Abstract
There is no clear gold standard treatment for childhood posttraumatic stress disorder (PTSD). An annotated bibliography and meta-analysis were used to examine the efficacy of cognitive behavioral therapy (CBT) in the treatment of pediatric PTSD as measured by outcome data from the Child Behavior Checklist (CBCL).
A literature search produced 21 studies; of these, 10 utilized the CBCL but only eight were both 1) randomized; and 2) reported pre- and post-intervention scores.
The annotated bibliography revealed efficacy in general of CBT for pediatric PTSD. Using four indices of the CBCL, the meta-analysis identified statistically significant effect sizes for three of the four scales: Total Problems (TP; −.327; p = .003), Internalizing (INT; −.314; p = .001), and Externalizing (EXT; −.192; p = .040). The results for TP and INT were reliable as indicated by the fail-safe N and rank correlation tests. The effect size for the Total Competence (TCOMP; −.054; p = .620) index did not reach statistical significance.
Limitations included methodological inconsistencies across studies and lack of a randomized control group design, yielding few studies for meta-analysis.
The efficacy of CBT in the treatment of pediatric PTSD was supported by the annotated bibliography and meta-analysis, contributing to best practices data. CBT addressed internalizing signs and symptoms (as measured by the CBCL) such as anxiety and depression more robustly than it did externalizing symptoms such as aggression and rule-breaking behavior, consistent with its purpose as a therapeutic intervention.
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► Pediatric PTSD is a seriously disabling condition. ► Little research is available on a gold standard approach to treatment or treatment outcomes. ► This study attempts to address these issues using a meta-analysis of available published data. ► Meta-analysis allows us to synthesize quantitative results from multiple studies of cognitive behavioral therapy for pediatric PTSD in order to estimate the overall effectiveness of this modality in treating this condition. ► Cognitive-behavioral treatment has benefits for pediatric PTSD, and more studies are warranted using comparable outcome measures and/or similar methodology.