A1 Refereed original research article in a scientific journal
Changes in Traumatic Memories and Posttraumatic Cognitions Associate with PTSD Symptom Improvement in Treatment of Multiply Traumatized Children and Adolescents
Authors: Kangaslampi S, Peltonen K
Publisher: SPRINGER HEIDELBERG
Publication year: 2020
Journal: Journal of child and adolescent trauma
Journal name in source: JOURNAL OF CHILD & ADOLESCENT TRAUMA
Journal acronym: J CHILD ADOLES TRAUM
Volume: 13
First page : 103
Last page: 112
Number of pages: 10
ISSN: 1936-1521
DOI: https://doi.org/10.1007/s40653-019-00255-3(external)
Web address : https://doi.org/10.1007/s40653-019-00255-3(external)
Abstract
Refinement, targeting, and better dissemination of trauma-focused therapies requires understanding their underlying mechanisms of change. Research on such mechanisms among multiply traumatized children and adolescents is scarce. We examined the role of improvements in problematic qualities of traumatic memories and maladaptive posttraumatic cognitions in PTSD symptom reduction, in a randomized, pragmatic trial of narrative exposure therapy vs. treatment as usual with 40 participants 9-17 years old (48% female, 75% refugee background) repeatedly exposed to war or family violence related trauma. Posttraumatic cognitions, quality of traumatic memories and PTSD symptoms were assessed by self-report before and after treatment. Improvements in both quality of traumatic memories (r(MI)=.36) and posttraumatic cognitions (r(MI)=.46) correlated with symptom reduction. However, improvement during treatment was only significant for quality of traumatic memories (F-MI(11,333.56)=4.77), not for posttraumatic cognitions. We detected no difference in effects of narrative exposure therapy and treatment as usual on cognitions or memories. We tentatively suggest problematic, overly sensory and incoherent quality of traumatic memories may be a useful target in the treatment of PTSD symptoms among multiply traumatized children and adolescents. Changing maladaptive posttraumatic cognitions, though important, may be challenging among those with severe, repeated trauma.
Refinement, targeting, and better dissemination of trauma-focused therapies requires understanding their underlying mechanisms of change. Research on such mechanisms among multiply traumatized children and adolescents is scarce. We examined the role of improvements in problematic qualities of traumatic memories and maladaptive posttraumatic cognitions in PTSD symptom reduction, in a randomized, pragmatic trial of narrative exposure therapy vs. treatment as usual with 40 participants 9-17 years old (48% female, 75% refugee background) repeatedly exposed to war or family violence related trauma. Posttraumatic cognitions, quality of traumatic memories and PTSD symptoms were assessed by self-report before and after treatment. Improvements in both quality of traumatic memories (r(MI)=.36) and posttraumatic cognitions (r(MI)=.46) correlated with symptom reduction. However, improvement during treatment was only significant for quality of traumatic memories (F-MI(11,333.56)=4.77), not for posttraumatic cognitions. We detected no difference in effects of narrative exposure therapy and treatment as usual on cognitions or memories. We tentatively suggest problematic, overly sensory and incoherent quality of traumatic memories may be a useful target in the treatment of PTSD symptoms among multiply traumatized children and adolescents. Changing maladaptive posttraumatic cognitions, though important, may be challenging among those with severe, repeated trauma.
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