Systematic review and meta-analysis: do best-evidenced trauma-focused interventions for children and young people with PTSD lead to changes in social and interpersonal domains?

Objective: Young people with post-traumatic stress disorder experience difficulties in social and interpersonal domains. We examined whether the best-evidenced treatments of PTSD for children and young people (Trauma-focussed Cognitive Behavioural Therapy or Eye Movement Desensitisation and Reprocessing; aged 5–25) improve social or interpersonal factors in randomised controlled trials, compared to a comparator condition.
Method: The review was preregistered on PROSPERO (CRD42023455615; 18th August 2023). Web of Science Core Collection, EMBASE, CINAHL, Pubmed, PsycINFO, Cochrane Central Register of Controlled Trials and PTSDPubs were searched, and data were extracted for social and interpersonal outcomes post treatment. A random effect meta-analysis was conducted to obtain between-group pooled effect size estimates.
Results: The search resulted in 792 studies, of which 17 met our inclusion criteria (N = 2498). Our meta-analysis included 13 studies which investigated social skills and functioning, revealing a small but non-significant effect favouring the evidence-based treatment versus comparison (g = .20, 95% CI [−0.03, 0.44], p = .09). We narratively synthesised six studies which reported other social-related outcomes (e.g. perceptions of social support), and four out of six reported improved social domain outcomes for the evidence-based PTSD treatment condition. There was a large amount of heterogeneity, with no evidence that this could be explained by moderators.
Conclusion: Few trials report on social and interpersonal outcomes, and where they are reported the evidence is mixed. It may be that trauma-focused therapies for PTSD need to be adapted in some circumstances, so that they address social and interpersonal deficits often seen in children and young people with PTSD.

We used a systematic review and meta-analysis to see whether the best treatments for PTSD in children and young people (aged 5–25) improve social or interpersonal factors. These treatments include Trauma-Focused Cognitive Behavioural Therapy and Eye Movement Desensitisation and Reprocessing.
Our meta-analysis looked at 13 studies and found a small but not significant improvement in social functioning for those who received the evidence-based treatments compared to other conditions.
We found that few studies report on social and interpersonal outcomes, and when they do the results are mixed. Trauma-focused therapies for PTSD might need to be adjusted to better address social and interpersonal issues in young people.

We used a systematic review and meta-analysis to see whether the best treatments for PTSD in children and young people (aged 5–25) improve social or interpersonal factors. These treatments include Trauma-Focused Cognitive Behavioural Therapy and Eye Movement Desensitisation and Reprocessing.
Our meta-analysis looked at 13 studies and found a small but not significant improvement in social functioning for those who received the evidence-based treatments compared to other conditions.
We found that few studies report on social and interpersonal outcomes, and when they do the results are mixed. Trauma-focused therapies for PTSD might need to be adjusted to better address social and interpersonal issues in young people.

研究目的：罹患创伤后应激障碍（Post-traumatic Stress Disorder, PTSD）的青少年群体在社会与人际领域存在功能障碍。本研究旨在对比随机对照试验（randomised controlled trials, RCTs）中，针对5至25岁儿童与青少年的PTSD循证治疗方案——创伤聚焦认知行为疗法（Trauma-focussed Cognitive Behavioural Therapy）与眼动脱敏与再加工疗法（Eye Movement Desensitisation and Reprocessing），相较于对照干预条件，能否改善受试的社会与人际相关指标。
研究方法：本综述已于2023年8月18日在PROSPERO平台完成前瞻性注册（注册号：CRD42023455615）。检索了Web of Science核心合集、EMBASE、CINAHL、PubMed、PsycINFO、Cochrane对照试验中心注册库及PTSDPubs数据库，提取治疗后社会与人际结局相关数据。采用随机效应元分析计算组间合并效应量估计值。
研究结果：初步检索共获取792项研究，其中17项符合纳入标准（总样本量N=2498）。本元分析纳入13项探讨社交技能与社会功能的研究，结果显示循证治疗组相较于对照组的效应量较小且未达统计学显著性（g=0.20，95%置信区间[-0.03, 0.44]，p=0.09）。本研究对另外6项报告其他社会相关结局（如社会支持感知）的研究进行了叙述性合成，其中4项结果表明PTSD循证治疗组的社会领域结局得到改善。研究存在较高异质性，且未发现可解释该异质性的调节变量证据。
研究结论：目前仅有极少数试验报告了社会与人际相关结局，且已报告的研究证据存在不一致性。在部分情境下，PTSD创伤聚焦疗法或许需要进行调整，以更好地解决儿童与青少年PTSD患者常出现的社会与人际功能缺陷问题。

本研究采用系统综述与元分析方法，探究针对5至25岁儿童与青少年的PTSD最佳治疗方案——创伤聚焦认知行为疗法与眼动脱敏与再加工疗法，能否改善其社会与人际相关指标。
本元分析纳入13项研究，结果显示接受循证治疗的受试相较于其他干预组，其社会功能存在小幅但未达统计学显著性的改善。
本研究发现，仅有极少数研究报告了社会与人际相关结局，且已报告的研究结果存在不一致性。PTSD创伤聚焦疗法或许需要进行调整，以更好地解决青少年群体常出现的社会与人际问题。

本研究采用系统综述与元分析方法，探究针对5至25岁儿童与青少年的PTSD最佳治疗方案——创伤聚焦认知行为疗法与眼动脱敏与再加工疗法，能否改善其社会与人际相关指标。
本元分析纳入13项研究，结果显示接受循证治疗的受试相较于其他干预组，其社会功能存在小幅但未达统计学显著性的改善。
本研究发现，仅有极少数研究报告了社会与人际相关结局，且已报告的研究结果存在不一致性。PTSD创伤聚焦疗法或许需要进行调整，以更好地解决青少年群体常出现的社会与人际问题。