Systematic Review and Meta-Analysis: Imputing Response Rates for First-Line Psychological Treatments for...

Area of Science:

• Child and Adolescent Psychiatry
• Clinical Psychology
• Evidence-Based Practice

Background:

• Posttraumatic stress disorder (PTSD) significantly impacts youth mental health.
• Meta-analyses confirm the efficacy of psychological interventions for pediatric PTSD.
• Interpreting treatment effectiveness through response rates offers clinical utility.

Purpose of the Study:

• To evaluate the effectiveness of psychological therapies for youth with PTSD.
• To impute response rates (e.g., 50% symptom reduction) for PTSD treatments in children and adolescents.
• To compare trauma-focused cognitive-behavioral therapy (TF-CBT) and eye movement desensitization (EMDR) against control conditions.

Main Methods:

• A systematic review and meta-analysis of 60 randomized controlled trials involving 5,113 youth.
• Included studies focused on TF-CBT and EMDR for PTSD in pediatric populations.
• Response rates, including 50% symptom reduction, reliable improvement, and deterioration, were calculated.

Main Results:

• Approximately 48% of youth receiving TF-CBT and 30% receiving EMDR achieved a 50% reduction in PTSD symptoms.
• Overall, 46% of youth in psychological therapy showed a 50% symptom reduction, compared to 20% in control groups.
• Reliable improvement was observed in 53% of youth receiving psychological therapies, versus 25% in controls, with minimal reliable deterioration (1%).

Conclusions:

• Psychological therapies, especially TF-CBT, are effective treatments for PTSD in young people.
• These interventions are unlikely to cause harm, with a low rate of reliable deterioration.
• The findings support the use of TF-CBT for achieving significant symptom reduction in youth with PTSD.