Differences of TF-CBT treatment effects using various outcome measures: a meta-analysis

Area of Science:

• Child and Adolescent Psychiatry
• Psychological Treatments
• Clinical Psychology

Background:

• Diagnostic criteria for pediatric posttraumatic stress disorder (PTSD) and assessment tools have evolved.
• The influence of varying outcome measures on treatment efficacy for pediatric posttraumatic stress symptoms (PTSS) remains under-explored.

Purpose of the Study:

• To meta-analytically examine the impact of different outcome measures on treatment effects for pediatric PTSS.
• To evaluate Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) as a model for this investigation due to its established efficacy.

Main Methods:

• A comprehensive literature search identified 76 studies (35 RCTs) examining TF-CBT for pediatric PTSS.
• Treatment effects were extracted, analyzing differences based on outcome measures and Diagnostic and Statistical Manual of Mental Disorders (DSM) versions (DSM-IV vs. DSM-5).
• Hedges g effect sizes were computed, excluding high-risk of bias studies.

Main Results:

• No significant differences in treatment effects were found between DSM-IV and DSM-5 based instruments.
• While individual outcome measures showed minor variations, they were largely comparable.
• TF-CBT demonstrated large within-study effect sizes (g=1.32) and medium between-studies effect sizes (g=0.57) for PTSS.

Conclusions:

• The choice of outcome measure and underlying DSM version does not appear to significantly alter the measurement of TF-CBT treatment effects for pediatric PTSS.
• TF-CBT is confirmed as a highly effective intervention for pediatric PTSS and associated secondary outcomes.