Treatment of Adolescent PTSD: The Impact of Prolonged Exposure Versus Client-Centered Therapy on Co-Occurring Emotional and Behavioral Problems
Authors:
Zandberg, L; Kaczkurkin, AN; McLean, CP; Rescorla, L; Yadin, E; Foa, EB
Source:
JOURNAL OF TRAUMATIC STRESS, 29 (6):507-514; 10.1002/jts.22138 DEC 2016
Abstract:
The present study evaluated secondary emotional and behavioral outcomes
among adolescents who received prolonged exposure (PE-A) or
client-centered therapy (CCT) for posttraumatic stress disorder (PTSD)
in a randomized controlled trial. Participants were 61 adolescent girls
(age: M = 15.33, SD = 1.50 years) with sexual abuse related PTSD seeking
treatment at a community mental health clinic. Multilevel modeling was
employed to evaluate group differences on the Youth Self-Report (YSR)
over acute treatment and 12-month follow-up. Both treatment groups
showed significant improvements on all YSR scales from baseline to
12-month follow-up. Adolescents who received PE-A showed significantly
greater reductions than those receiving CCT on the Externalizing
subscale (d = 0.70), rule-breaking behavior (d = 0.63), aggressive
behavior (d = 0.62), and conduct problems (d = 0.78). No treatment
differences were found on the Internalizing subscale or among other YSR
problem areas. Both PE-A and CCT effectively reduced many co-occurring
problems among adolescents with PTSD. Although PE-A focuses on PTSD and
not on disruptive behaviors, PE-A was associated with greater sustained
changes in externalizing symptoms, supporting broad effects of
trauma-focused treatment on associated problem areas.