[Posttraumatic stress disorder in children and adolescents: results of a cross-sectional study on the effects of the newly formulated PTSD and CPTSD diagnoses in the ICD-11]. / Posttraumatische Belastungsstörung bei Kindern und Jugendlichen: Ergebnisse einer Querschnittsstudie zu Auswirkungen der neu formulierten Diagnosen PTBS und kPTBS in der ICD-11.

BACKGROUND: ICD-11 presents narrowed criteria for posttraumatic stress disorder (PTSD) and introduces complex PTSD (CPTSD) with additional difficulties in self-organization (DSO). These changes can have significant effects on the frequency of the diagnosis. The aim of this study was to investigate which ICD-11 symptom clusters cause children and adolescents to miss the diagnosis and whether caregivers are more likely to attribute changes in DSO to developmental level or to the traumatic event, and how these attributions are in turn related to symptom severity. METHODS: N = 88 German-speaking children and adolescents (age: 7-17 years) after traumatic events and N = 79 caregivers participated between September 2019 and November 2020 in a survey on PTSD symptom severity (CATS-2) and attribution of DSO symptoms (caregiver questionnaire). RESULTS: The ICD-11 criteria (CATS­2 and a developmentally adapted version) showed lower frequency rates for PTSD as compared to DSM­5 and ICD-10. The ICD-11 clusters re-experiencing and hyperarousal were met the least often. Changes in DSO symptoms were predominantly rated as event-related. This attribution was associated with higher PTSD and DSO symptom severity in caregiver reports. The age-related attribution was associated with higher DSO-symptom severity, but not PTSD symptom severity in caregiver reports. DISCUSSION: In the context of the diagnostic process and the revision of diagnostic instruments for ICD-11 (C)PTSD, development-specific symptoms should be taken into account. The trauma-related differentiation of DSO symptom changes as compared to development-related fluctuations is challenging and therefore requires several sources of information.

Stability of Treatment Effects and Caregiver-Reported Outcomes: A Meta-Analysis of Trauma-Focused Cognitive Behavioral Therapy for Children and Adolescents.

The efficacy of trauma-focused treatments for children and adolescents is well researched. However, less is known about the long-term and caregiver-reported effects. Searched databases were PsychInfo, MEDLINE, Cochrane Library, PTSDPubs, PubMed, Web of Science, and OpenGrey. Treatment effects of trauma-focused cognitive behavioral therapy (TF-CBT) were computed at 12-month follow-up with posttraumatic stress symptoms (PTSS) as primary outcome and symptoms of depression, anxiety, and grief as secondary outcomes. Concordance between participant and caregiver ratings were investigated. TF-CBT showed large improvements across all outcomes from pre-treatment to 12-month follow-up (PTSS: g = 1.71, CI 1.27-2.15) and favorable results compared to active treatments and treatment as usual at 12-month follow-up (PTSS: g = .35, CI .13-.56). More pronounced effects were found in group settings. No significant differences were detected between participant and caregiver ratings with high reliability across almost all outcomes and assessment points. TF-CBT is a reliable treatment for pediatric PTSS and secondary symptoms with stable results at 12-month follow-up.

Online training for evidence-based child trauma treatment: evaluation of the German language TF-CBT-Web.

Background: Evidence-based trauma-focused interventions for treating PTSD in children and youth are barely used in practice. Web-based training has proven to be an effective way of transferring knowledge to healthcare professionals. Objective: TF-CBT Web is a web-based training programme designed to foster the dissemination of Trauma Focused Cognitive Behavioural Therapy (TF-CBT) for children and youth, and is run by the Medical University of South Carolina. This paper describes the characteristics of healthcare professionals who registered for the adapted German language version of TF-CBT Web. It evaluates the effectiveness and user friendliness of the programme. Method: : Similar to the TF-CBT treatment manual, the German language TF-CBT Web contains 12 modules. Between 2018 and 2020, 4,020 users registered for the programme. During the registration process users provided demographic information. The knowledge of users regarding the TF-CBT components was assessed via pre-tests and post-tests in each module. Results: The programme was accessed by a sample of mostly German users with varying professional health care backgrounds and a wide-ranging spread of work experience. The results indicated a significant knowledge gain and high rates of user satisfaction with the programme. Conclusions: In summary, the results of this study suggested that web-based training is an effective and well-accepted method for knowledge gain in trauma-focused interventions. Future research should evaluate the actual application of the taught methods in clinical practice. HIGHLIGHTS: Children and adolescents with PTSD require trauma-focused treatment. However, evidence-based interventions for this patient population are barely used. Therefore, it is necessary to expand professional training for the treatment of traumatised children and adolescents.Our evaluation showed the effectiveness and feasibility of a web-based training programme for mental health practitioners in an evidence-based treatment for children and youth with PTSD (TF-CBT). Results show a significant knowledge gain of users who participate in the web-based training programme.The user satisfaction survey also revealed that users found the modus and content of the web-based training applicable and relevant for their clinical practice.

Antecedentes: Las intervenciones centradas en el trauma basadas en la evidencia para tratar el TEPT en niños y jóvenes apenas se utilizan en la práctica. La capacitación basada en la web ha demostrado ser una forma efectiva de transferir conocimientos a los profesionales de la salud.Objetivo: TF-CBT Web es un programa de capacitación basado en la web, diseñado para fomentar la difusión de la Terapia cognitiva conductual centrada en el trauma (TF-CBT por sus siglas en ingles) para niños y jóvenes, y está a cargo de la Universidad Médica de Carolina del Sur. Este artículo describe las características de los profesionales de la salud que se registraron en la versión alemana adaptada del TF-CBT Web. Evalúa la eficacia y la facilidad de uso del programa.Método: Similar al manual de tratamiento de TF-CBT, el sitio web de TF-CBT en alemán contiene 12 módulos. Entre 2018 y 2020 se registraron 4.020 usuarios en el programa. Durante el proceso de registro, los usuarios proporcionaron información demográfica. El conocimiento de los usuarios sobre los componentes de la TF-CBT se evaluó mediante pruebas previas y posteriores en cada módulo.Resultados: El programa fue completado por una muestra de usuarios en su mayoría alemanes con diferentes antecedentes profesionales en el cuidado de la salud, y una amplia variedad de experiencia laboral. Los resultados indicaron una ganancia de conocimiento significativa y altos índices de satisfacción de los usuarios con el programa.Conclusiones: En resumen, los resultados de este estudio sugirieron que la capacitación basada en la web es un método efectivo y bien aceptado para adquirir conocimientos en intervenciones centradas en el trauma. La investigación futura debe evaluar la aplicación real de los métodos enseñados en la práctica clínica.