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Efficacy of trauma-focused-cognitive behavioral therapy on comorbid symptoms in preschool children: A systematic literature review

Forfatter(e)
Philippine, V., Andréa, S., Sébastien, F., Florence, A.
År
2026
DOI
10.1016/j.ejtd.2026.100641
Tidsskrift
European Journal of Trauma & Dissociation
Volum
10
Sider
12
Kategori(er)
Angst og engstelighet (inkl. både vansker og lidelse) ADHDAtferdsproblemer, antisosial atferd og atferdsforstyrrelser Depresjon og nedstemthet (inkl. både vansker og lidelse) Traumatiske belastninger/stress (PTSD)
Tiltakstype(r)
Kognitiv atferdsterapi, atferdsterapi og kognitiv terapi
Abstract

Purpose: This systematic review evaluates the efficacy of trauma-focused cognitive behavioral therapy (TF-CBT) in treating comorbid symptoms in preschool-aged children exposed to traumatic events.

Method: Following PRISMA guidelines, five databases were systematically searched to identify articles (ProQuest, PubMed, Cochrane, Sage, Scopus) and 19 studies were included (N = 3437).

Main findings: Strong to moderate evidence supports the efficacy of TF-CBT-based interventions in reducing internalizing symptoms (e.g., anxiety, depression, dissociation), particularly when core components targeting emotion regulation, avoidance, and caregiver co-regulation are preserved. Evidence for externalizing symptoms (e.g., oppositionality, inappropriate sexual behaviors) was more heterogeneous and dependent on the intensity of caregiver-mediated behavioral components. In contrast, evidence for neurodevelopmental symptoms such as attention-deficit/hyperactivity disorder (ADHD) was limited, indicating that TF-CBT does not consistently target core executive and attentional processes underlying these difficulties.

Conclusion: These findings highlight the importance of developmentally informed, caregiver-centered, and process-based approaches when addressing comorbidity in trauma-exposed preschool-aged children. Further well-powered randomized controlled trials focusing on comorbid outcomes in preschool-aged children are needed.