Gutermann, J., Schwartzkopff, L., & Steil, R. (2017). Meta-analysis of the long-term treatment effects of psychological interventions in youth with PTSD symptoms. Clinical Child and Family Psychology Review, 20, 422-434.
Natural disasters, physical abuse, sexual abuse, war, accidents, loss and severe illness are traumatic events that can occur during childhood and adolescence. These potentially traumatic events are highly prevalent in youth, and approximately 15% of children and adolescents who have been exposed to traumatic events meet the diagnostic criteria for post-traumatic stress disorder (PTSD). Criteria for a diagnosis of PTSD include: intrusive memories of the traumatic event, avoidance, hyperarousal, and negative change in mood or cognitions. PTSD symptoms are also highly stable over time, and so without intervention they do not tend to improve. In this meta-analysis, Gutermann and colleagues assess the effects of psychological treatments for PTSD in youth, with a special emphasis on their long term therapeutic effects. Forty-seven studies of 3767 participants were included in the analyses. Traumas were varied and included childhood abuse, physical abuse, accidents, wars, and natural disasters. About 68% of interventions were CBT-oriented, and 67% were provided in a group therapy format. The uncontrolled pre-treatment to follow-up effect sizes for PTSD symptoms was large for studies with a follow-up period greater than 6 months (N = 30; g = .99, CI .83, 1.16). However, when psychological interventions were compared to treatment as usual or an active control group in a randomized controlled trial, the effects at post-treatment were small (N = 6; g = .38, CI .03–.74), and effects at follow up periods combined were also small (N = 19; g = .38, CI .20, .55).
Psychological interventions resulted large effects to reduce PTSD symptoms from pre-treatment to follow-up from treatment. However, compared to treatment as usual or other active control groups, psychological treatments resulted in small effects in the longer term. There were too few studies to assess different treatment approaches, age groups, and modalities (group vs individual). Nevertheless, the results provide support for the efficacy of psychological treatments for PTSD in youth with modest effects at follow-up.
Author email: Gutermann@psych.uni-frankfurt.de