ABSTRACT

Youth exposed to a wide range of potentially traumatic events, such as natural disasters, acts of violence, terrorism, motor vehicle accidents, and life-threatening illnesses, are at risk for developing posttraumatic stress disorder (PTSD) or significant posttraumatic stress symptoms (PTSS). Recent reviews of the existing evidence-base for the treatment of PTSD in children and adolescents identified trauma-focused cognitive behavioral therapy (TF-CBT) and cognitive behavioral therapy (CBT) as well-established treatments. However, studies that evaluated treatment moderators have been scant. Research on treatment moderators is important for guiding clinical decision-making around selecting treatments that might be most effective given the characteristics and circumstances of a particular child or adolescent. Thus, this article provides an updated review of potential moderators evaluated in recent (i.e., past 5 years) meta-analyses and systematic reviews of psychological treatments for PTSD in youth. The moderators examined were in the areas of youth characteristics (age, gender, ethnicity, domicile), parent/caregiver factors (involvement, functioning), trauma type, and treatment factors (dose, individual/group, provider, exposure elements, sudden gains). Some support was identified for age, gender, domicile, parent/caregiver involvement, maternal depressive symptoms, treatment dose, individual/group, and sudden gains as possible treatment moderators, although the strength of the evidence varied and more research is needed to clarify findings. Further study of moderators will be essential to advance the knowledge base in the treatment of PTSD in youth.

摘要

暴露于各种潜在创伤事件（例如自然灾害、暴力行为、恐怖主义、机动车事故和危及生命的疾病）的青少年有患创伤后应激障碍 (PTSD) 或严重创伤后应激障碍 (PTSS) 的风险）。最近对治疗儿童和青少年 PTSD 的现有证据基础的审查发现，以创伤为中心的认知行为疗法 (TF-CBT) 和认知行为疗法 (CBT) 是成熟的治疗方法。然而，评估治疗调节剂的研究很少。治疗调节剂的研究对于指导临床决策非常重要，因为根据特定儿童或青少年的特征和情况，选择可能最有效的治疗方法。因此，本文提供了对近期（即过去 5 年）青年 PTSD 心理治疗的荟萃分析和系统评价中评估的潜在调节者的最新评论。审查的主持人涉及青年特征（年龄、性别、种族、住所）、父母/照顾者因素（参与、功能）、创伤类型和治疗因素（剂量、个人/群体、提供者、暴露因素、突然增加） ）。尽管证据的强度各不相同，但需要更多的研究来澄清发现，但确定了一些支持年龄、性别、住所、父母/照顾者的参与、母亲的抑郁症状、治疗剂量、个人/群体和可能的治疗调节剂的突然收益. 对调节器的进一步研究对于推进青年 PTSD 治疗的知识基础至关重要。