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The Child and Family Traumatic Stress Intervention: secondary prevention for youth at risk of developing PTSD
Steven J Berkowitz1, Carla Smith Stover, Steven R Marans
1Department of Psychiatry, University of Pennsylvania, USA Yale University Child Study Center, USA. steven.berkowitz@uphs.upenn.edu
Insights
The Child and Family Traumatic Stress Intervention (CFTSI) significantly reduced posttraumatic stress disorder (PTSD) diagnoses in youth exposed to potentially traumatic events (PTEs). This brief, early intervention shows promise for preventing chronic PTSD in children and adolescents.
Area of Science:
- Child and Adolescent Psychology
- Trauma Studies
- Clinical Psychology
Background:
- Posttraumatic stress disorder (PTSD) is a significant concern following exposure to potentially traumatic events (PTEs).
- Early intervention is crucial to prevent the development of chronic PTSD in youth.
- The Child and Family Traumatic Stress Intervention (CFTSI) is a brief, caregiver-child intervention designed for early use after a PTE.
Purpose of the Study:
- To evaluate the effectiveness of a four-session CFTSI.
- To determine if CFTSI can prevent chronic PTSD in youth exposed to a PTE.
- To assess intervention outcomes within 30 days of a potentially traumatic event.
Main Methods:
- 176 youth (7-17 years) reporting a new PTSD symptom after a PTE were screened.
- 106 youth were randomized to either CFTSI (n=53) or a supportive comparison condition (n=53).
- Symptom severity was assessed using mixed-effects models; PTSD diagnoses were evaluated via logistic regression at 3-month follow-up.
Main Results:
- The CFTSI group showed significantly fewer full and partial PTSD diagnoses compared to the comparison group at follow-up.
- A significant group-by-time interaction was observed for PTSD and anxiety symptom scores on the Trauma Symptom Checklist for Children.
- The CFTSI group reported significantly lower posttraumatic and anxiety symptom scores than the comparison group.
Conclusions:
- The brief, caregiver-child CFTSI is a promising preventative approach for youth exposed to PTEs.
- Early intervention using CFTSI may effectively prevent the onset of chronic PTSD in young populations.
- Findings support the utility of CFTSI in reducing PTSD symptoms and diagnoses in at-risk youth.
Objective:
This pilot study evaluated the effectiveness of a four-session, caregiver-child Intervention, the Child and Family Traumatic Stress Intervention (CFTSI), to prevent the development of chronic posttraumatic stress disorder (PTSD) provided within 30 days of exposure to a potentially traumatic event (PTE).
Method:
One-hundred seventy-six 7 to 17-year-old youth were recruited through telephone screening based on report of one new distressing posttraumatic stress symptom after a PTE. Of those, 106 youth were randomly assigned to the Intervention (n = 53) or a four-session supportive Comparison condition (N = 53). Group differences in symptom severity were assessed using repeated measures with mixed effects models of intervention group, time, and the interaction of intervention and time. Logistic regression analyses were performed to assess treatment condition and any subsequent traumas experienced as predictors for full and partial PTSD diagnosis at 3-month follow-up. An exploratory chi-square analysis was performed to examine the differences in PTSD symptom criteria B, C, and D at follow-up.
Results:
At baseline, youth in both groups had similar demographics, past trauma exposures and symptom severity. At follow-up, the Intervention group demonstrated significantly fewer full and partial PTSD diagnoses than the Comparison group on a standardized diagnostic measure of PTSD. Also, there was a significant group by time interaction for Trauma Symptom Checklist for Children's Posttraumatic Stress and Anxiety Indices as the CFTSI group had significantly lower posttraumatic and anxiety scores than the Comparison group.
Conclusions:
The results suggest that a caregiver-youth, brief preventative early intervention for youth exposed to a PTE is a promising approach to preventing chronic PTSD.
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