Trauma-focused Cognitive Behavioral Therapy For Post-traumatic Stress Disorder In Children And Adolescents:A Meta-analysis

Objective: As a manual psychotherapy approach,a number of studies have explored the effect of Trauma-focused cognitive behavioral therapy(TF-CBT)on post-traumatic stress disorder(PTSD)in children and adolescents.However,inconsistencies between studies remain.Therefore,this study applied systematic literature search and meta-analysis methods to further evaluate the efficacy and compliance of this therapy by comparing it with control measures.Methods: Relevant randomized controlled trials of TF-CBT in children and adolescents with PTSD were retrieved from Pubmed,Embase,Cochrane Library,Psyc INFO,and web of science databases prior to November 31,2022.In addition,these documents are imported into bibliographic management software Endnote X9 and duplicate documents are removed.According to the pre-set inclusion and exclusion criteria,studies that meet the criteria are further screened,and then the quality of the included studies is evaluated and the required data and information are extracted.The results are obtained through statistical analysis through Review Manager 5.4.Finally,Egger’s test was completed by Stata17.0 software to carry out quantitative detection of publication bias of major results.Results: 14 randomized controlled trials involving 2007 participants were included in this study.The efficacy and acceptability of CBT were compared with non-active control.The results of meta-analysis showed that the overall efficacy of TF-CBT for children and adolescents with PTSD was significantly better than that of non-active control measures(SMD=-0.95,95%CI=[-1.24,-0.66],P<0.00001).The comparison of the efficacy of TF-CBT in the three sub-symptoms of intrusion,avoidance,and increased alertness,as well as depression and anxiety also showed a significant therapeutic advantage of TF-CBT(intrusion: SMD=-0.53,95%CI=[-0.72,-0.34],P<0.00001.Avoidance: SMD=-0.53,95%CI=[-0.70,-0.37],P<0.00001.Increased alertness: SMD=-0.64,95%CI=[-1.00,-0.28],P=0.008.Depression: SMD=-0.45,95%CI=[-0.61,-0.30],P<0.00001.Anxiety:SMD=-0.31,95%CI=[-0.48,-0.15],P=0.0001).About compliance,compared with all the positive control measures,the combined effect of the result not seen statistically significant(RR=1.08,95%CI=[0.81,1.42],P =0.60).Conclusion: TF-CBT can significantly improve the typical clinical symptoms of children and adolescents with post-traumatic stress disorder,and can relieve their depression and anxiety to a certain extent.