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...
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BMJ Publishing Group
2021-02-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/2/e047212.full |
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| 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 |
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