A systematic review of controlled-trials for PTSD in maltreated children and adolescents

Rhiannon Bennett, Megan Denne, Rosie McGuire, Rachel Hiller

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Abstract

Child maltreatment is associated with elevated risk of post-traumatic stress disorder (PTSD), which can often present alongside comorbidities. While evidence-based treatments for PTSD in young people already exist, there remains ongoing clinical and academic debate about the suitability of these approaches, particularly cognitive-behavioral approaches, for young people who have been exposed to more complex traumatic experiences, such as maltreatment. We conducted an updated systematic review of the evidence-base for psychological treatments for PTSD, specifically for maltreated young people. Fifteen randomized controlled trials and five non-randomized controlled clinical trials satisfied the inclusion criteria. Trials included treatments ranging from trauma-focused CBT to creative-based therapies. Trauma-focused CBT remained the best supported treatment for children and adolescents following child maltreatment, with new evidence that symptom improvements are maintained at longer-term follow up. The evidence for other therapies remained limited, and there were concerns regarding methodological quality. Implications for treatment decision-making are discussed.

Original languageEnglish
Pages (from-to)325-343
Number of pages19
JournalChild Maltreatment
Volume26
Issue number3
Early online date5 Oct 2020
DOIs
Publication statusPublished - 1 Aug 2021

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The project was partially funded by an ESRC Future Leader grant and University of Bath Prize Research Fellowship awarded to RMH. RMH also receives funding from the National Institute of Health Research (Grant Reference Number NIHR200586). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Publisher Copyright:
© The Author(s) 2020.

Keywords

  • PTSD treatment
  • child maltreatment
  • systematic review
  • youth

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology

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