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Raccanello D, Vicentini G, Rocca E, Hall R, Burro R. Can a web application foster emotional competence in children and adolescents? The case of PandHEMOT®. Appl Psychol Health Well Being 2024; 16:672-695. [PMID: 38035795 DOI: 10.1111/aphw.12511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/31/2023] [Indexed: 12/02/2023]
Abstract
The COVID-19 pandemic has had many traumatic consequences for the physical and psychological functioning of children and adolescents. Internet-based interventions can reach a large audience and be a potentially powerful resource for promoting well-being among young people. We tested the efficacy of the web application PandHEMOT®, developed ad hoc for increasing knowledge about pandemics, emotions, and emotion regulation. We involved a sample of 147 Italian third and seventh graders. The sample was assigned to an experimental (participating in the training) and a waitlist condition (who participated following a waitlist design). All the participants completed pretest and posttest measures. The intervention was structured into three units. The training took place between November and December 2021. Generalized linear mixed models and linear mixed models revealed that knowledge about pandemics, emotions, emotion regulation, and metacognitive awareness increased for the experimental condition. Moreover, adolescents performed better than children. The findings supported the efficacy of an Internet-based training for increasing children and adolescents' resilience, according to the standards of evidence-based research.
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Affiliation(s)
| | - Giada Vicentini
- Department of Human Sciences, University of Verona, Verona, Italy
| | - Emmanuela Rocca
- Department of Human Sciences, University of Verona, Verona, Italy
| | - Rob Hall
- Macquarie University, Sydney, New South Wales, Australia
- Environmetrics, Killara, New South Wales, Australia
| | - Roberto Burro
- Department of Human Sciences, University of Verona, Verona, Italy
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Cihanoğlu M, Vatansever M, Erden G. School-based psychosocial and educational interventions for children and adolescents after the 1999 Marmara earthquakes in Turkey: A review on lessons learned. Eval Program Plann 2024; 103:102403. [PMID: 38237313 DOI: 10.1016/j.evalprogplan.2024.102403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 04/30/2023] [Accepted: 01/04/2024] [Indexed: 03/25/2024]
Abstract
The massive earthquakes experienced in August and November 1999 affected thousands of people in the Marmara region, the most densely populated and industrialized part of Turkey. The humanitarian and economic cost was so enormous, and these earthquakes have changed the Turkish disaster management system and the Turkish people's approach to disasters. Marmara earthquakes are also considered as a milestone in the provision of psychosocial services for disaster victims. This paper aims to review the psychosocial interventions targeting children, adolescents, and their families after the 1999 earthquakes in Turkey. The progression from initial responses to more organized psychosocial interventions is outlined. Conducting the interventions at schools has ensured that thousands of children, teachers, and parents are reached in the most efficient and effective way possible. The significance of the school context in designing psychosocial interventions is highlighted and implications of the lessons learned for traumatic experiences of children and parents are also explored. It is evaluated that these inferences obtained from the Marmara earthquake in Turkey can be used in disasters around the world.
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Affiliation(s)
- Mine Cihanoğlu
- Department of Psychology, Atılım University, Ankara, Turkey
| | - Merve Vatansever
- Department of Psychology, Kırıkkale University, Kırıkkale, Turkey
| | - Gülsen Erden
- Department of Psychology, Beykoz University, Istanbul, Turkey.
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3
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Lee K, Kronick R, Miconi D, Rousseau C. Moving Forward in Mental Health Care for Refugee, Asylum-Seeking, and Undocumented Children: Social Determinants, Phased Approach to Care, and Advocacy. Child Adolesc Psychiatr Clin N Am 2024; 33:237-250. [PMID: 38395508 DOI: 10.1016/j.chc.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Given the current political and climate crisis, the number of forcedly displaced individuals continues to rise, posing new challenges to host societies aiming to support and respond to the needs of those fleeing war or persecution. In this article, we turn our attention to current and historical sociopolitical contexts influencing the mental health of forcedly displaced children (ie, refugee, asylum-seeking, and undocumented) during their resettlement in high-income countries, proposing timely ways to respond to evolving needs and recommendations to redress ubiquitous structural inequities that act as barriers to education and care for the children, youth, and families seeking sanctuary.
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Affiliation(s)
- Keven Lee
- Division of Social and Transcultural Psychiatry, McGill University, 1033 Pine Avenue, Montreal, Quebec, Canada; Lady Davis Institute, 3755 Côte Ste-Catherine Road, Montreal, Quebec.
| | - Rachel Kronick
- Division of Social and Transcultural Psychiatry, McGill University, 1033 Pine Avenue, Montreal, Quebec, Canada; Lady Davis Institute, 3755 Côte Ste-Catherine Road, Montreal, Quebec
| | - Diana Miconi
- Department of Educational Psychology and Adult Education, Université de Montréal, 90 Vincent D'Indy Avenue, Outremont, Montréal, QC, Canada
| | - Cécile Rousseau
- Division of Social and Transcultural Psychiatry, McGill University, 1033 Pine Avenue, Montreal, Quebec, Canada
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4
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Oswald TK, Nguyen MT, Mirza L, Lund C, Jones HG, Crowley G, Aslanyan D, Dean K, Schofield P, Hotopf M, Das-Munshi J. Interventions targeting social determinants of mental disorders and the Sustainable Development Goals: a systematic review of reviews. Psychol Med 2024:1-25. [PMID: 38523245 DOI: 10.1017/s0033291724000333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
Globally, mental disorders account for almost 20% of disease burden and there is growing evidence that mental disorders are socially determined. Tackling the United Nations Sustainable Development Goals (UN SDGs), which address social determinants of mental disorders, may be an effective way to reduce the global burden of mental disorders. We conducted a systematic review of reviews to examine the evidence base for interventions that map onto the UN SDGs and seek to improve mental health through targeting known social determinants of mental disorders. We included 101 reviews in the final review, covering demographic, economic, environmental events, neighborhood, and sociocultural domains. This review presents interventions with the strongest evidence base for the prevention of mental disorders and highlights synergies where addressing the UN SDGs can be beneficial for mental health.
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Affiliation(s)
- Tassia Kate Oswald
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Minh Thu Nguyen
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Luwaiza Mirza
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- University Hospitals Sussex, UK
| | - Crick Lund
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Hannah Grace Jones
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Grace Crowley
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Daron Aslanyan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Kimberlie Dean
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- Justice Health and Forensic Mental Health Network, New South Wales, Australia
| | - Peter Schofield
- School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, UK
| | - Matthew Hotopf
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Jayati Das-Munshi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
- ESRC Centre for Society and Mental Health, King's College London, UK
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5
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Witt A, Sachser C, Fegert JM. Scoping review on trauma and recovery in youth after natural disasters: what Europe can learn from natural disasters around the world. Eur Child Adolesc Psychiatry 2024; 33:651-665. [PMID: 35426528 PMCID: PMC10894166 DOI: 10.1007/s00787-022-01983-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 03/29/2022] [Indexed: 11/27/2022]
Abstract
In the last decade, Europe has seen a rise in natural disasters. Due to climate change, an increase of such events is predicted for the future. While natural disasters have been a rare phenomenon in Europe so far, other regions of the world, such as Central and North America or Southeast Asia, have regularly been affected by Hurricanes and Tsunamis. The aim of the current study is to synthesize the literature on child development in immediate stress, prolonged reactions, trauma, and recovery after natural disasters with a special focus on trajectories of (mal-)adaptation. In a literature search using PubMed, Psychinfo and EBSCOhost, 15 studies reporting about 11 independent samples, including 11,519 participants aged 3-18 years, were identified. All studies identified resilience, recovery, and chronic trajectories. There was also evidence for delayed or relapsing trajectories. The proportions of participants within each trajectory varied across studies, but the more favorable trajectories such as resilient or recovering trajectory were the most prevalent. The results suggested a more dynamic development within the first 12 months post-disaster. Female gender, a higher trauma exposure, more life events, less social support, and negative coping emerged as risk factors. Based on the results, a stepped care approach seems useful for the treatment of victims of natural disasters. This may support victims in their recovery and strengthen their resilience. As mental health responses to disasters vary, a coordinated screening process is necessary, to plan interventions and to detect delayed or chronic trauma responses and initiate effective interventions.
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Affiliation(s)
- Andreas Witt
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhövelstraße 1, 89073, Ulm, Germany.
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhövelstraße 1, 89073, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhövelstraße 1, 89073, Ulm, Germany
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6
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Höhne E, Böge K, Karnouk C, Tschorn M, Banaschewski T, Hoell A, Sukale T, Plener P, Schneider F, Padberg F, Hasan A, Rapp MA, Bajbouj M, Kamp-Becker I. Culturally sensitive stepped care for adolescent refugees: efficacy and cost-utility of a multicentric randomized controlled trial. Eur Child Adolesc Psychiatry 2024; 33:581-593. [PMID: 36922435 PMCID: PMC10869413 DOI: 10.1007/s00787-023-02179-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 02/27/2023] [Indexed: 03/18/2023]
Abstract
Adolescent refugees and asylum seekers (ARAS) are highly vulnerable to mental health problems. Stepped care models (SCM) and culturally sensitive therapies offer promising treatment approaches to effectively provide necessary medical and psychological support. To our knowledge, we were the first to investigate whether a culturally sensitive SCM will reduce symptoms of depression and PTSD in ARAS more effectively and efficiently than treatment as usual (TAU). We conducted a multicentric, randomized, controlled and rater-blinded trial across Germany with ARAS between the ages of 14 to 21 years. Participants (N = 158) were stratified by their level of depressive symptom severity and then equally randomized to either SCM or TAU. Depending on their severity level, SCM participants were allocated to tailored interventions. Symptom changes were assessed for depression (PHQ) and PTSD (CATS) at four time points, with the primary end point at post-intervention after 12 weeks. Based on an intention-to-treat sample, we used a linear mixed model approach for the main statistical analyses. Further evaluations included cost-utility analyses, sensitivity analyses, follow-up-analyses, response and remission rates and subgroup analysis. We found a significant reduction of PHQ (d = 0.52) and CATS (d = 0.27) scores in both groups. However, there was no significant difference between SCM and TAU. Cost-utility analyses indicated that SCM generated greater cost-utility when measured as quality-adjusted life years compared to TAU. Subgroup analysis revealed different effects for the SCM interventions depending on the outcome measure. Although culturally sensitive, SCMs did not prove to be more effective in symptom change and represent a more cost-effective treatment alternative for mentally burdened ARAS. Our research contributes to the optimization of clinical productivity and the improvement of therapeutic care for ARAS. Disorder-specific interventions should be further investigated.
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Affiliation(s)
- Edgar Höhne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Clinic, Philipps-University Marburg, Marburg, Germany.
| | - Kerem Böge
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Carine Karnouk
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Mira Tschorn
- Department of Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Andreas Hoell
- Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Thorsten Sukale
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
| | - Paul Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Frank Schneider
- University Hospital Düsseldorf, Medical School University of Duesseldorf, Düsseldorf, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, BKH Augsburg, Augsburg, Germany
| | - Michael A Rapp
- Department of Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | - Malek Bajbouj
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Inge Kamp-Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Clinic, Philipps-University Marburg, Marburg, Germany
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Protić S, Wittmann L, Taubner S, Conejo-Cerón S, Ioannou Y, Heinonen E, Saliba A, Moreno-Peral P, Volkert J, Barkauskiene R, Julia Schmidt S, Rangel Santos Henriques MI, Pinheiro Mota C, Sales CMD, Røssberg JI, Adler A, Giacomo DD, Mucha Vieira F, Drndarević N, Ulberg R, Stepisnik Perdih T, Mestre JM. Mediators of Outcome in Trauma-Focused Psychotherapy with Youth: A Systematic Review. Trauma Violence Abuse 2024:15248380231223264. [PMID: 38281152 DOI: 10.1177/15248380231223264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
This article aimed to provide a systematic narrative synthesis of existing studies on the mediators of change in psychotherapy with adolescents (10-19 years) and transition age youth (TAY) (20-29 years) who have experienced trauma-related symptoms or posttraumatic disorder. Additionally, we were interested in identifying psychotherapy-, trauma type-, and clients' age- and gender-specific mediators of treatment outcome. Following the preferred reporting items for systematic reviews and meta-analyses, a total of 3,723 studies published in PubMed and PsycINFO databases were screened against inclusion criteria, revealing 15 eligible studies. No studies with only TAY were found; therefore, all results were limited to therapy with adolescents. Cognitive mediators were tested in 66% of selected studies, followed by parents/family-related, mental-health-related, therapy-related, and behavioral mediators. Moderate evidence was found for posttraumatic cognitions, whereas therapeutic alliance seemed to be a promising candidate for future research. Striking absence of non-cognitive-behavioral therapy interventions, emotional and adolescent-specific mediators, as well as studies with males and in non-Western societies was evident. Future original studies would benefit from applying methodological rigor in respect to mediation testing.
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Affiliation(s)
- Sonja Protić
- Institute of Criminological and Sociological Research, Belgrade, Serbia
- Evangelische Hochschule Darmstadt/University of Applied Science Darmstadt, Darmstadt, Germany
| | - Lutz Wittmann
- International Psychoanalytic University Berlin, Germany
| | | | - Sonia Conejo-Cerón
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAN, Malaga, Andalucía, Spain
| | | | - Erkki Heinonen
- National Institute for Health and Welfare, Helsinki, Finland
- University of Oslo, Norway
| | - Andrea Saliba
- University of Malta and Mental Health Services Malta, Malta
| | - Patricia Moreno-Peral
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAN, Malaga, Andalucía, Spain
| | - Jana Volkert
- Clinic for Psychosomatic Medicine and Psychotherapy University of Ulm, Ulm, Germany
| | | | | | | | | | | | | | | | | | | | - Nikola Drndarević
- Institute of Criminological and Sociological Research, Belgrade, Serbia
| | - Randi Ulberg
- University of Oslo, Norway
- Diakonhjemmet Hospital, Oslo, Norway
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Mayer B, Elbing U, Ostermann T. Trauma treatment using Narrative Exposure Therapy adapted to persons with intellectual disabilities or severe chronic mental disorders - a randomised controlled pilot study with an embedded observational study. J Intellect Disabil Res 2023; 67:1096-1112. [PMID: 37582663 DOI: 10.1111/jir.13076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND Despite an increased likelihood of experiencing traumatic events and increased vulnerability, there are only few publications on trauma therapy for persons with intellectual disabilities (IDs). This pilot study for the first time investigates the feasibility and effectiveness of Narrative Exposure Therapy (NET) within this target group modified by Plain Language. METHODS A group of n = 10 participants with ID dual diagnoses and another group of n = 5 participants with severe and chronic mental disorders were separately stratified and randomised, then forming together an intervention group (n = 7) and a waiting list control group (n = 8). All participants were treated with NET attuned to their communication abilities by using Plain Language. Primary outcome was the post-traumatic stress measured with the Post-Traumatic Symptom Scale-10 before and after the intervention. In addition, the Adverse Childhood Experience Index was used for diagnostic purposes. Data were analysed using t-test for repeated measures and analysis of covariance. RESULTS Narrative Exposure Therapy and the randomised controlled trial study proved to be successfully conductible with participants with IDs in a congregated residential service. Although the corresponding effect size was high (partial eta square = 0.188), the between-group difference was not significant (P = 0.12). Analysis of the observational study resulted in a highly significant improvement for participants with IDs (P < 0.001; Hedges' g = 2.36) and in a significant improvement in participants with severe and chronic mental disorders (P < 0.013; Hedges' g = 1.52). Additionally, the participants with IDs show a significantly better reduction of symptom burden (P = 0.03; partial eta square = 0.327). CONCLUSIONS The results provide a first evidence for a possible and successful implementation of NET modified in Plain Language for persons with IDs and complex mental health support needs. Completeness in responding to the items of Post-Traumatic Symptom Scale-10 and Adverse Childhood Experience Index indicates the suitability of these instruments for both groups of participants. Although the group difference in the randomised controlled trial failed to achieve statistical significance mainly due to the small sample size, the results of the embedded observational study are promising for the conduct of further studies with the modified NET.
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Affiliation(s)
- B Mayer
- Residence Tilia Rheinau, Rheinau, Switzerland
| | - U Elbing
- Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
| | - T Ostermann
- Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
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Raccanello D, Vicentini G, Rocca E, Hall R, Burro R. Preparing children to cope with earthquakes: Building emotional competence. Br J Psychol 2023; 114:871-907. [PMID: 37171875 DOI: 10.1111/bjop.12661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 04/17/2023] [Accepted: 04/20/2023] [Indexed: 05/14/2023]
Abstract
Natural disasters, including earthquakes, can have a traumatic impact on children's psychological wellbeing and development. The efficacy of interventions aimed at enhancing children's socio-emotional learning has been documented in the literature. At the same time, these techniques are the key for training children for possible future disasters by enhancing their knowledge about behavioural preparedness and emotional competence. However, research on evidence-based training programs on earthquakes combining digital and traditional activities is scarce. We tested the efficacy of a 10-unit training program for primary school children, developed within the Emotional Prevention and Earthquakes in Primary School (PrEmT) project. The program aimed at increasing knowledge of and metacognition about earthquakes, safety behaviours, emotions, and coping strategies, through digital (using the web-application HEMOT® , Helmet for EMOTions, developed ad-hoc) and traditional activities (completing paper-and-pencil tasks). The participants were 548 second and fourth-graders from Italian schools. They were divided into an experimental group (participating in the training program) and a control group. Both groups participated in pretests and posttests to evaluate changes in their knowledge of training-related contents. For ethical reasons, we also measured children's wellbeing. Generalized linear mixed models indicated an improvement in the experimental group's knowledge and metacognition about earthquakes, safety behaviours, emotions, and coping strategies after the training program, compared to the control group. Children's general wellbeing did not deteriorate during participation in the project. The results documented the efficacy of the evidence-based training program developed within the PrEmT project. The program provides a preventive method for enhancing earthquake-related resilience that could be generalized to other kinds of disasters.
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Affiliation(s)
| | - Giada Vicentini
- Department of Human Sciences, University of Verona, Verona, Italy
| | - Emmanuela Rocca
- Department of Human Sciences, University of Verona, Verona, Italy
| | - Rob Hall
- Macquarie University, Sydney, New South Wales, Australia
- Environmetrics, Killara, New South Wales, Australia
| | - Roberto Burro
- Department of Human Sciences, University of Verona, Verona, Italy
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10
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Tsheole P, Makhado L, Maphula A. Childhood Trauma and Exposure to Violence Interventions: The Need for Effective and Feasible Evidence-Based Interventions. Children (Basel) 2023; 10:1760. [PMID: 38002851 PMCID: PMC10670457 DOI: 10.3390/children10111760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/11/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023]
Abstract
Several crimes in South Africa cause physical, economic, and mental problems. Xenophobic attacks, mob justice, and other violent conduct directly traumatise children. Service delivery riots and physical and sexual abuse are examples. This evaluation evaluates childhood trauma and exposure to violence interventions. The review describes the therapeutic methods for traumatised children exposed to violence, the healthcare professionals administering them, and the strategies used to tailor the interventions. The researcher systematically searched PsycINFO, Google Scholar, PubMed, Science Direct, and EBSCOhost. Literature from 2011 to 31 July 2023 was searched, and 19 papers were chosen for further review after the systematic search. The authors conducted an eligibility evaluation according to PRISMA guidelines. A thorough review of article texts identified 19 papers that met eligibility standards. Only nineteen studies have validated trauma and violence therapies for children. An effective multi-phased intervention that is feasible and adaptable to varied socioeconomic backgrounds is needed. Further studies on the mental health benefits of brief trauma intervention treatment are needed.
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Affiliation(s)
- Petunia Tsheole
- Department of Psychology, Faculty of Health Sciences, University of Venda, Thohoyandou 0950, South Africa
| | - Lufuno Makhado
- Public Health, Faculty of Health Care Sciences, University of Venda, Thohoyandou 0950, South Africa; (L.M.); (A.M.)
| | - Angelina Maphula
- Public Health, Faculty of Health Care Sciences, University of Venda, Thohoyandou 0950, South Africa; (L.M.); (A.M.)
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11
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Feinstein D. Using energy psychology to remediate emotional wounds rooted in childhood trauma: preliminary clinical guidelines. Front Psychol 2023; 14:1277555. [PMID: 37920741 PMCID: PMC10619750 DOI: 10.3389/fpsyg.2023.1277555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 09/13/2023] [Indexed: 11/04/2023] Open
Abstract
Adverse childhood experiences (ACEs) are potentially traumatic events that occur in childhood, such as violence, abuse, severe neglect, or mental health problems in caregivers. The negative physical and mental health consequences of severe or multiple ACEs provide a major challenge for the health care community. Psychotherapies that utilize a mind-body approach in treating ACE-related conditions are seen by their proponents as having advantages for bringing healing and restoration compared with talk, introspective, interpersonal, and exposure therapies that do not intervene at the body level, as famously encapsulated by Bessel van der Kolk's observation that "the body keeps the score." A mind-body approach whose use has been rapidly increasing in clinical settings as well as on a self-help basis is called "energy psychology." Energy psychology combines conventional therapeutic techniques such as cognitive restructuring and psychological exposure with the stimulation of acupuncture points (acupoints) by tapping on them. A review of the development, efficacy, and plausible mechanisms of energy psychology is presented, and several strengths are enumerated, such as how integrating acupoint tapping into conventional exposure methods enhances the speed and power of outcomes. The impact of energy psychology protocols on the three brain networks most centrally involved with ACEs is also examined. Finally, recommendations are offered for using an energy psychology approach at each stage of therapy with individuals who have endured severe or multiple ACES, from establishing a therapeutic alliance to assessment to treatment to follow-up.
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12
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Lyons JS, Fernando AD. Creating the necessary infrastructure for a trauma-informed system of care for children and youth. Front Psychol 2023; 14:1129197. [PMID: 37496789 PMCID: PMC10366599 DOI: 10.3389/fpsyg.2023.1129197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/21/2023] [Indexed: 07/28/2023] Open
Abstract
Understanding and addressing the impact of adverse life events is an important priority in the design of helping systems. However, creating trauma-informed systems requires efforts to embed effective trauma-informed work in routine practice. This article discusses a model for developing trauma-informed systems using the Transformational Collaborative Outcomes Management (TCOM) framework, a strategy for engineering person-centered care. Person-centered care is naturally congruent with trauma-informed care. We describe the initial stages of implementation of a trauma-informed standardized assessment process to support the sustained evolution of trauma-informed care. Distinguishing between traumatic experiences and traumatic stress is fundamental to an effective trauma-informed system. We describe two sets of analyses-one in a statewide child welfare system and the other in a statewide behavioral health system. These projects found opportunities in the analysis of the detection of traumatic stress based on traumatic experiences to inform practice and policy. Being trauma-informed in child welfare is distinct from being trauma-informed in behavioral health. In child welfare, it appears that a number of children are resilient in the face of traumatic experiences and do not require trauma treatment interventions. However, delayed and missed traumatic stress responses are common. In behavioral health, misses often occur among adolescents, particularly boys, who engage in acting out behavior. Opportunities for the ongoing development of trauma-informed systems using the TCOM framework are discussed.
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Al-Shatanawi TN, Khader Y, ALSalamat H, Al Hadid L, Jarboua A, Amarneh B, Alkouri O, Alfaqih MA, Alrabadi N. Identifying psychosocial problems, needs, and coping mechanisms of adolescent Syrian refugees in Jordan. Front Psychiatry 2023; 14:1184098. [PMID: 37426088 PMCID: PMC10325618 DOI: 10.3389/fpsyt.2023.1184098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 05/23/2023] [Indexed: 07/11/2023] Open
Abstract
Background Refugees who have fled war zones are at a heightened risk of psychosocial problems that can impact their ability to function in day-to-day life and place a significant burden on the family structure. This study aimed to assess the psychosocial problems and needs and coping mechanisms of Adolescent Syrian refugees in Jordan. Methods Between October and December 2018, we conducted a qualitative study using semi-structured interviews with a sample of key and individual informants. Our sample included 20 primary healthcare professionals, 20 schoolteachers, 20 Syrian parents, and 20 adolescents aged 12-17 years. All interviews were transcribed verbatim, and we utilized thematic analysis to group, categorize, and analyze the original Arabic language transcripts. To ensure thorough analysis, we adopted a bottom-up inductive approach that covered the six-phase iterative process proposed by Braun and Clarke. Results The main psychosocial problems encountered by Syrian adolescents included stress, depression, loneliness, lack of a sense of security, isolation, aggressiveness, fear of war, and family disintegration. Almost all schoolteachers reported that they observed that Jordanian adolescents are more settled, self-confident, and financially stable relative to their Syrian peers. The Jordanian government and community were praised for their support, including education, recreational centers, health services, and awareness campaigns. Going to school, praying and reading the Holy Quran, listening to music, and talking to friends and engaging with them were reported as the main coping mechanisms. The majority of respondents said that more services are still needed for adolescents, including more places for entertainment, psychosocial support and psychological counseling, medical care, job creation, and providing health insurance. Conclusion Syrian refugees are aware of the psychological aspects of their situation, but they are not always able to access clinic-based humanitarian assistance for mental health and psychosocial support. Stakeholders must interact with refugees to learn about their needs and develop services that are appropriate for their culture.
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Affiliation(s)
- Tariq N. Al-Shatanawi
- Department of Public Health and Community Medicine, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
| | - Yousef Khader
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Husam ALSalamat
- Department of Public Health and Community Medicine, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | | | - Alaa Jarboua
- Department of Legal Medicine, Toxicology and Forensic Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Basil Amarneh
- Department of Community and Mental Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Osama Alkouri
- Faculty of Nursing, Yarmouk University, Irbid, Jordan
| | - Mahmoud A. Alfaqih
- Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- Department of Biochemistry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Nasr Alrabadi
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Semerci M, Uzun S. The effectiveness of post-disaster psychotherapeutic interventions: A systematic review and meta-analysis study. Asian J Psychiatr 2023; 85:103615. [PMID: 37201380 DOI: 10.1016/j.ajp.2023.103615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/24/2023] [Accepted: 04/28/2023] [Indexed: 05/20/2023]
Abstract
OBJECTIVE This study aimed to determine the level of impact of post-disaster psychotherapeutic interventions. MATERIAL METHOD For this systematic review and meta-analysis study, the studies were accessed through the databases of PubMed, Web of Science, EBSCOhost, Google Scholar, and YÖK Thesis Center in July-September 2022 without any year limitation. As a result of the examinations, 27 studies were included in the study. The data were synthesized by meta-analysis and narrative methods. RESULTS According to the results of this systematic review and meta-analysis, post-disaster psychotherapeutic interventions were found to be effective (SMD:-0838, %95 CI: -1,087- 0.588; Z = -6588, p = 0.000, I2 = %95,249). Individuals who have undergone psychotherapeutic interventions experience either no or fewer post-traumatic stress disorder symptoms. The country/continent of the research, the types of psychotherapeutic interventions, the type of disaster, and the measurement tool used influence the effectiveness of the psychotherapeutic interventions. Psychotherapeutic interventions applied especially after earthquakes, one of the types of disasters, were found to be effective. In addition, EMDR, cognitive behavioral therapy, psychotherapy, and exposure method were found to reduce posttraumatic stress disorder symptoms in individuals in the post-disaster period. CONCLUSION Post-disaster psychotherapeutic interventions have positive impacts on people and improve their mental health.
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Affiliation(s)
- Murat Semerci
- Department of Nursing, Gümüşhane University Faculty of Health Sciences, Gümüşhane, Turkey
| | - Sevda Uzun
- Department of Nursing, Gümüşhane University Faculty of Health Sciences, Gümüşhane, Turkey.
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15
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Akena D, Kiguba R, Muwhezi WW, Kwesiga B, Kigozi G, Lukwata H, Nakasujja N. The prevalence and factors associated with mental disorders in a community setting in central Uganda. PLoS One 2023; 18:e0285091. [PMID: 37141327 PMCID: PMC10159349 DOI: 10.1371/journal.pone.0285091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 04/15/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Mental disorders are known to predict poverty, morbidity and mortality. In resource limited settings, low levels of mental health literacy (MHL) and high mental illness stigma (MIS) have been sighted as possible factors that may impede access to mental health care. However, little has been done to examine the association between mental disorders and these factors (MHL and MIS) in sub-Saharan Africa. METHODS We assessed for the prevalence of major depressive disorders (MDD), substance use disorders (SUD), post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), documented MHL and MIS among 814 participants from 24 villages in central Uganda. We conducted regression analyses to examine the association between the prevalence of mental disorders, demographic factors as well as MIS and MHL. RESULTS Over two thirds of the participants 581 (70%) were female. The mean age of the participants was 38 years (SD± 13.5). The prevalence of mental disorders ranged from 6.8-32%. Participants who were older were less likely to screen positive for GAD (OR 0.98; 0.96-0.99), female gender was protective against SUD (OR 0.46; 0.3-0.68) and those with MDD had lower education level (OR 0.23; 0.1-0.53). The mean MIS score was 11.3 (SD± 5.4) with a range of 6-30 and the mean MHL score was 21.7 (SD ±3.0) with a range of 10-30. MIS was negatively associated with GAD [β = -1.211 (-2.382 to -0.040)]. There no statistically significant association between MHL and a mental disorder. CONCLUSION There was a high prevalence of mental disorders in the community that we studied. Adequate resources should be allocated to address this burden.
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Affiliation(s)
- Dickens Akena
- Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ronald Kiguba
- Department of Pharmacology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Wilson W. Muwhezi
- Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda
| | - Brendan Kwesiga
- Health Systems Strengthening Cluster, World Health Organization, Kenya Country Office, Gigiri, Kenya
| | - Gwendolyne Kigozi
- Grants office, Makerere University College of Health Sciences, Kampala, Uganda
| | - Hafsa Lukwata
- Department of Mental Health, Ministry of Health of Uganda, Kampala, Uganda
| | - Noeline Nakasujja
- Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda
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Lotzin A, Franc de Pommereau A, Laskowsky I. Promoting Recovery from Disasters, Pandemics, and Trauma: A Systematic Review of Brief Psychological Interventions to Reduce Distress in Adults, Children, and Adolescents. Int J Environ Res Public Health 2023; 20:5339. [PMID: 37047954 PMCID: PMC10094700 DOI: 10.3390/ijerph20075339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/28/2023] [Accepted: 03/09/2023] [Indexed: 06/19/2023]
Abstract
A substantial number of survivors of disasters, pandemics, and other severe stressors develop persistent distress that impairs mental health and well-being. However, only a few brief psychological interventions target distress or subclinical symptoms. This systematic review aimed to identify and describe brief psychological interventions to reduce distress or subclinical symptoms in survivors of disasters, pandemics, and other severe stressors. Based on a systematic literature search (MEDLINE, PsycINFO, PSYNDEX, PTSDpubs, and Web of Science), we reviewed published studies and study protocols on self-help, psychosocial support, or brief psychotherapeutic interventions to reduce distress and/or subclinical symptoms following natural hazards and man-made disasters, pandemics, or other traumatic events. We included 27 published studies or study protocols (n = 15 RCTs, n = 3 controlled pre-post studies, and n = 9 uncontrolled pre-post studies) describing 22 interventions. We found evidence for reducing psychological distress and/or subclinical symptoms in 9 out of 15 RCTs, 2 out of 3 controlled pre-post studies, and 9 out of 9 uncontrolled pre-post studies. One RCT provided evidence of increasing well-being. Innovative brief interventions have been developed to reduce distress and/or subclinical symptoms that have an emerging evidence base.
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Affiliation(s)
- Annett Lotzin
- Institute for Clinical Psychology and Psychotherapy, Department of Psychology, MSH Medical School Hamburg, 20457 Hamburg, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Alicia Franc de Pommereau
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Isabelle Laskowsky
- Institute for Clinical Psychology and Psychotherapy, Department of Psychology, MSH Medical School Hamburg, 20457 Hamburg, Germany
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Goetz AR, Kennedy SM, Kook M, Guzick AG, Nwankwo GNA, Hana LM, Schneider SC, Cepeda SL, Weinzimmer SA, Shah AA, Goodman WK, Salloum A, Ehrenreich-May J, Storch EA. Examining the Effectiveness of the Transdiagnostic Unified Protocol for Emotional Disorders Delivered to Youth Following Hurricane Harvey. Child Youth Care Forum 2023. [DOI: 10.1007/s10566-023-09740-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
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Abstract
The Russian invasion of Ukraine on 24th February 2022 has prompted this article to summarise some of the salient mental health issues experienced by young asylum seekers and refugees focussing on resettlement countries, drawing on the substantial literature, for Child and Adolescent Mental Health Practitioners. Firstly, the various UNHCR categories of persons affected by war and persecution and statistics are described. By July 2022, over 100 million people globally were of concern to UNHCR, a number increased by the many millions of refugees fleeing Ukraine to neighbouring countries. Selected findings on the psychiatric epidemiology of young refugees are summarised, and some principles of Child and Adolescent Mental Health Service delivery and treatments are outlined. The research on Ukrainian refugees' mental health is limited and this is an area that requires further investigation alongside active attempts to meet their mental health needs.
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Affiliation(s)
- Matthew Hodes
- Division of Psychiatry, Imperial College London, London, UK; Westminster Child and Adolescent Mental Health Service, Central and North West London NHS Foundation Trust, London, UK
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19
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Raccanello D, Rocca E, Barnaba V, Vicentini G, Hall R, Brondino M. Coping Strategies and Psychological Maladjustment/Adjustment: A Meta-Analytic Approach with Children and Adolescents Exposed to Natural Disasters. Child Youth Care Forum 2023; 52:25-63. [PMID: 35221639 PMCID: PMC8858219 DOI: 10.1007/s10566-022-09677-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2022] [Indexed: 01/28/2023]
Abstract
Background Following disasters, children and adolescents can use coping strategies to feel better. A growing body of studies investigated the relation between them and maladjustment/adjustment, i.e., negative symptomatology/positive indicators of development. Yet, these constructs are studied separately. Objective We conducted two meta-analyses to examine the mean correlation between disaster-related coping strategies and indicators of maladjustment/adjustment following natural disasters in children and adolescents, considering the role of some moderators. Methods We used PsycINFO, PubMed, Eric, and Scopus databases to identify articles on natural disasters (filters: participants ≤ 18 years at the disaster, peer-review, English language). Inclusion required investigating the relation between at least one coping strategy and at least one indicator of maladjustment (e.g., post-traumatic stress disorder, depression) and/or adjustment (e.g., self-efficacy, emotion understanding), for a total of 26 studies (k = 64, n = 9692, for maladjustment; k = 37, n = 3504, for adjustment). Results There were global positive significant correlations between coping strategies and negative symptomatology (r pooled = .23) for maladjustment, and positive indicators (r pooled = .17) for adjustment. Negative symptomatology positively correlated with escape (r = .19), social isolation (r = .15), submission (r = .64), and opposition (r = .16); positive indicators positively correlated with problem solving (r = .31), social support (r = .22), and submission (r = .30). We found a moderating role of age, disaster type, and continent for maladjustment. Conclusions The study presented an analysis of the coping strategies that can be effective for children and adolescents dealing with natural disasters.
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Affiliation(s)
- Daniela Raccanello
- grid.5611.30000 0004 1763 1124Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129 Verona, Italy
| | - Emmanuela Rocca
- grid.5611.30000 0004 1763 1124Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129 Verona, Italy
| | - Veronica Barnaba
- grid.5611.30000 0004 1763 1124Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129 Verona, Italy
| | - Giada Vicentini
- grid.5611.30000 0004 1763 1124Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129 Verona, Italy
| | - Rob Hall
- grid.1004.50000 0001 2158 5405Macquarie University and Environmetrics, Sydney, Australia
| | - Margherita Brondino
- grid.5611.30000 0004 1763 1124Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129 Verona, Italy
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Peters W, Rice S, Alvarez-Jimenez M, Hetrick SE, Halpin E, Kamitsis I, Santesteban-Echarri O, Bendall S. Relative efficacy of psychological interventions following interpersonal trauma on anxiety, depression, substance use, and PTSD symptoms in young people: A meta-analysis. Early Interv Psychiatry 2022; 16:1175-1184. [PMID: 35106931 PMCID: PMC9786735 DOI: 10.1111/eip.13265] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/21/2021] [Accepted: 01/18/2022] [Indexed: 12/30/2022]
Abstract
AIM Interpersonal trauma exposures are associated with anxiety, depression, and substance use in youth populations (aged 12-25 years). This meta-analysis reports on the efficacy of psychological interventions on these symptom domains in addition to post-traumatic stress. METHODS Following PRISMA guidelines, a search of electronic databases was performed for randomized controlled trials (RCTs) assessing interventions for young people following interpersonal trauma exposure. Risk of bias was assessed using the Cochrane Risk of Bias tool. Data were analysed using random-effects meta-analyses. RESULTS Of the 4832 records screened, 78 studies were reviewed, and 10 RCTs, involving 679 participants (mean age 15.6 years), were analysed. There was a large pooled effect size for post-traumatic stress (7 studies, g = 1.43, 95% CI [0.37, 2.15], p = .002) and substance use (2 studies, g = 0.70, 95% CI [-0.11, 1.22], p < .001) and small effect sizes for anxiety (4 studies, g = 0.30, 95% CI [0.10, 0.49], p = .003), and trend-level effect for depression (10 studies, g = 0.27, 95% CI [0.00, 0.54], p = .052). Heterogeneity was significant for post-traumatic stress and moderate for depression. CONCLUSIONS High-quality RCTs of psychological interventions for anxiety, depression, substance use, and post-traumatic stress symptoms in young people exposed to interpersonal trauma are scarce. While available studies show either statistically significant or trend-level efficacy for psychological interventions in reducing these symptoms, wide confidence intervals, heterogeneity and small sample size mean that results need to be interpreted with caution.
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Affiliation(s)
- Wilma Peters
- Department of Research and Translation, Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Simon Rice
- Department of Research and Translation, Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Mario Alvarez-Jimenez
- Department of Research and Translation, Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Sarah E Hetrick
- Department of Psychological Medicine, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand.,Centre for Youth Mental Health, University of Auckland, Auckland, New Zealand
| | - Emma Halpin
- Department of Research and Translation, Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Ilias Kamitsis
- Department of Research and Translation, Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Olga Santesteban-Echarri
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Sarah Bendall
- Department of Research and Translation, Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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Rossouw J, Sharp T, Halligan S, Seedat S. Psychotherapeutic interventions for childhood posttraumatic stress disorder: an update. Curr Opin Psychiatry 2022; 35:417-424. [PMID: 36044299 DOI: 10.1097/yco.0000000000000821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF THE REVIEW We review treatment outcome studies and systematic reviews for childhood and adolescent posttraumatic stress disorder (PTSD) between January 2020 and August 2022, including studies involving younger children and different treatment delivery methods and models. We address predictors, moderators, treatment engagement, and attrition. RECENT FINDINGS Recent randomised controlled trials corroborate earlier trials documenting trauma-focused cognitive behaviour therapy (TF-CBT) as a highly efficacious treatment for PTSD. Evidence for treatment effects in complex PTSD in youth is still sparse. Research on moderators and predictors of treatment continues to be hampered by multiple factors, including a lack of sufficiently large homogeneous trauma samples. SUMMARY TF-CBT is a very effective treatment for children and adolescents with PTSD. Further work is needed to (i) demonstrate that task-shifting models utilising lay community health counsellors and peer counsellors can effectively and cost-effectively close the mental health treatment gap that exists world-wide in children and adolescents diagnosed with PTSD, but particularly within low- and middle income countries, and (ii) better understand moderators and predictors of treatment which remains a priority.
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Affiliation(s)
- Jaco Rossouw
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University
| | - Tamsin Sharp
- Department of Psychology, University of Bath, Bath, UK
| | | | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University
- South African Research Chair in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University
- South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Newnham EA, Mergelsberg ELP, Chen Y, Kim Y, Gibbs L, Dzidic PL, Ishida DaSilva M, Chan EYY, Shimomura K, Narita Z, Huang Z, Leaning J. Long term mental health trajectories after disasters and pandemics: A multilingual systematic review of prevalence, risk and protective factors. Clin Psychol Rev 2022; 97:102203. [PMID: 36162175 DOI: 10.1016/j.cpr.2022.102203] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 07/29/2022] [Accepted: 09/08/2022] [Indexed: 11/25/2022]
Abstract
The patterns of long-term psychological response after disasters and pandemics remain unclear. We aimed to determine the trajectories for post-traumatic stress symptoms (PTSS), depression and anxiety prevalence following disasters and pandemic exposure; and identify associated risk and protective factors. A systematic review of the English, Chinese, and Japanese longitudinal mental health literature was conducted. We searched Cochrane, MEDLINE, ProQuest, PsycINFO, PubMed, Web of Science, and CINAHL (English), CNKI and SINOMED (Chinese) and CiNii (Japanese) for studies published between January 2000 and May 2022. Following a pre-specified protocol (PROSPERO: CRD42020206424), conditional linear growth curve models and ANOVA analyses were conducted. The search identified 77,891 papers, with a final sample of 234: 206 English, 24 Chinese, and 4 Japanese-language papers. PTSS rates improved for all ages (p = .018, eta2 = 0.035). In contrast, depression and anxiety prevalence remained elevated for years following exposure (p = .424, eta2 = 0.019 and p = .051, eta2 = 0.064, respectively), with significantly higher rates for children and adolescents (p < .005, eta2 > 0.056). Earthquakes and pandemics were associated with higher prevalence of PTSS (p < .019, eta2 > 0.019). Multi-level risk and protective factors were identified. The chronicity of mental health outcomes highlights a critical need for tailored, sustainable mental health services, particularly for children and adolescents, in disaster- and pandemic-affected settings.
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Affiliation(s)
- Elizabeth A Newnham
- School of Population Health, Curtin University, Kent Street, Bentley, WA, Australia; Curtin enAble Institute, Kent Street, Bentley, WA, Australia; FXB Center for Health and Human Rights, Harvard T. H. Chan School of Public Health, Boston, USA.
| | - Enrique L P Mergelsberg
- School of Population Health, Curtin University, Kent Street, Bentley, WA, Australia; Curtin enAble Institute, Kent Street, Bentley, WA, Australia
| | - Yanyu Chen
- School of Population Health, Curtin University, Kent Street, Bentley, WA, Australia
| | - Yoshiharu Kim
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Lisa Gibbs
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; Centre for Disaster Management and Public Safety, University of Melbourne, Melbourne, Australia
| | - Peta L Dzidic
- School of Population Health, Curtin University, Kent Street, Bentley, WA, Australia; Curtin enAble Institute, Kent Street, Bentley, WA, Australia
| | - Makiko Ishida DaSilva
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Emily Y Y Chan
- FXB Center for Health and Human Rights, Harvard T. H. Chan School of Public Health, Boston, USA; Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, Chinese University of Hong Kong, Hong Kong, China; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Kanji Shimomura
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan; Physical and Health Education, Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Zui Narita
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Zhe Huang
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, Chinese University of Hong Kong, Hong Kong, China
| | - Jennifer Leaning
- FXB Center for Health and Human Rights, Harvard T. H. Chan School of Public Health, Boston, USA
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Dong S, Dong Q, Chen H, Yang S. Childhood emotional neglect and adolescent depression: the role of self-compassion and friendship quality. Curr Psychol. [DOI: 10.1007/s12144-022-03539-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Morris H, Hatzikiriakidis K, Savaglio M, Dwyer J, Lewis C, Miller R, Skouteris H. Eye movement desensitization and reprocessing for the treatment and early intervention of trauma among first responders: A systematic review. J Trauma Stress 2022; 35:778-790. [PMID: 35064977 DOI: 10.1002/jts.22792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 11/09/2022]
Abstract
First responders are exposed to repetitive work-related trauma and, thus, are at risk of developing posttraumatic stress disorder (PTSD). Eye-movement desensitization and reprocessing (EMDR) is a psychotherapy intervention designed to treat symptoms of posttraumatic stress. We conducted a systematic review to examine the viability of EMDR among first responders. The primary aim of this review was to identify studies that have trialed EMDR among first responders and evaluate its effectiveness in reducing trauma-related symptoms; a secondary aim was to identify whether EMDR has been used as an early intervention for this cohort and determine its effectiveness as such. Four databases were searched. Studies were included if they evaluated the extent to which EMDR was effective in alleviating symptoms stemming from work-related trauma exposure among first responders. The findings from each study were reported descriptively, and eight studies that evaluated the efficacy of EMDR in this population were included. There was substantial variation in how EMDR was implemented, particularly in the type, duration, frequency, and timing. The findings suggest that EMDR can alleviate symptoms of work-related trauma exposure among first responders; however, findings regarding early intervention were inconclusive, and a methodological quality assessment revealed that all studies were classified as being of either weak or medium quality. Although this review provides preliminary insights into the effectiveness of EMDR for first responders, the conclusions that can be drawn from the literature are limited, and the findings highlight several gaps in the literature.
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Affiliation(s)
- Heather Morris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Kostas Hatzikiriakidis
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Melissa Savaglio
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | | | - Catrin Lewis
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK
| | | | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.,Warwick Business School, Warwick University, Coventry, UK
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Abstract
Energy psychology, as most widely practiced, integrates the manual stimulation of acupuncture points with imaginal exposure, cognitive restructuring, and other evidence-based psychotherapeutic procedures. Efficacy for energy psychology protocols has been established in more than 120 clinical trials, with meta-analyses showing strong effect sizes for PTSD, anxiety, and depression. The approach has been applied in the wake of natural and human-made disasters in more than 30 countries. Four tiers of energy psychology interventions following the establishment of safety, trust, and rapport are described, including (1) immediate relief/stabilization, (2) reducing limbic arousal to trauma-based triggers, (3) overcoming complex psychological difficulties, and (4) promoting optimal functioning. The first tier is most pertinent in psychological first aid immediately following a disaster, with the subsequent tiers progressively being introduced over time with complex stress reactions and chronic disorders. Advantages of adding the stimulation of acupuncture points to a conventional exposure approach are identified, and challenges around cultural sensitivities and unintended effects are discussed. After establishing a framework for introducing energy psychology in disaster relief efforts, reports from a sampling of settings are presented, based on interviews with this paper's author. These include accounts of relief work with survivors of mass shootings, genocide, ethnic warfare, earthquakes, hurricanes, tornadoes, floods, wildfires, and the COVID-19 pandemic. Hundreds of other reports from the field show a pattern of strong outcomes following the use of energy psychology in the days or weeks after a disaster and in the subsequent treatment of trauma-based psychological problems. Many of these accounts corroborate one another in terms of rapid relief and long-term benefits. Finally, examples of more efficient delivery methods utilizing large groups, lay counselors, digital technology, and cultivating community resilience are presented.
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Yohannan J, Carlson JS, Volker MA. Cognitive behavioral treatments for children and adolescents exposed to traumatic events: A meta-analysis examining variables moderating treatment outcomes. J Trauma Stress 2022; 35:706-717. [PMID: 34800050 DOI: 10.1002/jts.22755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 08/13/2021] [Accepted: 08/14/2021] [Indexed: 11/06/2022]
Abstract
Due to the negative impact of trauma exposure, effective treatments are necessary to prevent and improve negative trauma-related outcomes. Cognitive behavioral therapy (CBT) is considered an efficacious treatment for children and adolescents exposed to traumatic events. Despite the various meta-analyses that have examined trauma treatments, there is a paucity of research on the moderating variables that may impact treatment outcomes. This meta-analytic CBT study addressed those limitations by examining the moderating effects of treatment components on outcomes. A search identified 94 CBT studies with 97 relevant effect sizes for children and adolescents exposed to traumatic events. Consistent with prior meta-analytic studies, CBT was shown to be effective for trauma-exposed youth. CBT subtreatments did not produce significantly different results from one another. Moderators shown to significantly impact CBT treatment outcomes for posttraumatic stress symptom were trauma type, Q = 24.09, p = .004, ds = -0.22 to -1.42, and gender, Q = 10.68, p = .005, ds = -0.53 to -1.36, whereas moderators shown to impact treatment outcomes for depression were study design, Q = 10.95, p = .004, ds = -0.26 to -0.50, and treatment setting, Q = 10.98, p = .004, ds = -0.31 to -0.56. The implications of these findings for research and practice are discussed.
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Affiliation(s)
- Justina Yohannan
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, Michigan, USA
| | - John S Carlson
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, Michigan, USA
| | - Martin A Volker
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, Michigan, USA
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Bürgin D, Anagnostopoulos D, Vitiello B, Sukale T, Schmid M, Fegert JM. Impact of war and forced displacement on children's mental health-multilevel, needs-oriented, and trauma-informed approaches. Eur Child Adolesc Psychiatry 2022; 31:845-853. [PMID: 35286450 PMCID: PMC9209349 DOI: 10.1007/s00787-022-01974-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The infliction of war and military aggression upon children must be considered a violation of their basic human rights and can have a persistent impact on their physical and mental health and well-being, with long-term consequences for their development. Given the recent events in Ukraine with millions on the flight, this scoping policy editorial aims to help guide mental health support for young victims of war through an overview of the direct and indirect burden of war on child mental health. We highlight multilevel, need-oriented, and trauma-informed approaches to regaining and sustaining outer and inner security after exposure to the trauma of war. The impact of war on children is tremendous and pervasive, with multiple implications, including immediate stress-responses, increased risk for specific mental disorders, distress from forced separation from parents, and fear for personal and family's safety. Thus, the experiences that children have to endure during and as consequence of war are in harsh contrast to their developmental needs and their right to grow up in a physically and emotionally safe and predictable environment. Mental health and psychosocial interventions for war-affected children should be multileveled, specifically targeted towards the child's needs, trauma-informed, and strength- and resilience-oriented. Immediate supportive interventions should focus on providing basic physical and emotional resources and care to children to help them regain both external safety and inner security. Screening and assessment of the child's mental health burden and resources are indicated to inform targeted interventions. A growing body of research demonstrates the efficacy and effectiveness of evidence-based interventions, from lower-threshold and short-term group-based interventions to individualized evidence-based psychotherapy. Obviously, supporting children also entails enabling and supporting parents in the care for their children, as well as providing post-migration infrastructures and social environments that foster mental health. Health systems in Europe should undertake a concerted effort to meet the increased mental health needs of refugee children directly exposed and traumatized by the recent war in Ukraine as well as to those indirectly affected by these events. The current crisis necessitates political action and collective engagement, together with guidelines by mental health professionals on how to reduce harm in children either directly or indirectly exposed to war and its consequences.
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Affiliation(s)
- David Bürgin
- grid.410712.10000 0004 0473 882XDepartment of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, University of Ulm, Steinhövelstrasse 5, 89073 Ulm, Germany ,grid.6612.30000 0004 1937 0642Child and Adolescent Psychiatric Research Department, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | | | | | - Benedetto Vitiello
- grid.7605.40000 0001 2336 6580Division of Child Neurology and Psychiatry, Department of Public Health and Pediatric Sciences, Regina Margherita Pediatric Hospital, University of Turin, Turin, Italy
| | - Thorsten Sukale
- grid.410712.10000 0004 0473 882XDepartment of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, University of Ulm, Steinhövelstrasse 5, 89073 Ulm, Germany
| | - Marc Schmid
- grid.6612.30000 0004 1937 0642Child and Adolescent Psychiatric Research Department, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Jörg M. Fegert
- grid.410712.10000 0004 0473 882XDepartment of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, University of Ulm, Steinhövelstrasse 5, 89073 Ulm, Germany
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Trimboli C, Parsons L, Fleay C, Parsons D, Buchanan A. A systematic review and meta-analysis of psychosocial interventions for 6–12-year-old children who have been forcibly displaced. SSM - Mental Health 2021. [DOI: 10.1016/j.ssmmh.2021.100028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Le Roux IH, Cobham VE. Psychological Interventions for Children Experiencing PTSD After Exposure to a Natural Disaster: A Scoping Review. Clin Child Fam Psychol Rev 2021; 25:249-282. [PMID: 34779953 DOI: 10.1007/s10567-021-00373-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 11/25/2022]
Abstract
Exposure to a natural disaster can have a myriad of significant and adverse psychological consequences. Children have been identified as a particularly vulnerable population being uniquely susceptible to post-disaster psychological morbidity, including post-traumatic stress disorder (PTSD). Without effective intervention, the impact of natural disasters on children's developmental trajectory can be detrimental, however, research is yet to find evidence to definitively establish the comparative efficacy or unequivocal superiority of any specific psychological intervention. A scoping review was undertaken according to the Preferred Reporting Items extension for Scoping Reviews Guidelines (PRISMA-ScR), to evaluate the current research regarding psychological interventions for children (below 18 years of age) experiencing PTSD after exposure to natural disasters, a single incident trauma. Fifteen studies involving 1337 children were included in the review. Overall, psychological interventions, irrespective of type, were associated with statistically significant and sustained reductions in PTSD symptomatology across all symptom clusters. However, whilst evidence supported the general efficacy of psychological interventions in this population, the majority of studies were considered retrospective field research designed in response to the urgent need for clinical service in the aftermath of a natural disaster. Consequently, studies were largely limited by environmental and resource constraints and marked by methodological flaws resulting in diverse and highly heterogeneous data. As such, definitive conclusions regarding the treatment efficacy of specific psychological interventions, and furthermore their ameliorative contributions constituting the necessary mechanisms of change remains largely speculative. As natural disasters can have a catastrophic impact on human lives, establishing levels of evidence for the efficacy of different psychological interventions for children represents a global public health priority.
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Affiliation(s)
- Isabella H Le Roux
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Vanessa E Cobham
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia.
- Children's Health Queensland Child and Youth Mental Health Service (CHQ CYMHS), Brisbane, QLD, Australia.
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Nickerson AB, Fernandez BS, Cruz M, Stanford SE. Implementation of an Evaluation Mindset in School Crisis Response. Journal of Applied School Psychology 2021. [DOI: 10.1080/15377903.2021.1998279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Amanda B. Nickerson
- Alberti Center for Bullying Abuse Prevention, University at Buffalo, The State University of New York Buffalo, Buffalo, NY, USA
| | | | - Melinda Cruz
- Department of Psychology, Radford University, Radford, VA, USA
| | - Samantha E. Stanford
- Alberti Center for Bullying Abuse Prevention, University at Buffalo, The State University of New York Buffalo, Buffalo, NY, USA
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Morikawa A, Takayama M, Yoshizawa E. The efficacy of thought field therapy and its impact on heart rate variability in student counseling: A randomized controlled trial. Explore (NY) 2021:S1550-8307(21)00190-7. [PMID: 34642106 DOI: 10.1016/j.explore.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/03/2021] [Accepted: 09/20/2021] [Indexed: 11/27/2022]
Abstract
CONTEXT Thought Field Therapy is an evidence-based method validated by 17 clinical trials, including five Randomized Controlled Trials. This study investigates whether a single Thought Field Therapy session can improve psychological issues such as stress, depression, and performance anxiety in university students. METHODS Fifty university students were randomly assigned to an intervention group or a waitlist control group. The intervention group received a single counseling session of Thought Field Therapy and was assessed by Subjective Units of Distress and Heart Rate Variability before and after the session. The waitlist group received Thought Field Therapy and was administered the Profile of Mood States Second Edition. All participants completed the latter after a waiting period of 1-3 weeks. RESULTS The 39 students who received Thought Field Therapy showed significantly higher Heart Rate Variability post-compared to pre-therapy (p < .001). The 33 students who were assessed for Subjective Units of Distress also reported significant improvements (p < .001) by a 91% reduction in distress for an average duration of 36 minutes. The Profile of Mood States Second Edition score did not show significant improvements in the intervention group (n = 24) as compared to the control group (n = 15). CONCLUSION A brief intervention of Thought Field Therapy can reduce stress and psychological distress among university students, and increase their physiological resilience in a limited timeframe, after a single session of counseling. However, the single session did not suffice to significantly improve their psychological conditions over the long term.
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Akena D, Kiguba R, Muhwezi WW, Kwesiga B, Kigozi G, Nakasujja N, Lukwata H. The effectiveness of a psycho-education intervention on mental health literacy in communities affected by the COVID-19 pandemic-a cluster randomized trial of 24 villages in central Uganda-a research protocol. Trials 2021; 22:446. [PMID: 34256810 PMCID: PMC8276200 DOI: 10.1186/s13063-021-05391-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 06/22/2021] [Indexed: 01/22/2023] Open
Abstract
Background Literature shows a high prevalence of psychological distress (PD) as well as common mental disorders (CMD) such as major depressive disorders (MDD), generalized anxiety disorders (GAD), post-traumatic stress disorders (PTSD), and substance misuse disorders (SUD) among people exposed to disasters and pandemics like the COVID-19. Moreover, CMD are associated with increased mortality (mainly through suicide) and morbidity (loss of productivity). A number of countries have made deliberate efforts to identify and manage CMD in light of COVID-19. However, low levels of mental health literacy (MHL) manifested by the individual’s unawareness of CMD symptoms, limited human and mental health infrastructure resources, and high levels of mental illness stigma (MIS) are barriers to integration of mental health care in general health care during pandemics and epidemics such as the COVID-19. Objectives For the proposed study, we will determine effectiveness of a psycho-education intervention delivered by village health team (VHT) members. Methods We will employ a cluster randomized trial design in 24 villages in central Uganda. We will collect baseline data to and document the prevalence of MHL, PD, MDD, PTSD, GAD, and SUD. We will distribute information education and communication materials (IEC) aimed at improving MHL to 420 adult individuals in the intervention arm (n = 12 villages). In the control arm (n = 12 villages), VHTs will distribute ministry of health COVID-19 information leaflets to 420 participants. Within 7 days of distributing the materials, research assistants will conduct a follow-up interview and assess for the same parameters (MHL, PD, MDD, PTSD, GAD, and SUD). We will use an intention to treat analysis to estimate the effectiveness of the psycho-education intervention. Discussion Findings from this research will guide policy and practice regarding the integration of mental health services in the community in the context of epidemic preparedness and response. Trial registration ClinicalTrials.govNCT04616989. Registered on 05 November 2020
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Affiliation(s)
- Dickens Akena
- Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Ronald Kiguba
- Department of Pharmacology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Wilson W Muhwezi
- Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda
| | - Brendan Kwesiga
- Health Systems Strengthening Cluster, World Health Organization, Kenya Country Office, Nairobi, Kenya
| | - Gwendolyne Kigozi
- Grants office, Makerere University College of Health Sciences, Kampala, Uganda
| | - Noeline Nakasujja
- Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda
| | - Hafsa Lukwata
- Department of Mental Health, Ministry of Health of Uganda, Kampala, Uganda
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Vogel A, Rosner R. Lost in Transition? Evidence-Based Treatments for Adolescents and Young Adults with Posttraumatic Stress Disorder and Results of an Uncontrolled Feasibility Trial Evaluating Cognitive Processing Therapy. Clin Child Fam Psychol Rev 2021; 23:122-152. [PMID: 31620891 DOI: 10.1007/s10567-019-00305-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Posttraumatic stress disorder (PTSD) is not uncommon among adolescents and young adults (AYAs). Left untreated, transition to adulthood might be especially challenging and/or prolonged for AYAs. However, it is unclear whether AYAs are adequately represented in current PTSD treatment research and whether they benefit to the same degree as younger or older individuals. In the first part of the paper, we reflect on developmental considerations in the treatment of AYAs and give an overview of current age-specific results in PTSD treatment research. Furthermore, we review individual trauma-focused evidence-based treatments that were examined in AYAs over the last 10 years. In the second part, we present data from an uncontrolled feasibility trial evaluating cognitive processing therapy (CPT) with some age-adapted modifications and an exposure component (written accounts). We treated 17 AYAs (aged 14 to 21) suffering from posttraumatic stress symptoms (PTSS). At posttreatment, participants had improved significantly with respect to clinician-rated PTSS severity (d = 1.32). Treatment gains were maintained throughout the 6-week and 6-month follow-ups. Results indicated that CPT, with only minor adaptations, was feasible and safe in AYAs. The recommendations for future research focus on the inclusion of young adults in trials with adolescents, more refined age reporting in clinical trials, and the encouragement of dismantling studies in youth. To conclude, clinical recommendations for caregiver involvement and the addressing of developmental tasks, motivational issues and emotion regulation problems are discussed.
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Affiliation(s)
- Anna Vogel
- Department of Psychology, Catholic University Eichstätt-Ingolstadt, Ostenstr. 25, 85072, Eichstätt, Germany.
| | - Rita Rosner
- Department of Psychology, Catholic University Eichstätt-Ingolstadt, Ostenstr. 25, 85072, Eichstätt, Germany
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Ahmadi Forooshani S, Murray K, Khawaja N, Izadikhah Z. Identifying the Links Between Trauma and Social Adjustment: Implications for More Effective Psychotherapy With Traumatized Youth. Front Psychol 2021; 12:666807. [PMID: 33967924 PMCID: PMC8100691 DOI: 10.3389/fpsyg.2021.666807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 03/24/2021] [Indexed: 12/26/2022] Open
Abstract
Background: Past research has highlighted the role of trauma in social adjustment problems, but little is known about the underlying process. This is a barrier to developing effective interventions for social adjustment of traumatized individuals. The present study addressed this research gap through a cognitive model. Methods: A total of 604 young adults (aged 18–24; living in Australia) from different backgrounds (refugee, non-refugee immigrant, and Australian) were assessed through self-report questionnaires. The data were analyzed through path analysis and multivariate analysis of variance. Two path analyses were conducted separately for migrant (including non-refugee and refugee immigrants) and Australian groups. Results: Analyses indicated that cognitive avoidance and social problem solving can significantly mediate the relation between trauma and social adjustment (p < 0.05). The model explaining this process statistically fit the data (e.g., NFI, TLI, CFI > 0.95). According to the model, reacting to trauma by cognitive avoidance (i.e., chronic thought suppression and over-general autobiographical memory) can disturb the cognitive capacities that are required for social problem solving. Consequently, a lack of effective social problem solving significantly hinders social adjustment. There were no significant differences among the Australian, non-refugee immigrant and refugee participants on the dependent variables. Moreover, the hypothesized links between the variables was confirmed similarly for both migrant (including refugee and non-refugee immigrants) and Australian groups. Conclusion: The findings have important implications for interventions targeting the social adjustment of young individuals. We assert that overlooking the processes identified in this study, can hinder the improvement of social adjustment in young adults with a history of trauma. Recommendations for future research and practice are discussed.
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Affiliation(s)
| | - Kate Murray
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Nigar Khawaja
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Zahra Izadikhah
- School of Psychology and Counselling, University of Southern Queensland, Ipswich, QLD, Australia
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35
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Connolly SM, Vanchu-Orosco M, Warner J, Seidi PA, Edwards J, Boath E, Irgens AC. Mental health interventions by lay counsellors: a systematic review and meta-analysis. Bull World Health Organ 2021; 99:572-582. [PMID: 34354312 PMCID: PMC8319860 DOI: 10.2471/blt.20.269050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 03/04/2021] [Accepted: 03/11/2021] [Indexed: 11/27/2022] Open
Abstract
Objective To investigate the effectiveness of community-based mental health interventions by professionally trained, lay counsellors in low- and middle-income countries. Methods We searched PubMed®, Cochrane Central Register of Controlled Trials, PROSPERO and EBSCO databases and professional section publications of the United States National Center for PTSD for randomized controlled trials of mental health interventions by professionally trained, lay counsellors in low- and middle-income countries published between 2000 and 2019. Studies of interventions by professional mental health workers, medical professionals or community health workers were excluded because there are shortages of these personnel in the study countries. Additional data were obtained from study authors. The primary outcomes were measures of post-traumatic stress disorder, depression, anxiety and alcohol use. To estimate effect size, we used a random-effects meta-analysis model. Findings We identified 1072 studies, of which 19 (involving 20 trials and 5612 participants in total) met the inclusion criteria. Hedges' g for the aggregate effect size of the interventions by professionally trained, lay counsellors compared with mostly either no intervention or usual care was -0.616 (95% confidence interval: -0.866 to -0.366). This result indicates a significant, medium-sized effect. There was no evidence of publication bias or any other form of bias across the studies and there were no extreme outliers among the study results. Conclusion The use of professionally trained, lay counsellors to provide mental health interventions in low- and middle-income countries was associated with significant improvements in mental health symptoms across a range of settings.
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Affiliation(s)
- Suzanne M Connolly
- 70 Payne Place, Suite 6, Sedona, AZ 86446, United States of America (USA)
| | | | - Jan Warner
- Department of Social Work Services, Veterans Affairs Medical Center, Cleveland, USA
| | | | - Jenny Edwards
- School of Leadership Studies, Fielding Graduate University, Santa Barbara, USA
| | - Elisabeth Boath
- Department of Social Work and Social Welfare, Staffordshire University, Stoke-on-Trent, England
| | - A C Irgens
- Department of Psychiatry, Sørlandet Hospital, Arendal, Norway
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Sarman A, Tuncay S. Principles of approach to suspected or infected patients related Covid-19 in newborn intensive care unit and pediatric intensive care unit. Perspect Psychiatr Care 2021; 57:957-964. [PMID: 33184910 DOI: 10.1111/ppc.12643] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 09/08/2020] [Accepted: 09/30/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE In this study, it was aimed to evaluate physical and mental health (MH) effects of children and their parents in newborn intensive care unit and pediatric intensive care unit due to Covid-19. CONCLUSIONS Children are less likely to develop severe illness than adults. It may benefit from medical and psychological/behavioral interventions. Prevent negative MH outcomes for babies/children/caregivers affected by Covid-19. PRACTICE IMPLICATIONS It is useful to clarify the clinical course of children (treatment, care procedures, psychosocial effects, etc.). The establishment of mental health expert nursing teams, psychological counseling (synchronous telemedicine services for support purposes, telepsychiatry for parents, etc.) may have helped prevent negative mental health of Covid-19 outcomes. Continuous updating of medical staff's knowledge and skills for the prevention of Covid-19 is expected to slow the spread of the disease.
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Affiliation(s)
- Abdullah Sarman
- Department of Medical Services and Techniques, Vocational School of Health Services, Bingol University, Bingol, Turkey
| | - Suat Tuncay
- Department of Pediatric Nursing, Bingol University, Bingol, Turkey
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Michalek JE, Lisi M, Awad D, Hadfield K, Mareschal I, Dajani R. The Effects of a Reading-Based Intervention on Emotion Processing in Children Who Have Suffered Early Adversity and War Related Trauma. Front Psychol 2021; 12:613754. [PMID: 33841247 PMCID: PMC8024483 DOI: 10.3389/fpsyg.2021.613754] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 03/02/2021] [Indexed: 12/31/2022] Open
Abstract
Early adversity and trauma can have profound effects on children's affective development and mental health outcomes. Interventions that improve mental health and socioemotional development are essential to mitigate these effects. We conducted a pilot study examining whether a reading-based program (We Love Reading) improves emotion recognition and mental health through socialization in Syrian refugee (n = 49) and Jordanian non-refugee children (n = 45) aged 7-12 years old (M = 8.9, 57% girls) living in Jordan. To measure emotion recognition, children classified the expression in faces morphed between two emotions (happy-sad and fear-anger), while mental health was assessed using survey measures of optimism, depression, anxiety, distress, and insecurity. Prior to the intervention, both groups of children were significantly biased to interpret ambiguous facial expressions as sad, while there was no clear bias on the fear-anger spectrum. Following the intervention, we found changes in Syrian refugee children's bias in emotion recognition away from sad facial expressions, although this returned to pre-intervention levels 2 months after the end of the program. This shift in the bias away from sad facial expressions was not associated with changes in self-reported mental health symptoms. These results suggest a potential positive role of the reading intervention on affective development, but further research is required to determine the longer-term impacts of the program.
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Affiliation(s)
- Julia E. Michalek
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, United Kingdom
| | - Matteo Lisi
- Department of Psychology, University of Essex, Colchester, United Kingdom
| | - Deema Awad
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, United Kingdom
| | | | - Isabelle Mareschal
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, United Kingdom
| | - Rana Dajani
- Biology and Biotechnology Department, Hashemite University, Zarqa, Jordan
- Jepson School of Leadership Studies, University of Richmond, Richmond, VA, United States
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Bastoni S, Wrede C, Ammar A, Braakman-Jansen A, Sanderman R, Gaggioli A, Trabelsi K, Masmoudi L, Boukhris O, Glenn JM, Bouaziz B, Chtourou H, van Gemert-Pijnen L. Psychosocial Effects and Use of Communication Technologies during Home Confinement in the First Wave of the COVID-19 Pandemic in Italy and The Netherlands. Int J Environ Res Public Health 2021; 18:2619. [PMID: 33807851 PMCID: PMC7967354 DOI: 10.3390/ijerph18052619] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/17/2021] [Accepted: 03/03/2021] [Indexed: 12/31/2022]
Abstract
(1) Background: The COVID-19 pandemic forced people from all around the globe to strongly modify their daily routines, putting a significant strain on the social aspects of daily lives. While the first wave of the pandemic was a very challenging time in all countries, it is still uncertain whether various lockdown intensities and infection rates differed regarding their psychosocial impact. This work therefore aimed to investigate (i) the psychosocial effects of home confinement in two European countries that underwent different lockdown intensities: Italy and the Netherlands and (ii) the role of communication technology in relation to feelings of loneliness. (2) Methods: A cross-sectional online survey inquiring about different psychosocial variables and the use of and satisfaction towards communication technology was circulated among the general public during the first wave of the COVID-19 pandemic. In total, 629 participants (66% female, 68% from the Netherlands) answered each question twice, referring to "before" and "during" the pandemic. (3) Results: We found significant negative effects of COVID-19 home confinement on depressive feelings (p < 0.001, %∆ = +54%), loneliness (p < 0.001, %∆ = +37.3%), life satisfaction (p < 0.001, %∆ = -19.8%) and mental wellbeing (p < 0.001, %∆ = -10.6%) which were accompanied with a significantly increased need for psychosocial support (p < 0.001, %∆ = +17.3%). However, the magnitude of psychosocial impact did not significantly differ between residents undergoing a more intense (Italy) versus a less intense (Netherlands) lockdown, although the decrease in social participation was found to be significantly different for both countries (z = -7.714, p < 0.001). Furthermore, our findings demonstrate that the increase in loneliness was associated with the adoption of new digital communication tools (r = 0.21, p < 0.001), and significantly higher for individuals who started to adopt at least one new digital communication tool during confinement than for those who did not (z = -4.252, p < 0.001). (4) Conclusions: This study highlights that, although COVID-19 home confinement significantly impacted psychosocial wellbeing during the first wave of the pandemic, this impact did not differ based on lockdown intensity. Recognizing the increasing adoption of digital communication technology in an attempt to reduce lockdown loneliness, future studies should investigate what is needed from the technology to achieve this effect.
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Affiliation(s)
- Sofia Bastoni
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, 7522 NB Enschede, The Netherlands; (A.B.-J.); (R.S.); (L.v.G.-P.)
| | - Christian Wrede
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, 7522 NB Enschede, The Netherlands; (A.B.-J.); (R.S.); (L.v.G.-P.)
| | - Achraf Ammar
- Institute of Sport Science, Otto-von-Guericke University, 39106 Magdeburg, Germany;
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS, UPL, Paris Nanterre University, 92000 Nanterre, France
| | - Annemarie Braakman-Jansen
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, 7522 NB Enschede, The Netherlands; (A.B.-J.); (R.S.); (L.v.G.-P.)
| | - Robbert Sanderman
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, 7522 NB Enschede, The Netherlands; (A.B.-J.); (R.S.); (L.v.G.-P.)
- Department of Health Psychology, University Medical Center Groningen, 9712 Groningen, The Netherlands
| | - Andrea Gaggioli
- Department of Psychology, Universitá Cattolica del Sacro Cuore, 20123 Milan, Italy;
- Applied Technology for Neuro-Psychology Lab, I.r.c.c.s. Istituto Auxologico Italiano, 20149 Milan, Italy
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000 Sfax, Tunisia; (K.T.); (L.M.); (O.B.); (H.C.)
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000 Sfax, Tunisia
| | - Liwa Masmoudi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000 Sfax, Tunisia; (K.T.); (L.M.); (O.B.); (H.C.)
| | - Omar Boukhris
- High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000 Sfax, Tunisia; (K.T.); (L.M.); (O.B.); (H.C.)
| | - Jordan M. Glenn
- Exercise Science Research Center, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, NC AR72701, USA;
| | - Bassem Bouaziz
- Multimedia Information Systems and Advanced Computing Laboratory (MIRACL), University of Sfax, 3021 Sfax, Tunisia;
| | - Hamdi Chtourou
- High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000 Sfax, Tunisia; (K.T.); (L.M.); (O.B.); (H.C.)
- Activité Physique, Sport et Santé, UR18JS01, Observatoire National du Sport, 1003 Tunis, Tunisia
| | - Lisette van Gemert-Pijnen
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, 7522 NB Enschede, The Netherlands; (A.B.-J.); (R.S.); (L.v.G.-P.)
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Karadag M, Topal Z, Ezer RN, Gokcen C. Use of EMDR-Derived Self-Help Intervention in Children in the Period of COVID-19: A Randomized-Controlled Study. J EMDR Prac Res 2021. [DOI: 10.1891/emdr-d-20-00054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Self-help treatments are an important intervention tool, with high accessibility and ease of application. To our knowledge, no research has previously been conducted on any self-help intervention derived from eye movement desensitization and reprocessing (EMDR) therapy. In this study, we evaluated the mental health status of children not directly affected by the pandemic and investigated the effects of using an EMDR-derived self-help intervention in children as a low-intensity treatment. The mental health status of 178 children was evaluated online via the State-Trait Anxiety Inventory for Children (STAIC) and Childhood Posttraumatic Stress Reaction Index (CPTS-RI). Then, children were randomly assigned to intervention and waitlist. A booklet containing EMDR-derived techniques was sent via the school online portal and the intervention was conducted. Posttests were administered 4 weeks later. The attrition rate was 45.5%, with 97 children completing the trial (intervention: 52; waitlist: 45). At baseline, 76.4% of children showed posttraumatic stress symptoms (PTSS) above threshold. Results showed a statistically significant decrease in the posttest PTSS scores for the intervention group compared to waitlist. The intervention group had significant pre–post improvement on all but one subscale, while the waitlist group showed a significant increase in state anxiety on the STAIC. In conclusion, posttraumatic stress was found to be high in children during the COVID-19 outbreak period, and EMDR-derived self-help intervention appeared to be an effective psychosocial intervention tool.
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Pfefferbaum B, Nitiéma P, Newman E. A Critical Review of Effective Child Mass Trauma Interventions: What We Know and Do Not Know from the Evidence. Behav Sci (Basel) 2021; 11:bs11020025. [PMID: 33670239 PMCID: PMC7916921 DOI: 10.3390/bs11020025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 12/19/2022] Open
Abstract
Over the last 20 years, numerous interventions have been developed and evaluated for use with children exposed to mass trauma with six publications reporting meta-analyses of randomized controlled trials of child mass trauma interventions using inactive controls to examine intervention effects on posttraumatic stress, depression, anxiety, and functional impairment. The current report reviews the results of these meta-analytic studies to examine the status of the evidence for child mass trauma mental health interventions and to evaluate potential moderators of intervention effect and implications for practice. The meta-analyses reviewed for the current report revealed a small to medium overall effect of interventions on posttraumatic stress, a non-statistically significant to small overall effect on depression, a non-statistically significant overall effect on anxiety, and a small overall effect on functional impairment. The subgroup analyses suggest that interventions should be matched to the populations being served and to the context. Additional research is needed to tailor future interventions to further address outcomes other than posttraumatic stress including depression, anxiety, and functional impairment.
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Affiliation(s)
- Betty Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Oklahoma Health Sciences Center, P.O. Box 26901, WP3217, Oklahoma City, OK 73126, USA
- Correspondence: ; Tel.: +1-405-271-5121
| | - Pascal Nitiéma
- Department of Management Information Systems, Price College of Business, University of Oklahoma, Norman, OK 73069, USA;
| | - Elana Newman
- Dart Center for Journalism and Trauma, Department of Psychology, University of Tulsa, Tulsa, OK 74104, USA;
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Cadamuro A, Birtel MD, Di Bernardo GA, Crapolicchio E, Vezzali L, Drury J. Resilience in children in the aftermath of disasters: A systematic review and a new perspective on individual, interpersonal, group, and intergroup level factors. Community & Applied Soc Psy 2021. [DOI: 10.1002/casp.2500] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Alessia Cadamuro
- Department of Biomedical, Metabolic and Neural Science University of Modena and Reggio Emilia Modena Italy
| | | | | | | | - Loris Vezzali
- Faculty of Medicine University of Modena and Reggio Emilia Modena Italy
| | - John Drury
- School of Psychology University of Sussex Brighton UK
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L. G, K. M, J. N, A. TL, E. T, M. U, N. C, S. C, E. CV. Child and Adolescent Psychosocial Support Programs Following Natural Disasters-a Scoping Review of Emerging Evidence. Curr Psychiatry Rep 2021; 23:82. [PMID: 34652557 PMCID: PMC8517063 DOI: 10.1007/s11920-021-01293-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE OF REVIEW This review aimed to identify and describe evidence published in the past 3 years from trials of psychosocial support programs for children and adolescents affected by natural disasters. RECENT FINDINGS Previous reviews have indicated these programs are beneficial overall. Positive impacts were documented in school-based programs conducted by trained teachers and paraprofessionals with stronger effects achieved by more qualified professionals. The review found supporting evidence for positive impacts of post-disaster psychosocial programs. However, the strength of evidence is limited due to heterogeneity in interventions and evaluations. The stepped care model was found to be useful in differentiating between programs and level of available evidence. Hobfoll's five essential elements of mass trauma intervention provide an additional means of guiding program content and assessments, particularly for universal programs. Identified gaps in evidence included groups likely to be at most risk: preschool children, ethnically diverse groups, those with disability, and social disadvantage. There were promising indications of program benefits for groups with repeated exposure to natural disasters.
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Affiliation(s)
- Gibbs L.
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC Australia ,Centre for Disaster Management and Public Safety, University of Melbourne, Melbourne, VIC Australia
| | - Marinkovic K.
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC Australia
| | - Nursey J.
- Phoenix Australia: Centre for Posttraumatic Mental Health, Melbourne, Australia
| | - Tong L. A.
- Department of Economics, Deakin University, Burwood, VIC Australia
| | - Tekin E.
- School of Public Affairs, American University, Washington, D.C USA ,National Bureau of Economic Research (NBER), Cambridge, USA ,Institute of Labor Economics (IZA), Bonn, Germany
| | - Ulubasoglu M.
- Department of Economics, Deakin University, Burwood, VIC Australia
| | - Callard N.
- Children’s Health Queensland Hospital and Health Service, Queensland, Australia
| | - Cowlishaw S.
- Phoenix Australia: Centre for Posttraumatic Mental Health, Melbourne, Australia
| | - Cobham V. E.
- School of Psychology, The University of Queensland, Queensland, Australia ,Children’s Health Queensland Child and Youth Mental Health Service, Queensland, Australia
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de Roos C, Zijlstra B, Perrin S, van der Oord S, Lucassen S, Emmelkamp P, de Jongh A. Predictors and moderators of treatment outcome for single incident paediatric PTSD: a multi-centre randomized clinical trial. Eur J Psychotraumatol 2021; 12:1968138. [PMID: 34621497 PMCID: PMC8491723 DOI: 10.1080/20008198.2021.1968138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND With few RCTs having compared active treatments for paediatric PTSD, little is known about whether or which baseline (i.e. pre-randomization) variables predict or moderate outcomes in the evaluated treatments. OBJECTIVE To identify predictors and moderators of paediatric PTSD outcomes for Eye Movement Desensitization and Reprocessing Therapy (EMDR) and Cognitive Behavioural Writing Therapy (CBWT). METHOD Data were obtained as part of a multi-centre, randomized controlled trial of up to six sessions (up to 45 minutes each) of either EMDR therapy, CBWT, or wait-list, involving 101 youth (aged 8-18 years) with a PTSD diagnosis (full/subthreshold) tied to a single event. The predictive and moderating effects of the child's baseline sociodemographic and clinical characteristics, and parent's psychopathology were evaluated using linear mixed models (LMM) from pre- to post-treatment and from pre- to 3- and 12-month follow-ups. RESULTS At post-treatment and 3-month follow-up, youth with an index trauma of sexual abuse, severe symptoms of PTSD, anxiety, depression, more comorbid disorders, negative posttraumatic beliefs, and with a parent with more severe psychopathology fared worse in both treatments. For children with more severe self-reported PTSD symptoms at baseline, the (exploratory) moderator analysis showed that the EMDR group improved more than the CBWT group, with the opposite being true for children and parents with a less severe clinical profile. CONCLUSIONS The most consistent finding from the predictor analyses was that parental symptomatology predicted poorer outcomes, suggesting that parents should be assessed, supported and referred for their own treatment where indicated. The effect of the significant moderator variables was time-limited, and given the large response rate (>90%) and brevity (<4 hours) of both treatments, the present findings suggest a focus on implementation and dissemination, rather than tailoring, of evidence-based trauma-focused treatments for paediatric PTSD tied to a single event.
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Affiliation(s)
- Carlijn de Roos
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Bonne Zijlstra
- Department of Child Development and Education, University of Amsterdam (UVA), Amsterdam, The Netherlands
| | - Sean Perrin
- Department of Psychology, Lund University, Lund, Sweden
| | - Saskia van der Oord
- Faculty of Psychology and Educational Sciences, Research Group Clinical Psychology, Ku Leuven, Leuven, Belgium.,Department of Developmental Psychology, University of Amsterdam (Uva), Amsterdam, The Netherlands
| | - Sacha Lucassen
- UvA Minds Academic Treatment Centre, Amsterdam, The Netherlands
| | - Paul Emmelkamp
- Department Of Clinical Psychology, University of Amsterdam (Uva), Amsterdam, The Netherlands.,Paris Institute For Advanced Studies, France
| | - Ad de Jongh
- Department Of Social Dentistry And Behavioral Sciences, Academic Centre for Dentistry Amsterdam (Acta), University of Amsterdam, Amsterdam, The Netherlands.,Institute Of Health And Society, University Of Worcester, Worcester, UK.,School Of Psychology, Queen's University, Belfast, Northern Ireland
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44
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Seidi PA, Jaff D, Connolly SM, Hoffart A. Applying Cognitive Behavioral Therapy and Thought Field Therapy in Kurdistan region of Iraq: A retrospective case series study of mental-health interventions in a setting of political instability and armed conflicts. Explore (NY) 2021; 17:84-91. [DOI: 10.1016/j.explore.2020.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 05/27/2020] [Accepted: 06/21/2020] [Indexed: 11/18/2022]
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Abstract
Interest in resilience is surging in research, policy and practice as threats from disasters rise and humanity confronts a global pandemic. This commentary highlights the importance of defining resilience for portability across system levels and disciplines in order to integrate knowledge and prepare adequately for the challenges posed to children and youth by multisystem disasters. A scalable definition of resilience is recommended: The capacity of a dynamic system to adapt successfully to challenges that threaten the function, survival or development of the system. Major determinants of adaptation among young people in the context of disaster are highlighted, including variations in adversity exposure dose, developmental timing, individual differences and the socio-ecological systems of children's lives that can be mobilised in response. Adaptation of children in disasters depends on the resilience of interconnected systems, including families, schools, communities and policy sectors. Implications of a multisystem perspective for disaster risk reduction and preparedness are discussed with a focus on nurturing the resilience of children and their societies for challenges in the near term and long into the future.
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Affiliation(s)
- Ann S Masten
- University of Minnesota Twin Cities, Institute of Child Development, Minneapolis, MN, 55455, USA
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46
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Reddaway J, Brydges NM. Enduring neuroimmunological consequences of developmental experiences: From vulnerability to resilience. Mol Cell Neurosci 2020; 109:103567. [PMID: 33068720 PMCID: PMC7556274 DOI: 10.1016/j.mcn.2020.103567] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 09/14/2020] [Accepted: 10/12/2020] [Indexed: 12/14/2022] Open
Abstract
The immune system is crucial for normal neuronal development and function (neuroimmune system). Both immune and neuronal systems undergo significant postnatal development and are sensitive to developmental programming by environmental experiences. Negative experiences from infection to psychological stress at a range of different time points (in utero to adolescence) can permanently alter the function of the neuroimmune system: given its prominent role in normal brain development and function this dysregulation may increase vulnerability to psychiatric illness. In contrast, positive experiences such as exercise and environmental enrichment are protective and can promote resilience, even restoring the detrimental effects of negative experiences on the neuroimmune system. This suggests the neuroimmune system is a viable therapeutic target for treatment and prevention of psychiatric illnesses, especially those related to stress. In this review we will summarise the main cells, molecules and functions of the immune system in general and with specific reference to central nervous system development and function. We will then discuss the effects of negative and positive environmental experiences, especially during development, in programming the long-term functioning of the neuroimmune system. Finally, we will review the sparse but growing literature on sex differences in neuroimmune development and response to environmental experiences. The immune system is essential for development and function of the central nervous system (neuroimmune system) Environmental experiences can permanently alter neuroimmune function and associated brain development Altered neuroimmune function following negative developmental experiences may play a role in psychiatric illnesses Positive experiences can promote resilience and rescue the effects of negative experiences on the neuroimmune system The neuroimmune system is therefore a viable therapeutic target for preventing and treating psychiatric illnesses
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Affiliation(s)
- Jack Reddaway
- Neuroscience and Mental Health Research Institute, Cardiff University, Hadyn Ellis Building, Maindy Road, Cardiff CF24 4HQ, UK
| | - Nichola M Brydges
- Neuroscience and Mental Health Research Institute, Cardiff University, Hadyn Ellis Building, Maindy Road, Cardiff CF24 4HQ, UK.
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Whitson ML, Champine RB, Griffin A, Corto-Mergins C, Lusa J, Jaffe J, Hemmelgarn A, Bryden E, Clark K, Kaufman JS. Impact of an Integrated EMDR Treatment Program for Children and Youth Exposed to Potentially Traumatic Events: The Village Collaborative Trauma Center. J EMDR Prac Res 2020. [DOI: 10.1891/emdr-d-20-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Exposure to adverse events during childhood and adolescence is associated with problematic outcomes across the life span, including the development of posttraumatic stress disorder (PTSD). A growing body of research examining the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy in treating PTSD among young people has yielded mixed findings. More work is needed that elucidates whether EMDR is linked to positive and sustained reductions in symptoms among youth who experience potentially traumatic events. For this open trial, we analyzed data from 143 youth (Mage = 12.9, standard deviation [SD] = 3.4, Range = 6–18) who received outpatient behavioral health clinic services, including EMDR. We assessed whether the number of types of exposure to family-related and non-family-related traumatic events, as well as differences in severity of PTSD symptomatology, was associated with changes in internalizing and externalizing problem behaviors from intake to 6 months. Results indicated that youth with (a) fewer exposures to non-family-related potentially traumatic events and (b) more severe PTSD symptoms, showed greater improvements in externalizing problem behaviors. We discuss limitations of the present study and implications for future research.
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48
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Matthijssen SJMA, Lee CW, de Roos C, Barron IG, Jarero I, Shapiro E, Hurley EC, Schubert SJ, Baptist J, Amann BL, Moreno-Alcázar A, Tesarz J, de Jongh A. The Current Status of EMDR Therapy, Specific Target Areas, and Goals for the Future. J EMDR Prac Res 2020. [DOI: 10.1891/emdr-d-20-00039] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
While eye movement desensitization and reprocessing (EMDR) is considered an evidence-based treatment for posttraumatic stress disorder (PTSD) in adults, there are differences as to how various international treatment guidelines judge the strength of this evidence base. Furthermore, in areas other than adult PTSD, major guidelines differ even more as to the strength of the evidence base and when to use EMDR. In 2019, the Council of Scholars: The Future of EMDR Therapy Project was initiated. Several working groups were established, with one assigned to the focus area of research. This article is a product of that working group. Firstly the group concluded that there were five areas where there was some base that EMDR was effective, but more data were needed to increase the likelihood that it would be considered in future international treatment guidelines. These areas were PTSD in children and adolescents, early EMDR interventions, combat PTSD, unipolar depression, and chronic pain. In addition, research into cost-effectiveness of EMDR therapy was identified as one of the priorities. A hierarchical system was used for classifying and rating evidence in the focus areas. After assessing the 120 outcome studies pertaining to the focus areas, we conclude that for two of the areas (i.e., PTSD in children and adolescents and EMDR early interventions research) the strength of the evidence is rated at the highest level, whereas the other areas obtain the second highest level. Some general recommendations for improving the quality of future research on the effectiveness of EMDR therapy are formulated.
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Danzi BA, La Greca AM. Treating Children and Adolescents with Posttraumatic Stress Disorder: Moderators of Treatment Response. Journal of Clinical Child & Adolescent Psychology 2020; 50:510-516. [DOI: 10.1080/15374416.2020.1823849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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50
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Malejko K, Tumani V, Rau V, Neumann F, Plener PL, Fegert JM, Abler B, Straub J. Neural correlates of script-driven imagery in adolescents with interpersonal traumatic experiences: A pilot study. Psychiatry Res Neuroimaging 2020; 303:111131. [PMID: 32585577 DOI: 10.1016/j.pscychresns.2020.111131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 04/03/2020] [Accepted: 06/18/2020] [Indexed: 01/22/2023]
Abstract
In adults, trauma imagery has proven to be a useful tool to assess the neural mechanisms of psychological trauma processing. In adolescents, heterogeneous results could be found for other tasks, however, a trauma imagery paradigm has not been evaluated. For this purpose, we investigated a trauma imagery paradigm with control scripts to assess neural correlates of traumatic experiences in youth. 15 adolescents, who had experienced a traumatic interpersonal event in the past and have developed clinically relevant symptoms, underwent an fMRI scan while listening to their individual trauma- versus two control scripts (positive/negative). We analysed a parametric contrast of the imagery phases (trauma > negative > positive) which revealed activity in the thalamus, dorsal anterior cingulate cortex, cuneus, dorsomedial prefrontal cortex and amygdala. Additionally, amygdala-activity correlated positively with depression-symptom-severity. Our data provide evidence for the feasibility of fMRI during a trauma imagery task in adolescents to investigate networks previously related to hyperarousal in adults with PTSD. Further, we demonstrate the specificity of the activated networks for trauma imagery as compared to imagery of other emotional situations. The task might be particularly useful to evaluate neural correlates of treatment in adolescents when hyperarousal is a target symptom.
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Affiliation(s)
- K Malejko
- Ulm University, Department of Psychiatry and Psychotherapy III, Ulm, Germany.
| | - V Tumani
- Ulm University, Department of Psychiatry and Psychotherapy III, Ulm, Germany
| | - V Rau
- Ulm University, Department of Psychiatry and Psychotherapy III, Ulm, Germany
| | - F Neumann
- Ulm University, Department of Child and Adolescent Psychiatry and Psychotherapy, Ulm, Germany
| | - P L Plener
- Ulm University, Department of Child and Adolescent Psychiatry and Psychotherapy, Ulm, Germany; Medical University Vienna, Department of Child and Adolescent Psychiatry, Vienna, Austria
| | - J M Fegert
- Ulm University, Department of Child and Adolescent Psychiatry and Psychotherapy, Ulm, Germany
| | - B Abler
- Ulm University, Department of Psychiatry and Psychotherapy III, Ulm, Germany
| | - J Straub
- Ulm University, Department of Child and Adolescent Psychiatry and Psychotherapy, Ulm, Germany
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