Community Treatment of Posttraumatic Stress Disorder for Children Exposed to Intimate Partner Violence: A Randomized Controlled Trial
Abstract
OBJECTIVE: To evaluate community-provided trauma-focused cognitive behavior therapy (TF-CBT) compared with usual community treatment for children with intimate partner violence (IPV)-related posttraumatic stress disorder (PTSD) symptoms. DESIGN: Randomized controlled trial conducted using blinded evaluators. SETTING: Recruitment, screening, and treatment were conducted at a community IPV center between September 1, 2004, and June 30, 2009. PARTICIPANTS: Of 140 consecutively referred 7- to 14-year-old children, 124 participated. INTERVENTIONS: Children and mothers were randomly assigned to receive 8 sessions of TF-CBT or usual care (child-centered therapy). MAIN OUTCOME MEASURES: Total child PTSD symptoms assessed using child and parent structured interview (Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Version [K-SADS-PL]) and self-report (University of California at Los Angeles PTSD Reaction Index [RI]). Secondary child outcomes were scores on the K-SADS-PL (PTSD symptom clusters), Screen for Child Anxiety Related Emotional Disorders (SCARED) (anxiety), Children's Depression Inventory (depression), Kaufman Brief Intelligence Test (cognitive functioning), and Child Behavior Checklist (total behavior problems). RESULTS: Intent-to-treat analysis using last observation carried forward showed superior outcomes for TF-CBT on the total K-SADS-PL (mean difference, 1.63; 95% confidence interval [CI], 0.44-2.82), RI (mean difference, 5.5; 95% CI, 1.37-9.63), K-SADS-PL hyperarousal (mean difference, 0.71; 95% CI, 0.22-1.20), K-SADS-PL avoidance (0.55; 0.07-1.03), and SCARED (mean difference, 5.13; 95% CI, 1.31-8.96). Multiple imputation analyses confirmed most of these findings. The TF-CBT completers experienced significantly greater PTSD diagnostic remission (χ(2) = 4.67, P = .03) and had significantly fewer serious adverse events. CONCLUSIONS: Community TF-CBT effectively improves children's IPV-related PTSD and anxiety. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00183326.
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There is some evidence that treatments can be effective in situations of ongoing adversity, whereas other studies have shown reduced treatment benefits for populations facing chronic adversity.
“With regard to the second question, there is some evidence that treatments can be effective in situations of ongoing adversity [19],[20], whereas other studies have shown reduced treatment benefits for populations facing chronic adversity [21].”
From World Health Organization guidelines for management of acute stress, PTSD, and bereavement: key challenges on the road ahead (2014) · cites this paper as [20]
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References 23 · Cited by 347
- Authors
- Cohen, J. A., Mannarino, A. P., & Iyengar, S.
- Affiliations
- Allegheny General Hospital (US)
- Venue
- Archives of Pediatrics & Adolescent Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2011-01-01
- Volume
- 165
- Issue
- 1
- Pages
- 16-21
- ISSN
- 1072-4710 (ISSN-L)
- OpenAlex
- W1996446802
- Cited by
- 347
- References
- 23
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 13 · 2023: 19 · 2022: 25 · 2021: 24 · 2020: 24 · 2019: 20 · 2018: 20 · 2017: 22 · 2016: 42 · 2015: 30 · 2014: 28 · 2013: 31 · 2012: 19
- FWCI
- 31.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Pediatrics and Adolescent Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (R01MH072590, R01 MH72590)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Health › Intimate Partner and Family Violence
- Keywords
- post-traumatic stress disorder, trauma-focused cognitive behavioral therapy, community-based treatment, childhood anxiety, PTSD symptom clusters, hyperarousal, avoidance, PTSD remission, adverse events, childhood depression, behavioral problems, cognitive function, K-SADS-PL, SCARED, Children's Depression Inventory
- MeSH terms
- Adolescent, Age Factors, Anxiety Disorders, Child, Child Health Services, Community Mental Health Services, Depression, Environmental Exposure, Female, Follow-Up Studies, Humans, Male, Psychiatric Status Rating Scales, Reference Values, Sex Factors, Sex Offenses, Stress Disorders, Post-Traumatic, Time Factors, Reproducibility of Results, Cognitive Behavioral Therapy, Confidence Intervals, Single-Blind Method, Treatment Outcome, Domestic Violence, Risk Assessment, Patient-Centered Care
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