1. Comparison of eye movement desensitization and reprocessing therapy, cognitive behavioral writing therapy, and wait-list in pediatric posttraumatic stress disorder following single-incident trauma: a multicenter randomized clinical trial.
- Author
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Roos, Carlijn, Oord, Saskia, Zijlstra, Bonne, Lucassen, Sacha, Perrin, Sean, Emmelkamp, Paul, and Jongh, Ad
- Subjects
COGNITIVE therapy ,EMDR (Eye-movement desensitization & reprocessing) ,LONGITUDINAL method ,MEDICAL cooperation ,POST-traumatic stress disorder ,RESEARCH ,COMORBIDITY ,BLIND experiment ,CHILDREN - Abstract
Background Practice guidelines for childhood posttraumatic stress disorder ( PTSD) recommend trauma-focused psychotherapies, mainly cognitive behavioral therapy ( CBT). Eye movement desensitization and reprocessing ( EMDR) therapy is a brief trauma-focused, evidence-based treatment for PTSD in adults, but with few well-designed trials involving children and adolescents. Methods We conducted a single-blind, randomized trial with three arms ( n = 103): EMDR ( n = 43), Cognitive Behavior Writing Therapy ( CBWT; n = 42), and wait-list ( WL; n = 18). WL participants were randomly reallocated to CBWT or EMDR after 6 weeks; follow-ups were conducted at 3 and 12 months posttreatment. Participants were treatment-seeking youth (aged 8-18 years) with a DSM- IV diagnosis of PTSD (or subthreshold PTSD) tied to a single trauma, who received up to six sessions of EMDR or CBWT lasting maximally 45 min each. Results Both treatments were well-tolerated and relative to WL yielded large, intent-to-treat effect sizes for the primary outcomes at posttreatment: PTSD symptoms ( EMDR: d = 1.27; CBWT: d = 1.24). At posttreatment 92.5% of EMDR, and 90.2% of CBWT no longer met the diagnostic criteria for PTSD. All gains were maintained at follow-up. Compared to WL, small to large (range d = 0.39-1.03) intent-to-treat effect sizes were obtained at posttreatment for negative trauma-related appraisals, anxiety, depression, and behavior problems with these gains being maintained at follow-up. Gains were attained with significantly less therapist contact time for EMDR than CBWT (mean = 4.1 sessions/140 min vs. 5.4 sessions/227 min). Conclusions EMDR and CBWT are brief, trauma-focused treatments that yielded equally large remission rates for PTSD and reductions in the severity of PTSD and comorbid difficulties in children and adolescents seeking treatment for PTSD tied to a single event. Further trials of both treatments with PTSD tied to multiple traumas are warranted. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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