Systematic Review and Meta-Analysis: Imputing Response Rates for First-Line Psychological Treatments for Posttraumatic Stress Disorder in Youth
- Forfatter(e)
- Lofthouse, K., Davies, A., Hodgekins, J., Meiser-Stedman, R.
- År
- 2025
- Tidsskrift
- Journal of the American Academy of Child & Adolescent Psychiatry
- Volum
- 28
- Sider
- 28
- Kategori(er)
- Depresjon og nedstemthet (inkl. både vansker og lidelse) Angst og engstelighet (inkl. både vansker og lidelse) Traumatiske belastninger/stress (PTSD)
- Tiltakstype(r)
- Kognitiv atferdsterapi, atferdsterapi og kognitiv terapi
- Abstract
OBJECTIVE
Meta-analyses assessing psychological therapies for posttraumatic stress disorder (PTSD) in youth have demonstrated their effectiveness using standardized mean differences. Imputation of response rates (ie, 50% or greater reduction in symptoms) may facilitate easier interpretation for clinicians.
METHOD
We searched 4 databases (MEDLINE, PsycINFO, PTSDPubs, and Web of Science) and screened 1,654 records to include 60 randomized controlled trials (52 trauma-focused cognitive-behavioral therapy [TF-CBT], 8 eye movement desensitization [EMDR]) with a total of 5,113 participants, comparing psychological therapies for PTSD against control conditions in youth. Data from randomized controlled trials of EMDR and TF-CBT for PTSD were used to impute response rates, establishing how many patients display 50% reduction, 20% reduction, and reliable improvement and deterioration (using reliable change indices) in PTSD and depression.
RESULTS
The proportion of youth exhibiting a 50% reduction in PTSD symptoms was 0.48 (95% CI = 0.41-0.55) for TF-CBT, 0.30 (0.24-0.37) for EMDR, and 0.46 (0.39-0.52) for all psychological therapies, compared to 0.20 (0.16-0.24) for youth in control conditions. Reliable improvement was displayed by 0.53 (0.45-0.61; TF-CBT 0.55 [0.46-0.64], EMDR 0.42[0.30-0.55]) of youth receiving psychological therapies, compared to 0.25 (0.20-0.30) of youth in control conditions. Reliable deterioration was seen in 0.01 (0.01-0.02) of youth receiving psychological therapies, compared to 0.13 (0.08-0.20) of youth in control conditions. There was a high degree of heterogeneity in the included studies.
CONCLUSION
Psychological therapies, in particular TF-CBT, for young people with PTSD are effective and unlikely to cause deterioration, with around half of youth receiving TF-CBT exhibiting 50% symptom reduction.