Efficacy and moderators of efficacy of trauma-focused cognitive behavioural therapies in children and adolescents: protocol for an individual participant data meta-analysis from randomised trials

Introduction Trauma-focused cognitive behavioural therapies are the first-line treatment for posttraumatic stress disorder (PTSD) in children and adolescents. Nevertheless, open questions remain with respect to efficacy: why does this first-line treatment not work for everyone? For whom does it work...

Full description

Saved in:
Bibliographic Details
Main Authors: Isla Kuhn, Caitlin Hitchcock, Tim Dalgleish, Markus A Landolt, Richard Meiser-Stedman, Anke de Haan, Melissa J Black, Kristel Klaus, Shivam D Patel, David J Fisher
Format: Article
Language:English
Published: BMJ Publishing Group 2021-02-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/2/e047212.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846165244499460096
author Isla Kuhn
Caitlin Hitchcock
Tim Dalgleish
Markus A Landolt
Richard Meiser-Stedman
Anke de Haan
Melissa J Black
Kristel Klaus
Shivam D Patel
David J Fisher
author_facet Isla Kuhn
Caitlin Hitchcock
Tim Dalgleish
Markus A Landolt
Richard Meiser-Stedman
Anke de Haan
Melissa J Black
Kristel Klaus
Shivam D Patel
David J Fisher
author_sort Isla Kuhn
collection DOAJ
description Introduction Trauma-focused cognitive behavioural therapies are the first-line treatment for posttraumatic stress disorder (PTSD) in children and adolescents. Nevertheless, open questions remain with respect to efficacy: why does this first-line treatment not work for everyone? For whom does it work best? Individual clinical trials often do not provide sufficient statistical power to examine and substantiate moderating factors. To overcome the issue of limited power, an individual participant data meta-analysis of randomised trials evaluating forms of trauma-focused cognitive behavioural therapy in children and adolescents aged 6–18 years will be conducted.Methods and analysis We will update the National Institute for Health and Care Excellence guideline literature search from 2018 with an electronic search in the databases PsycINFO, MEDLINE, Embase, Cochrane Central Register of Controlled Trials and CINAHL with the terms (trauma* OR stress*) AND (cognitive therap* OR psychotherap*) AND (trial* OR review*). Electronic searches will be supplemented by a comprehensive grey literature search in archives and trial registries. Only randomised trials that used any manualised psychological treatment—that is a trauma-focused cognitive behavioural therapy for children and adolescents—will be included. The primary outcome variable will be child-reported posttraumatic stress symptoms (PTSS) post-treatment. Proxy-reports (teacher, parent and caregiver) will be analysed separately. Secondary outcomes will include follow-up assessments of PTSS, PTSD diagnosis and symptoms of comorbid disorders such as depression, anxiety-related and externalising problems. Random-effects models applying restricted maximum likelihood estimation will be used for all analyses. We will use the Revised Cochrane Risk of Bias tool to measure risk of bias.Ethics and dissemination Contributing study authors need to have permission to share anonymised data. Contributing studies will be required to remove patient identifiers before providing their data. Results will be published in a peer-reviewed journal and presented at international conferences.PROSPERO registration number CRD42019151954.
format Article
id doaj-art-2c60a2e4a5444355a587dc7cdafe6d50
institution Kabale University
issn 2044-6055
language English
publishDate 2021-02-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-2c60a2e4a5444355a587dc7cdafe6d502024-11-17T12:25:09ZengBMJ Publishing GroupBMJ Open2044-60552021-02-0111210.1136/bmjopen-2020-047212Efficacy and moderators of efficacy of trauma-focused cognitive behavioural therapies in children and adolescents: protocol for an individual participant data meta-analysis from randomised trialsIsla Kuhn0Caitlin Hitchcock1Tim Dalgleish2Markus A Landolt3Richard Meiser-Stedman4Anke de Haan5Melissa J Black6Kristel Klaus7Shivam D Patel8David J Fisher9School of Clinical Medicine, University of Cambridge, Cambridge, UKMedical Research Council Cognition and Brain Sciences Unit, Cambridge University, Cambridge, UKMedical Research Council Cognition and Brain Sciences Unit, Cambridge University, Cambridge, UKDepartment of Psychology - Division of Child and Adolescent Health Psychology, University of Zurich, Zurich, Switzerland9 Department of Clinical Psychology and Psychological Therapies, University of East Anglia Norwich Medical School, Norwich, UKMedical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UKMedical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UKMedical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UKMedical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UKMRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, UKIntroduction Trauma-focused cognitive behavioural therapies are the first-line treatment for posttraumatic stress disorder (PTSD) in children and adolescents. Nevertheless, open questions remain with respect to efficacy: why does this first-line treatment not work for everyone? For whom does it work best? Individual clinical trials often do not provide sufficient statistical power to examine and substantiate moderating factors. To overcome the issue of limited power, an individual participant data meta-analysis of randomised trials evaluating forms of trauma-focused cognitive behavioural therapy in children and adolescents aged 6–18 years will be conducted.Methods and analysis We will update the National Institute for Health and Care Excellence guideline literature search from 2018 with an electronic search in the databases PsycINFO, MEDLINE, Embase, Cochrane Central Register of Controlled Trials and CINAHL with the terms (trauma* OR stress*) AND (cognitive therap* OR psychotherap*) AND (trial* OR review*). Electronic searches will be supplemented by a comprehensive grey literature search in archives and trial registries. Only randomised trials that used any manualised psychological treatment—that is a trauma-focused cognitive behavioural therapy for children and adolescents—will be included. The primary outcome variable will be child-reported posttraumatic stress symptoms (PTSS) post-treatment. Proxy-reports (teacher, parent and caregiver) will be analysed separately. Secondary outcomes will include follow-up assessments of PTSS, PTSD diagnosis and symptoms of comorbid disorders such as depression, anxiety-related and externalising problems. Random-effects models applying restricted maximum likelihood estimation will be used for all analyses. We will use the Revised Cochrane Risk of Bias tool to measure risk of bias.Ethics and dissemination Contributing study authors need to have permission to share anonymised data. Contributing studies will be required to remove patient identifiers before providing their data. Results will be published in a peer-reviewed journal and presented at international conferences.PROSPERO registration number CRD42019151954.https://bmjopen.bmj.com/content/11/2/e047212.full
spellingShingle Isla Kuhn
Caitlin Hitchcock
Tim Dalgleish
Markus A Landolt
Richard Meiser-Stedman
Anke de Haan
Melissa J Black
Kristel Klaus
Shivam D Patel
David J Fisher
Efficacy and moderators of efficacy of trauma-focused cognitive behavioural therapies in children and adolescents: protocol for an individual participant data meta-analysis from randomised trials
BMJ Open
title Efficacy and moderators of efficacy of trauma-focused cognitive behavioural therapies in children and adolescents: protocol for an individual participant data meta-analysis from randomised trials
title_full Efficacy and moderators of efficacy of trauma-focused cognitive behavioural therapies in children and adolescents: protocol for an individual participant data meta-analysis from randomised trials
title_fullStr Efficacy and moderators of efficacy of trauma-focused cognitive behavioural therapies in children and adolescents: protocol for an individual participant data meta-analysis from randomised trials
title_full_unstemmed Efficacy and moderators of efficacy of trauma-focused cognitive behavioural therapies in children and adolescents: protocol for an individual participant data meta-analysis from randomised trials
title_short Efficacy and moderators of efficacy of trauma-focused cognitive behavioural therapies in children and adolescents: protocol for an individual participant data meta-analysis from randomised trials
title_sort efficacy and moderators of efficacy of trauma focused cognitive behavioural therapies in children and adolescents protocol for an individual participant data meta analysis from randomised trials
url https://bmjopen.bmj.com/content/11/2/e047212.full
work_keys_str_mv AT islakuhn efficacyandmoderatorsofefficacyoftraumafocusedcognitivebehaviouraltherapiesinchildrenandadolescentsprotocolforanindividualparticipantdatametaanalysisfromrandomisedtrials
AT caitlinhitchcock efficacyandmoderatorsofefficacyoftraumafocusedcognitivebehaviouraltherapiesinchildrenandadolescentsprotocolforanindividualparticipantdatametaanalysisfromrandomisedtrials
AT timdalgleish efficacyandmoderatorsofefficacyoftraumafocusedcognitivebehaviouraltherapiesinchildrenandadolescentsprotocolforanindividualparticipantdatametaanalysisfromrandomisedtrials
AT markusalandolt efficacyandmoderatorsofefficacyoftraumafocusedcognitivebehaviouraltherapiesinchildrenandadolescentsprotocolforanindividualparticipantdatametaanalysisfromrandomisedtrials
AT richardmeiserstedman efficacyandmoderatorsofefficacyoftraumafocusedcognitivebehaviouraltherapiesinchildrenandadolescentsprotocolforanindividualparticipantdatametaanalysisfromrandomisedtrials
AT ankedehaan efficacyandmoderatorsofefficacyoftraumafocusedcognitivebehaviouraltherapiesinchildrenandadolescentsprotocolforanindividualparticipantdatametaanalysisfromrandomisedtrials
AT melissajblack efficacyandmoderatorsofefficacyoftraumafocusedcognitivebehaviouraltherapiesinchildrenandadolescentsprotocolforanindividualparticipantdatametaanalysisfromrandomisedtrials
AT kristelklaus efficacyandmoderatorsofefficacyoftraumafocusedcognitivebehaviouraltherapiesinchildrenandadolescentsprotocolforanindividualparticipantdatametaanalysisfromrandomisedtrials
AT shivamdpatel efficacyandmoderatorsofefficacyoftraumafocusedcognitivebehaviouraltherapiesinchildrenandadolescentsprotocolforanindividualparticipantdatametaanalysisfromrandomisedtrials
AT davidjfisher efficacyandmoderatorsofefficacyoftraumafocusedcognitivebehaviouraltherapiesinchildrenandadolescentsprotocolforanindividualparticipantdatametaanalysisfromrandomisedtrials