Two out of three children experience at least one traumatic event before adulthood, but little research has been done to identify the most effective treatments to prevent and relieve stress symptoms that emerge after such incident, a new analysis shows.
The study — conducted by researchers at RTI International, the University of North Carolina School of Medicine, and Boston Medical Center — suggests more needs to be done to determine the best ways to help children cope with tragedies and disturbing events.
The findings, published in the journal Pediatrics, are particularly important in the wake of such incidents as the Sandy Hook school shooting, the researchers said.
"The current body of evidence provides only a little insight into best practices in treating children exposed to trauma, some of whom already have symptoms," said lead investigator Valerie Forman-Hoffman, a research epidemiologist at RTI International. "This is particularly discouraging given recent shootings at schools and other places where children have been victims. We simply don't have much of an evidence base to be able to recommend best treatment practices."
For the study, which was funded by the U.S. Agency for Healthcare Research and Quality, researchers reviewed more than 6,600 clinical studies of interventions for children who were exposed to at least one traumatic event before age 18 — including an accident, natural disaster, community violence, war, or political instability.
From that larger list, the investigators identified just 22 studies that examined psychotherapeutic treatments that showed possible benefits for children exposed to trauma. The most promising interventions were school-based psychotherapy interventions that included cognitive behavior therapy to address symptoms of post-traumatic stress, anxiety, depression, and anger.
The review did not find evidence that any of the drug treatments were effective.
"These findings serve as a call to action: psychotherapeutic intervention can provide some benefit to children exposed to traumatic events, but far more research is needed to make definitive conclusions,” said Adam Zolotor, M.D., a family physician at the University of North Carolina and a co-author of the review. “Because trauma is a common and costly source of childhood psychological distress, it is critical to understand effective forms of treatment."
The authors urged public health authorities to take aggressive steps to study the impact of trauma interventions to identify the most effective strategies.
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