Posttraumatic Stress Disorder in Youth

Article excerpt

Summarized by Elizabeth J. Zhe, PsyD, Culver Academies, Culver, IN

Professional Psychology: Research and Practice published a review article by Feeny, Foa, Treadwell, and March (2004) critiquing research on PTSD treatments for youth. Despite the substantial amount of research on the treatment of PTSD in adult populations, PTSD treatment outcome studies in youth populations are sparse. Feeny et al.'s review strives to bring light to the clinical implications of existing research and to detect gaps where future research is needed.

The authors review the prevalence of trauma exposure in school-age populations and youth with emotional disturbances, as well as common psychological reactions to exposure. PTSD is pinpointed as the most common type of psychological reaction to trauma exposure, and yet few youth with PTSD receive empirically supported treatments for their diagnosis. Common self-report measures used to evaluate traumatizedyouth are also briefly reviewed. Feeny et al. identify numerous self-reports as adequate initial screening instruments; however, none provides a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) diagnosis of PTSD. Foa, Johnson, Feeny, & Treadwell (2001) describe the Child PTSD Symptom Scale as a solid measure that evaluates both DSM-IV symptoms and functional impairment.

An empirical review of cognitive and behavioral treatments (CBT) for youth with PTSD is then provided. Due to the lack of research on other types of treatments for traumatized youth (i.e., one published randomized controlled study of a non-CBT psychosocial intervention and no published pharmacological interventions with controlled trials), only CBTs are reviewed. Reviewed treatments were individually delivered exposure treatment, eye-movement desensitization and reprocessing (EMDR), anxiety-management training (AMT), group-delivered treatments, and child-parent treatments for sexual abuse-related trauma.

On the whole, the authors assert that there is mounting empirical support for the use of numerous CBT programs in the treatment of youth with PTSD. Key findings are (a) there is preliminary evidence found in numerous single-case designs for the effectiveness of exposure, group CBT with exposure, and anxiety-management training; (b) evidence is found in well-designed re search studies with randomized trials that brief treatments for disaster- and violence-related PTSD are efficacious; (c) sequential studies of child and parent CBT programs (including exposure and parent-training for PTSD and symptoms of sexual abuse) are suggestive of short- and long-term efficacy when provided in either individual, group, or parallel child and parent treatments; and (d) effective CBT treatments for sexually abused youth, with or without a focus on treating PTSD, entail parent or family involvement. …