Do psychological treatments for PTSD in children and young people reduce trauma-related appraisals? : A systematic review and meta-analysis

Research is increasingly highlighting the role of negative trauma-related appraisals in child and adolescent post-traumatic stress disorder (PTSD). The cognitive model of PTSD claims that an essential mechanism of treatment is a reduction in these appraisals. The current systematic review with meta-analysis investigated the extent to which psychological treatments for PTSD reduce negative trauma-related appraisals in children and adolescents. Four databases (PsycINFO, Medline Complete, CINAHL Complete and PTSDpubs) were searched on the 11–12th December 2022. The Risk of Bias 2 (ROB-2) tool was used to assess for risk of bias. Thirteen studies were included in this review, comprising 937 child and adolescent participants. Using a random effects model to perform the meta-analysis, a medium pooled effect size for the effect of current treatments on trauma-related appraisals was found (g = −.67, 95% CI [-.86, −.48]). There was only a moderate level of heterogeneity between studies (I2 = 44.4%), increasing the confidence with which these findings can be interpreted. These results indicate that psychological treatments for child and adolescent PTSD significantly reduce negative trauma-related appraisals. However, it is important to note that no trial included in the review was categorised as having low risk of bias.

Highlights

• Negative appraisals are linked to more severe PTSD in children and adolescents.
• This systematic review considered the effect of PTSD treatment on appraisals.
• Data from 13 RCTs (N = 937) in children and adolescent samples were included.
• A significant medium-sized effect of treatment (g = −.67) was found.
• This effect was robust to trial quality, type of control condition and measure.