Treatment for Posttraumatic Stress Disorder in Children

儿童创伤后应激障碍的治疗

• 批准号: 7149202
• 负责人: MICHAEL S SCHEERINGA
• 金额: $ 19.01万
• 依托单位: TULANE UNIVERSITY OF LOUISIANA
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-03-03 至 2008-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7149202
• 关键词: 6 year old; Accidental Injury; Accidents; Acute; Adherence; Adolescent; Adult; Age; Anxiety; Behavior Therapy; Behavioral; Child; Classification; Clinic; Cognitive; Communities; Condition; Consensus; Consultations; Development; Diagnosis; Distress; Dog Bite; Domestic Violence; Effectiveness; Enrollment; Feedback; Individual; Intervention; Intervention Studies; Manuals; Measures; Methods; NIH Program Announcements; Numbers; Nursery Schools; Parenting behavior; Parents; Participant; Phase; Population; Post-Traumatic Stress Disorders; Preschool Child; Protocols documentation; Randomized; Recruitment Activity; Research; Research Project Grants; Services; Sexual abuse; Staging; Standardization; Stress; Supportive care; Symptoms; Techniques; Testing; Time; Training; Trauma; Treatment Protocols; Waiting Lists; Week; base; cohort; indexing; physical abuse; psychosocial; response; success; therapy development

DESCRIPTION (provided by applicant): The aims of this research plan are (1) to demonstrate the successful adaptation and implementation of a theoretically-based manualized cognitive-behavioral treatment (CBT) for preschool-age children (3-6 years) with PTSD, and (2) to demonstrate that PTSD symptoms in the children and level of distress in the parents can be meaningfully reduced. No studies have attempted to show effectiveness of any psychosocial treatment in preschool children who have suffered interpersonal traumas, except for sexual abuse. This application is meant to fill that gap. The manualized protocol utilizes the CBT techniques of graded exposure, anxiety management training, and developing a coherent narrative of the trauma free of cognitive distortions. This is combined with parent-child relational treatment techniques focused on supportive therapy, parent management training, and enhancement of parent compliance. The subjects will be heterogeneous in regard to type of trauma, including children who have witnessed severe domestic violence, and those that have suffered acute accidental injuries. In Phase 1, 8 children with PTSD will be recruited and enrolled in the treatment. We will use systematic checklists, consensus panel reviews, and expert consultation from individual cases to guide the developmental adaptation and implementation of this intervention. Multiple indices of success will be assessed including therapist adherence, child compliance, parent compliance, parent reluctance, and parent acceptance. Repeated feedback mechanisms will be used to revise the manual/protocol to eventually achieve 90% completion of CBT tasks and 90% therapist adherence to the manual. In Phase 2, 38 children with PTSD will be recruited and randomized for intervention into either immediate treatment or a 12-week wait-list condition to control for the passage of time. We will measure the change in children's symptoms, and change in parents' symptoms and distress levels, in addition to the adaptation and implementation measures from Phase 1.

描述（由申请人提供）：本研究计划的目的是（1）展示基于理论的手动认知行为治疗（CBT）对患有 PTSD 的学龄前儿童（3-6 岁）的成功适应和实施，(2) 证明儿童的 PTSD 症状和父母的痛苦程度可以显着减少。没有研究试图证明任何心理社会治疗对遭受人际创伤（性虐待除外）的学龄前儿童的有效性。该应用程序旨在填补这一空白。手动化方案利用了 CBT 技术，包括分级暴露、焦虑管理训练以及在没有认知扭曲的情况下对创伤进行连贯的叙述。这与亲子关系治疗技术相结合，重点是支持治疗、家长管理培训和增强家长的依从性。受试者的创伤类型各不相同，包括目睹严重家庭暴力的儿童和遭受严重意外伤害的儿童。在第一阶段，将招募 8 名患有 PTSD 的儿童并参加治疗。我们将使用系统检查表、共识小组审查和个案专家咨询来指导该干预措施的发展适应和实施。将评估多种成功指标，包括治疗师依从性、儿童依从性、父母依从性、父母不情愿和父母接受度。重复反馈机制将用于修订手册/协议，最终实现 CBT 任务的 90% 完成率和治疗师 90% 的手册遵守率。在第二阶段，将招募 38 名患有 PTSD 的儿童，并随机进行干预，要么立即治疗，要么等待 12 周，以控制时间的流逝。除了第一阶段的适应和实施措施外，我们还将衡量儿童症状的变化以及父母症状和痛苦程度的变化。