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A Meta Analysis of Randomised Controlled Trials on Psychological Interventions for PTSD and Depression in Adolescent
Shreya Kulshreshtha1, Sujata Satapathy1, Rajesh Sagar1
1Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
Abstract:
Adolescent sexual abuse (ASA) is a complex, multifactorial, less researched, and challenging issue leading to an enormous immediate and long-term adverse multidimensional impacts. And as these impacts could be unique and different than child sexual abuse (CSA), the treatment plans require special attention. While 2/3rd of the global sexual abuse literature is focused on CSA, the remaining studies focus on miscellaneous issues pertaining sexual abuse. Especially, there is a dearth of literature on ASA focused interventions to guide and provide directions to clinicians for treatment plans. This is the first meta-analysis to analyse the efficacy of randomised controlled studies (RCTs) on the psychotherapy interventions for adolescents experienced penetrative sexual abuse. An electronic search was performed using PubMed, PsycINFO, and ERIC from June 1995 to June 2025. Following PRISMA guidelines, the search yielded 29 potentially relevant studies out of which 4 studies met inclusion/exclusion criteria. Analyses mainly focused on the commonly reported mental health impacts (PTSD and depression) of ASA. Results indicated pooled effect size for post-traumatic stress disorder (PTSD) to be -1.07 with a 95% confidence interval (CI) of -2.8989; -0.2223, p < 0.05. The pooled effect size for depression was -1.57 (with a 95% confidence interval of -4.7587; 1.6183, p > 0.05). It was difficult to ascertain the effects of other variables (abuse related distress, anxiety or behavioural problems) on PTSD and depression due to inadequate information. Since, I2 value 72.8% showed substantial heterogeneity across studies, the findings on random effects of interventions are discussed and heterogeneity is explained by appropriate clinical or methodological differences. Except one study, all three studies included at least one parent session. TF-CBT without involving parents showed the largest effect size for ASA which should be compared specifically with TF-CBT involving parents.
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