{"doi":"10.1192/bjp.2023.24","title":"Efficacy of psychological interventions for post-traumatic stress disorder in children and adolescents exposed to single versus multiple traumas: meta-analysis of randomised controlled trials","abstract":"<jats:sec id=\"S0007125023000247_sec_a1\"><jats:title>Background</jats:title><jats:p>Previous meta-analyses of psychotherapies for children and adolescents with post-traumatic stress disorder (PTSD) did not investigate whether treatment efficacy is diminished when patients report multiple (versus single) traumas.</jats:p></jats:sec><jats:sec id=\"S0007125023000247_sec_a2\"><jats:title>Aims</jats:title><jats:p>To examine whether efficacy of psychological interventions for paediatric PTSD is diminished when patients report multiple (versus single) traumas.</jats:p></jats:sec><jats:sec id=\"S0007125023000247_sec_a3\" sec-type=\"methods\"><jats:title>Method</jats:title><jats:p>We systematically searched PsycInfo, MEDLINE, Web of Science and PTSDpubs on 21 April 2022 and included randomised controlled trials (RCTs) meeting the following criteria: (a) random allocation; (b) all participants presented with partial or full PTSD; (c) PTSD is the primary treatment focus; (d) sample mean age &lt;19 years; (e) sample size <jats:italic>n</jats:italic> ≥ 20. Trauma frequency was analysed as a dichotomous (single versus ≥2 traumas) and continuous (mean number of exposures) potential moderator of efficacy.</jats:p></jats:sec><jats:sec id=\"S0007125023000247_sec_a4\" sec-type=\"results\"><jats:title>Results</jats:title><jats:p>Of the 57 eligible RCTs (<jats:italic>n</jats:italic> = 4295), 51 RCTs were included in quantitative analyses. Relative to passive control conditions, interventions were found effective for single-trauma-related PTSD (Hedges’ <jats:italic>g</jats:italic> = 1.09; 95% CI 0.70–1.48; <jats:italic>k</jats:italic> = 8 trials) and multiple-trauma-related PTSD (<jats:italic>g</jats:italic> = 1.11; 95% CI 0.74–1.47; <jats:italic>k</jats:italic> = 12). Psychotherapies were also more effective than active control conditions in reducing multiple-trauma-related PTSD. Comparison with active control conditions regarding single-event PTSD was not possible owing to scarcity (<jats:italic>k</jats:italic> = 1) of available trials. Efficacy did not differ with trauma exposure frequency irrespective of its operationalisation and subgroup analyses (e.g. trauma-focused cognitive–behavioural therapy only).</jats:p></jats:sec><jats:sec id=\"S0007125023000247_sec_a5\" sec-type=\"conclusions\"><jats:title>Conclusions</jats:title><jats:p>The current evidence base suggests that psychological interventions for paediatric PTSD can effectively treat PTSD in populations reporting single and multiple traumas. Future trials for PTSD following single-event trauma need to involve active control conditions.</jats:p></jats:sec>","journal":"The British Journal of Psychiatry","year":2023,"id":614486,"datarank":0.4943755299006494,"base_score":3.295836866004329,"endowment":3.295836866004329,"self_citation_contribution":0.4943755299006494,"citation_network_contribution":0.0,"self_endowment_contribution":0.4943755299006494,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":26,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1583482,"name":"Richard Meiser-Stedman","orcid":"0000-0002-0262-623X","position":1,"is_corresponding":false},{"id":1214906,"name":"Tine K. Jensen","orcid":"0000-0002-0751-0228","position":2,"is_corresponding":false},{"id":1583483,"name":"Marianne Skogbrott Birkeland","orcid":"0000-0002-2388-8474","position":3,"is_corresponding":false},{"id":1583484,"name":"Nexhmedin Morina","orcid":"0000-0002-2331-9140","position":4,"is_corresponding":false},{"id":1583481,"name":"Thole H. Hoppen","orcid":"0000-0002-6050-8696","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Efficacy of psychological interventions for post-traumatic stress disorder in children and adolescents exposed to single versus multiple traumas: meta-analysis of randomised controlled trials","abstract":"<jats:sec id=\"S0007125023000247_sec_a1\"><jats:title>Background</jats:title><jats:p>Previous meta-analyses of psychotherapies for children and adolescents with post-traumatic stress disorder (PTSD) did not investigate whether treatment efficacy is diminished when patients report multiple (versus single) traumas.</jats:p></jats:sec><jats:sec id=\"S0007125023000247_sec_a2\"><jats:title>Aims</jats:title><jats:p>To examine whether efficacy of psychological interventions for paediatric PTSD is diminished when patients report multiple (versus single) traumas.</jats:p></jats:sec><jats:sec id=\"S0007125023000247_sec_a3\" sec-type=\"methods\"><jats:title>Method</jats:title><jats:p>We systematically searched PsycInfo, MEDLINE, Web of Science and PTSDpubs on 21 April 2022 and included randomised controlled trials (RCTs) meeting the following criteria: (a) random allocation; (b) all participants presented with partial or full PTSD; (c) PTSD is the primary treatment focus; (d) sample mean age &lt;19 years; (e) sample size <jats:italic>n</jats:italic> ≥ 20. Trauma frequency was analysed as a dichotomous (single versus ≥2 traumas) and continuous (mean number of exposures) potential moderator of efficacy.</jats:p></jats:sec><jats:sec id=\"S0007125023000247_sec_a4\" sec-type=\"results\"><jats:title>Results</jats:title><jats:p>Of the 57 eligible RCTs (<jats:italic>n</jats:italic> = 4295), 51 RCTs were included in quantitative analyses. Relative to passive control conditions, interventions were found effective for single-trauma-related PTSD (Hedges’ <jats:italic>g</jats:italic> = 1.09; 95% CI 0.70–1.48; <jats:italic>k</jats:italic> = 8 trials) and multiple-trauma-related PTSD (<jats:italic>g</jats:italic> = 1.11; 95% CI 0.74–1.47; <jats:italic>k</jats:italic> = 12). Psychotherapies were also more effective than active control conditions in reducing multiple-trauma-related PTSD. Comparison with active control conditions regarding single-event PTSD was not possible owing to scarcity (<jats:italic>k</jats:italic> = 1) of available trials. Efficacy did not differ with trauma exposure frequency irrespective of its operationalisation and subgroup analyses (e.g. trauma-focused cognitive–behavioural therapy only).</jats:p></jats:sec><jats:sec id=\"S0007125023000247_sec_a5\" sec-type=\"conclusions\"><jats:title>Conclusions</jats:title><jats:p>The current evidence base suggests that psychological interventions for paediatric PTSD can effectively treat PTSD in populations reporting single and multiple traumas. Future trials for PTSD following single-event trauma need to involve active control conditions.</jats:p></jats:sec>","is_dataset_classified":null,"base_score":3.295836866004329,"endowment":3.295836866004329,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"36855922","pmcid":"PMC10895514","openalex_id":"https://openalex.org/W4322720403","authors":[],"funders":[],"total_grants":0,"fwci":1.6479,"citation_percentile":0.80893186,"influential_citations":0,"citation_trend":[{"year":2023,"count":1},{"year":2024,"count":11},{"year":2025,"count":8},{"year":2026,"count":6}],"oa_status":"hybrid","license":"cc-by","oa_locations":[{"url":"https://www.cambridge.org/core/services/aop-cambridge-core/content/view/D2C852F813966D2A719413DBA809CBD9/S0007125023000247a.pdf/div-class-title-efficacy-of-psychological-interventions-for-post-traumatic-stress-disorder-in-children-and-adolescents-exposed-to-single-versus-multiple-traumas-meta-analysis-of-randomised-controlled-trials-div.pdf","host_type":"journal"},{"url":"https://www.cambridge.org/core/services/aop-cambridge-core/content/view/D2C852F813966D2A719413DBA809CBD9/S0007125023000247a.pdf/div-class-title-efficacy-of-psychological-interventions-for-post-traumatic-stress-disorder-in-children-and-adolescents-exposed-to-single-versus-multiple-traumas-meta-analysis-of-randomised-controlled-trials-div.pdf","host_type":"publisher"},{"url":"https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S0007125023000247","host_type":"publisher"},{"url":"https://doi.org/10.1192/bjp.2023.24","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/36855922","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/10895514","host_type":"repository"},{"url":"https://ueaeprints.uea.ac.uk/id/eprint/90966/3/Hoppen_ea_in_press_BJPsychiat_efficacy_psychological_interventions_PTSD_C_A_single_vs_multiple_traumas_MA.pdf","host_type":"repository"},{"url":"https://resolver.sub.uni-goettingen.de/purl?gro-2/151981","host_type":"repository"},{"url":"https://www.scopus.com/inward/record.url?eid=2-s2.0-85152636368&partnerID=MN8TOARS","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10895514/pdf/S0007125023000247a.pdf","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC10895514","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC10895514?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Posttraumatic Stress Disorder Research","Child Abuse and Trauma","Migration, Health and Trauma","Adolescent","Adult","Child","Humans","Young Adult","Cognitive Behavioral Therapy","Multiple Trauma","Psychosocial Intervention","Psychotherapy","Stress Disorders, Post-Traumatic","Randomized Controlled Trials as Topic"],"mesh_terms":["Psychosocial Intervention","Adolescent","Adult","Child","Humans","Multiple Trauma","Psychotherapy","Stress Disorders, Post-Traumatic","Cognitive Behavioral Therapy","Randomized Controlled Trials as Topic","Young Adult"],"keywords":["Psychological intervention","PsycINFO","Moderation","Randomized controlled trial","Meta-analysis","Clinical psychology","Traumatic stress","Medicine","Sample size determination","MEDLINE","Psychology","Psychiatry","Internal medicine","efficacy","Ptsd","Multiple Trauma"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-02T13:45:54.044866Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}