Article type
Year
Abstract
Background: Most people experience a traumatic event in childhood, and one in 5 have experienced violence, bullying, rape or childhood sexual abuse. In Norway, about half of those referred to special health services have experienced at least one potentially traumatizing event, and a substantial share of individuals with a trauma history develop long-term negative consequences. A range of treatment methods are available, and synthesized evidence of their efficiency is warranted in order to offer children the best possible treatment and improve quality of life for this group.
Objectives: The aim of this review of systematic reviews was to synthesize available international high-quality evidence of the effect of various interventions for trauma and post-traumatic stress disorder (PTSD) in children and adolescents (3-18 years old).
Methods: We searched for relevant reviews in IN SUM, an extensive database of systematic reviews evaluating interventions for mental health and welfare in children and adolescents, based on 8 research databases. We also hand searched systematic reviews developed by NICE, Socialstyrelsen and Sundhedsstyrelsen. The quality of the systematic reviews was assessed with AMSTAR, and the certainty of the evidence was considered using the GRADE criteria. Traumatic events were defined as neglect, abuse, sexual abuse, violence, child genital mutilation, natural/manmade disasters, parental bereavement, accidents, explosions, terror attacks, having experienced war, or being refugee or asylum seeker. Reviews were included if they reported treatment outcomes for trauma symptoms or PTSD.
Results: A total of 68 recent publications (published 2014-2018) were screened for inclusion, and of these 14 met the stringent inclusion and exclusion criteria and were selected for inclusion. A total of 39 different types of interventions were found, many of which had several treatment comparisons. Trauma focused cognitive behavioral therapy was found to be effective for children having experienced a wide range of traumas. For some of the traumatised groups, psychoeducation, attachment-based treatments, selective serotonin reuptake inhibitors ((SSRI) combined with cognitive processing therapy), Eye movement desensitization and reprocessing (EMDR), school-based interventions or support programs could improve symptoms. Improvement up to 6 years post treatment was found in some groups. Evidence was for some treatments limited by low quality (GRADE) or small sample sizes.
Conclusions: Effective treatments are available for trauma symptoms or post-traumatic stress disorder (PTSD) in children and adolescents. Trauma-focused cognitive behavioral therapy was overall found to be an efficient treatment for trauma symptoms and PTSD of various origin, but also other treatments yielded positive effects.
Patient or healthcare consumer involvement:The current review was performed as part of a project that aims to improve the public and providers’ access to reliable evidence on treatments of trauma and PTSD.
Objectives: The aim of this review of systematic reviews was to synthesize available international high-quality evidence of the effect of various interventions for trauma and post-traumatic stress disorder (PTSD) in children and adolescents (3-18 years old).
Methods: We searched for relevant reviews in IN SUM, an extensive database of systematic reviews evaluating interventions for mental health and welfare in children and adolescents, based on 8 research databases. We also hand searched systematic reviews developed by NICE, Socialstyrelsen and Sundhedsstyrelsen. The quality of the systematic reviews was assessed with AMSTAR, and the certainty of the evidence was considered using the GRADE criteria. Traumatic events were defined as neglect, abuse, sexual abuse, violence, child genital mutilation, natural/manmade disasters, parental bereavement, accidents, explosions, terror attacks, having experienced war, or being refugee or asylum seeker. Reviews were included if they reported treatment outcomes for trauma symptoms or PTSD.
Results: A total of 68 recent publications (published 2014-2018) were screened for inclusion, and of these 14 met the stringent inclusion and exclusion criteria and were selected for inclusion. A total of 39 different types of interventions were found, many of which had several treatment comparisons. Trauma focused cognitive behavioral therapy was found to be effective for children having experienced a wide range of traumas. For some of the traumatised groups, psychoeducation, attachment-based treatments, selective serotonin reuptake inhibitors ((SSRI) combined with cognitive processing therapy), Eye movement desensitization and reprocessing (EMDR), school-based interventions or support programs could improve symptoms. Improvement up to 6 years post treatment was found in some groups. Evidence was for some treatments limited by low quality (GRADE) or small sample sizes.
Conclusions: Effective treatments are available for trauma symptoms or post-traumatic stress disorder (PTSD) in children and adolescents. Trauma-focused cognitive behavioral therapy was overall found to be an efficient treatment for trauma symptoms and PTSD of various origin, but also other treatments yielded positive effects.
Patient or healthcare consumer involvement:The current review was performed as part of a project that aims to improve the public and providers’ access to reliable evidence on treatments of trauma and PTSD.