A pragmatic randomized controlled trial of cognitive therapy for post‐traumatic stress disorder in children and adolescents exposed to multiple traumatic stressors: the DECRYPT trial

作者：Richard Meiser‐Stedman, Leila Allen, Polly‐Anna Ashford, Ella Beeson, Sarah Byford, Andrea Danese, Annie Farr, Jack Finn, Ben Goodall, Lauren Grainger, Matthew Hammond, Rebecca Harmston, Ayla Humphrey, Dorothy King, Katie Lofthouse, Gerwyn Mahoney‐Davies, Sarah Miles, Jessica L. Moore, Nicola Morant, Sarah A. Robertson, Lee Shepstone, Erika Sims, Paul Stallard, Annie Swanepoel, David Trickey, Katie Trigg, Ramesh Vishwakarma, Jon Wilson, Tim Dalgleish, Patrick Smith · 发表于：World Psychiatry · 年份：2025 · DOI：10.1002/wps.21355 · 被引用次数：3 · 研究领域：Child Abuse and Trauma、Child and Adolescent Psychosocial and Emotional Development、Posttraumatic Stress Disorder Research

Trauma-focused cognitive-behavioral therapies (TF-CBTs) are efficacious in children and adolescents with post-traumatic stress disorder (PTSD). However, there is limited evidence in youth exposed to multiple traumas, especially in real-world settings. This paper reports on a pragmatic randomized controlled trial (RCT) evaluating whether one form of TF-CBT, cognitive therapy for PTSD (CT-PTSD), was effective for PTSD following multiple trauma exposure in 8-17 year-olds attending UK mental health services, relative to treatment-as-usual (TAU). Youth with PTSD (N=120) following multiple traumas were randomly allocated to receive CT-PTSD or TAU. At baseline, complex PTSD diagnosis was common (55.0% of cases), and a large proportion of youth had comorbid mental disorders. The primary outcome was the score on the Child Revised Impact of Event Scale, 8-item version (CRIES-8) at post-treatment. Secondary outcomes included the CRIES-8 score at 11 months post-randomization, and several measures of PTSD, anxiety, depression, suicidal ideation, affect regulation, irritability, and general functioning at post-treatment and 11 months post-randomization. CT-PTSD was not found to be significantly superior to TAU on the CRIES-8 at post-treatment (adjusted difference: -3.80, 95% CI: -7.56 to -0.06, p=0.095; Hedges' g=-0.37, 95% CI: -0.78 to 0.03), but it was superior to TAU when patients who had received TF-CBT were excluded from that arm (adjusted difference: -4.60, 95% CI: -8.36 to -0.81, p=...