Description

Approximately two-thirds of children and adolescents will experience at least one traumatic event, creating a critical need to identify effective child trauma interventions. While most children exposed to trauma do not experience long-term negative sequelae in terms of psychological and social functioning, some go on to develop traumatic stress syndromes, including post-traumatic stress disorder (PTSD). Studies have indicated that childhood traumatic stress syndromes are associated with a high degree of impairment that can carry into adolescence and adulthood. For example, childhood PTSD increases the risk for developing comorbid mental disorders, such as depression, substance abuse, and conduct disorder. Suicidality is a particular concern for children with PTSD. Decreased social, home, school (lower academic achievement), and relational functioning have also been observed in children and adolescents with PTSD. Although several guidelines on the treatment of PTSD during childhood and adolescence exist, the recommendations have not been largely based on evidence resulting from Comparative Effectiveness Reviews. Furthermore, the guidelines offer inconsistent recommendations for interventions. The current review is the second in a two-part series focusing on interventions that address child trauma. The first in the series focuses on the comparative effectiveness of interventions that address child exposure to trauma in the form of maltreatment (physical, sexual, and emotional/psychological abuse, and neglect). This review, the second in the series, addresses the treatment of children exposed to traumatic events other than child maltreatment or family violence, some of whom are already experiencing symptoms. Interventions for children exposed to family violence (i.e., intimate partner violence and other forms of violence exposure in the home) are not covered by either review given the heterogeneity in this population and the interventions used to treat family violence exposure. That is, children who witness but do not directly experience interpersonal violence represent different clinical populations in terms of the nature of the relationship disturbance and implications for treatment. The review also seeks to understand whether evidence exists for differences in the efficacy of interventions by specific child or treatment characteristics or by setting of the delivered intervention. Finally, the review attempts to identify adverse events associated with the interventions reviewed. An overarching goal of this review is to identify gaps in the current scientific literature, and to highlight important areas for future research, to help build the evidence base for interventions targeting traumatic stress symptoms or syndromes with children exposed to trauma other than maltreatment or family violence. Key Question 1: What is the comparative effectiveness of different types of pharmacotherapy, psychotherapy, complementary and alternative therapy, or other therapy, such as combined, for children ages 0 to 17 years exposed to trauma other than maltreatment? Key Question 2: What is the comparative effectiveness of different types of pharmacotherapy, psychotherapy, complementary and alternative therapy, or other therapy, such as combined, for children ages 0 to 17 years with traumatic stress symptoms from trauma other than maltreatment who are already experiencing symptoms? Key Question 3: Do interventions targeting children who were exposed to trauma and are already experiencing symptoms vary in their effectiveness by characteristics of the child, treatment, or setting? Key Question 4: What are the harms (e.g., low adherence/dropouts, side effects, retraumatization) associated with specific types of therapies targeting children exposed to trauma or targeting children who were exposed to trauma and are already experiencing symptoms?

Author: Human Services, U S Department of Heal, Author: And Quality, Agency for Healthcare Resea

Topic: Medical / Nursing
Media: Book
ISBN: 1483925854
Language: English
Pages: 344