUTHOR] |
| Abstract (Spanish): | Antecedentes: En los países de ingresos bajos y medios (LMIC, por sus siglas en inglés), la exposición al trauma entre los jóvenes es alta, pero los servicios de salud mental tienen una escasez crítica de recursos. En tales contextos, se necesitan tratamientos de trauma abreviados. Objetivo: Evaluar la eficacia de una versión abreviada de ocho sesiones de la Terapia cognitiva conductual centrada en el trauma (TCC-CT) para mejorar los síntomas del trastorno de estrés postraumático (TEPT) y de depresión en una muestra de adolescentes sudafricanos. Método: 75 adolescentes expuestos a trauma (21 hombres, 54 mujeres; edad media = 14,92, rango = 11–19) con síntomas de trastorno de estrés postraumático (TEPT) fueron asignados aleatoriamente a ocho sesiones de TCC-CT o a los servicios habituales (TAU por sus siglas en inglés). Al inicio del estudio, después del tratamiento y a los tres meses de seguimiento, los participantes completaron la Escala de síntomas de TEPT infantil para el DSM 5 (CPSS-5) y el Inventario de depresión de Beck II (BDI-II, por sus siglas en inglés). El ensayo está registrado en el Registro Panafricano de Ensayos (PACTR202011506380839). Resultados: El 95 % de los participantes de TCC-CT completó el tratamiento, mientras que solo el 47 % de los participantes de TAU accedió al tratamiento. Los análisis por intención de tratamiento encontraron que el grupo TCC-CT tuvo una reducción significativamente mayor en la gravedad de los síntomas de TEPT CPSS-5 después del tratamiento (d de Cohen = 0,60, p < 0,01) y a los tres meses de seguimiento (d de Cohen = 0,62, p < 0,01), y una mayor reducción en la proporción de participantes que cumplieron con el límite clínico CPSS-5 para TEPT en ambos puntos temporales (p = 0,02 y p = 0,03, respectivamente). También hubo una reducción significativamente mayor en la gravedad de los síntomas de depresión en el grupo de TCC-CT después del tratamiento (d de Cohen = 0,51, p = 0,03) y a los tres meses de seguimiento (d de Cohen = 0,41, p = 0,05), y una mayor reducción en la proporción de participantes de TCC-CT que alcanzaron el límite clínico BDI para la depresión en ambos puntos temporales (p = 0,02 y p = 0,03, respectivamente). Conclusión: Los hallazgos brindan evidencia preliminar de la eficacia de una versión abreviada de ocho sesiones de TCC-CT para reducir el TEPT y los síntomas de depresión en una muestra de adolescentes de LMIC con exposición a múltiples traumas. [ABSTRACT FROM AUTHOR] |
| Abstract (Chinese): | 背景：在低收入和中等收入国家 (LMIC)，年轻人创伤暴露程度很高，但心理健康服务资源严重不足。 在这种情况下，需要简短的创伤治疗。 目的：在南非青少年样本中评估简化版八疗程聚焦创伤的认知行为疗法 (TF-CBT)对改善创伤后应激障碍 (PTSD) 和抑郁症状的有效性。 方法：75 名有创伤后应激障碍 (PTSD) 症状的创伤暴露青少年（21 名男性，54 名女性；平均年龄 = 14.92，范围 = 11-19）被随机分配到八疗程TF-CBT 或常规服务。 在基线、治疗后和三个月的随访中，参与者完成了 DSM 5 儿童 PTSD 症状量表 (CPSS-5) 和贝克抑郁量表 II (BDI-II)。 该试验已在泛非试验注册中心注册(PACTR202011506380839)。 结果：95% 的 TF-CBT 参与者完成了治疗，而只有 47% 的 TAU 参与者接受了治疗。治疗意向分析发现，TF-CBT 组在治疗后 (Cohen's d = 0. 60, p <.01) 和三个月随访时 CPSS-5 PTSD 症状严重程度显著降低 (Cohen 的 d = 0.62， p <.01)，并且在这两个时间点满足 CPSS-5 PTSD 临床临界值的参与者比例都大幅下降（分别为 p =.02 和 p =.03）。TF-CBT 组的抑郁症状严重程度在治疗后（Cohen's d = 0.51， p =.03）和三个月的随访（Cohen's d = 0.41， p =.05）时也有显著降低，并且在两个时间点达到抑郁症 BDI 临床临界值的 TF-CBT 参与者比例大幅降低（分别为 p = 0.02 和 p = 0.03）。 结论：研究结果为简化版八疗程TF-CBT 在 LMIC多重创伤暴露青少年中减少 PTSD 和抑郁症状的有效性提供了初步证据，。 [ABSTRACT FROM AUTHOR] |
| Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
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| Items | – Name: Title Label: Title Group: Ti Data: Effectiveness of abbreviated trauma-focused cognitive behavioural therapy for South African adolescents: a randomized controlled trial. – Name: TitleAlt Label: Alternate Title Group: TiAlt Data: Eficacia de la terapia cognitiva conductual abreviada centrada en el trauma para adolescentes sudafricanos: un ensayo controlado aleatorizado.<br />简化版聚焦创伤的认知行为疗法对南非青少年的有效性：一项随机对照试验 – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Kaminer%2C+Debra%22">Kaminer, Debra</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Simmons%2C+Candice%22">Simmons, Candice</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Seedat%2C+Soraya%22">Seedat, Soraya</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Skavenski%2C+Stephanie%22">Skavenski, Stephanie</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Murray%2C+Laura%22">Murray, Laura</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kidd%2C+Martin%22">Kidd, Martin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cohen%2C+Judith+A%2E%22">Cohen, Judith A.</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Psychotraumatology%22">European Journal of Psychotraumatology</searchLink>. 2023, Vol. 14 Issue 1, p1-11. 11p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Post-traumatic+stress+disorder%22">Post-traumatic stress disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Exposure+therapy%22">Exposure therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Behavior+therapy%22">Behavior therapy</searchLink><br /><searchLink fieldCode="DE" term="%22South+Africans%22">South Africans</searchLink><br /><searchLink fieldCode="DE" term="%22Child+mental+health+services%22">Child mental health services</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+health+services%22">Mental health services</searchLink><br /><searchLink fieldCode="DE" term="%22Cognitive+therapy%22">Cognitive therapy</searchLink> – Name: SubjectGeographic Label: Geographic Terms Group: Su Data: <searchLink fieldCode="DE" term="%22South+Africa%22">South Africa</searchLink> – Name: Abstract Label: Abstract (English) Group: Ab Data: Background: In low- and middle- income countries (LMICs) trauma exposure among youth is high, but mental health services are critically under-resourced. In such contexts, abbreviated trauma treatments are needed. Objective: To evaluate the efficacy of an abbreviated eight-session version of Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) for improving posttraumatic stress disorder (PTSD) and depression symptoms in a sample of South African adolescents. Method: 75 trauma-exposed adolescents (21 males, 54 females; mean age = 14.92, range = 11–19) with posttraumatic stress disorder (PTSD) symptoms were randomly assigned to eight sessions of TF-CBT or to usual services. At baseline, post-treatment and three-month follow-up, participants completed the Child PTSD Symptom Scale for DSM 5 (CPSS-5) and the Beck Depression Inventory II (BDI-II). The trial is registered on the Pan African Trial Registry (PACTR202011506380839).6. Results: 95% of TF-CBT participants completed treatment while only 47% of TAU participants accessed treatment. Intention-to-treat analyses found that the TF-CBT group had a significantly greater reduction in CPSS-5 PTSD symptom severity at post-treatment (Cohen's d = 0. 60, p <.01) and three-month follow-up (Cohen's d = 0.62, p <. 01), and a greater reduction in the proportion of participants meeting the CPSS-5 clinical cut-off for PTSD at both time points (p =.02 and p =.03, respectively). There was also a significantly greater reduction in depression symptom severity in the TF-CBT group at post-treatment (Cohen's d = 0.51, p =.03) and three-month follow-up (Cohen's d = 0.41, p =.05), and a greater reduction in the proportion of TF-CBT participants meeting the BDI clinical cut-off for depression at both time points (p =.02 and p =.03, respectively). Conclusion: The findings provide preliminary evidence of the efficacy of an abbreviated eight-session version of TF-CBT for reducing PTSD and depression symptoms in a LMIC sample of adolescents with multiple trauma exposure. Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) is one of the leading evidence-based treatments for child and adolescent posttraumatic stress, but an abbreviated version has not been evaluated in low- and middle-income countries (LMICs). At post-treatment and three-month follow-up, eight sessions of TF-CBT were more effective than treatment-as-usual in reducing posttraumatic stress and depression symptoms in an LMIC sample of South African adolescents exposed to multiple traumas. Effect sizes were similar to those reported for standard length TF-CBT, indicating that abbreviated TF-CBT may be a suitable option for resource-constrained child and adolescent mental health services in LMICs. [ABSTRACT FROM AUTHOR] – Name: Abstract Label: Abstract (Spanish) Group: Ab Data: Antecedentes: En los países de ingresos bajos y medios (LMIC, por sus siglas en inglés), la exposición al trauma entre los jóvenes es alta, pero los servicios de salud mental tienen una escasez crítica de recursos. En tales contextos, se necesitan tratamientos de trauma abreviados. Objetivo: Evaluar la eficacia de una versión abreviada de ocho sesiones de la Terapia cognitiva conductual centrada en el trauma (TCC-CT) para mejorar los síntomas del trastorno de estrés postraumático (TEPT) y de depresión en una muestra de adolescentes sudafricanos. Método: 75 adolescentes expuestos a trauma (21 hombres, 54 mujeres; edad media = 14,92, rango = 11–19) con síntomas de trastorno de estrés postraumático (TEPT) fueron asignados aleatoriamente a ocho sesiones de TCC-CT o a los servicios habituales (TAU por sus siglas en inglés). Al inicio del estudio, después del tratamiento y a los tres meses de seguimiento, los participantes completaron la Escala de síntomas de TEPT infantil para el DSM 5 (CPSS-5) y el Inventario de depresión de Beck II (BDI-II, por sus siglas en inglés). El ensayo está registrado en el Registro Panafricano de Ensayos (PACTR202011506380839). Resultados: El 95 % de los participantes de TCC-CT completó el tratamiento, mientras que solo el 47 % de los participantes de TAU accedió al tratamiento. Los análisis por intención de tratamiento encontraron que el grupo TCC-CT tuvo una reducción significativamente mayor en la gravedad de los síntomas de TEPT CPSS-5 después del tratamiento (d de Cohen = 0,60, p < 0,01) y a los tres meses de seguimiento (d de Cohen = 0,62, p < 0,01), y una mayor reducción en la proporción de participantes que cumplieron con el límite clínico CPSS-5 para TEPT en ambos puntos temporales (p = 0,02 y p = 0,03, respectivamente). También hubo una reducción significativamente mayor en la gravedad de los síntomas de depresión en el grupo de TCC-CT después del tratamiento (d de Cohen = 0,51, p = 0,03) y a los tres meses de seguimiento (d de Cohen = 0,41, p = 0,05), y una mayor reducción en la proporción de participantes de TCC-CT que alcanzaron el límite clínico BDI para la depresión en ambos puntos temporales (p = 0,02 y p = 0,03, respectivamente). Conclusión: Los hallazgos brindan evidencia preliminar de la eficacia de una versión abreviada de ocho sesiones de TCC-CT para reducir el TEPT y los síntomas de depresión en una muestra de adolescentes de LMIC con exposición a múltiples traumas. [ABSTRACT FROM AUTHOR] – Name: Abstract Label: Abstract (Chinese) Group: Ab Data: 背景：在低收入和中等收入国家 (LMIC)，年轻人创伤暴露程度很高，但心理健康服务资源严重不足。 在这种情况下，需要简短的创伤治疗。 目的：在南非青少年样本中评估简化版八疗程聚焦创伤的认知行为疗法 (TF-CBT)对改善创伤后应激障碍 (PTSD) 和抑郁症状的有效性。 方法：75 名有创伤后应激障碍 (PTSD) 症状的创伤暴露青少年（21 名男性，54 名女性；平均年龄 = 14.92，范围 = 11-19）被随机分配到八疗程TF-CBT 或常规服务。 在基线、治疗后和三个月的随访中，参与者完成了 DSM 5 儿童 PTSD 症状量表 (CPSS-5) 和贝克抑郁量表 II (BDI-II)。 该试验已在泛非试验注册中心注册(PACTR202011506380839)。 结果：95% 的 TF-CBT 参与者完成了治疗，而只有 47% 的 TAU 参与者接受了治疗。治疗意向分析发现，TF-CBT 组在治疗后 (Cohen's d = 0. 60, p <.01) 和三个月随访时 CPSS-5 PTSD 症状严重程度显著降低 (Cohen 的 d = 0.62， p <.01)，并且在这两个时间点满足 CPSS-5 PTSD 临床临界值的参与者比例都大幅下降（分别为 p =.02 和 p =.03）。TF-CBT 组的抑郁症状严重程度在治疗后（Cohen's d = 0.51， p =.03）和三个月的随访（Cohen's d = 0.41， p =.05）时也有显著降低，并且在两个时间点达到抑郁症 BDI 临床临界值的 TF-CBT 参与者比例大幅降低（分别为 p = 0.02 和 p = 0.03）。 结论：研究结果为简化版八疗程TF-CBT 在 LMIC多重创伤暴露青少年中减少 PTSD 和抑郁症状的有效性提供了初步证据，。 [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1080/20008066.2023.2181602 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 11 StartPage: 1 Subjects: – SubjectFull: Post-traumatic stress disorder Type: general – SubjectFull: Exposure therapy Type: general – SubjectFull: Behavior therapy Type: general – SubjectFull: South Africans Type: general – SubjectFull: Child mental health services Type: general – SubjectFull: Mental health services Type: general – SubjectFull: Cognitive therapy Type: general – SubjectFull: South Africa Type: general Titles: – TitleFull: Effectiveness of abbreviated trauma-focused cognitive behavioural therapy for South African adolescents: a randomized controlled trial. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Kaminer, Debra – PersonEntity: Name: NameFull: Simmons, Candice – PersonEntity: Name: NameFull: Seedat, Soraya – PersonEntity: Name: NameFull: Skavenski, Stephanie – PersonEntity: Name: NameFull: Murray, Laura – PersonEntity: Name: NameFull: Kidd, Martin – PersonEntity: Name: NameFull: Cohen, Judith A. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 01 Text: 2023 Type: published Y: 2023 Identifiers: – Type: issn-print Value: 20008066 Numbering: – Type: volume Value: 14 – Type: issue Value: 1 Titles: – TitleFull: European Journal of Psychotraumatology Type: main |
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