A Critical Review of Effective Child Mass Trauma Interventions: What We Know and Do Not Know from the Evidence.

Betty Pfefferbaum,Pascal Nitiéma,Elana Newman

doi:10.3390/bs11020025

Abstract

Over the last 20 years, numerous interventions have been developed and evaluated for use with children exposed to mass trauma with six publications reporting meta-analyses of randomized controlled trials of child mass trauma interventions using inactive controls to examine intervention effects on posttraumatic stress, depression, anxiety, and functional impairment. The current report reviews the results of these meta-analytic studies to examine the status of the evidence for child mass trauma mental health interventions and to evaluate potential moderators of intervention effect and implications for practice. The meta-analyses reviewed for the current report revealed a small to medium overall effect of interventions on posttraumatic stress, a non-statistically significant to small overall effect on depression, a non-statistically significant overall effect on anxiety, and a small overall effect on functional impairment. The subgroup analyses suggest that interventions should be matched to the populations being served and to the context. Additional research is needed to tailor future interventions to further address outcomes other than posttraumatic stress including depression, anxiety, and functional impairment.

Highlights

Disasters and political violence, including war, political conflict, and terrorism, have devastating effects on children who are a priority for intervention [1,2]
The current review synthesizes the results of 12 meta-analyses of randomized controlled trials using inactive controls to examine posttraumatic stress [14,17,18,19], depression [14,15,18], anxiety [15,18], and functional impairment [14,16,18] outcomes in children receiving interventions for mass trauma
The current analysis suggests small [18] or medium [14,17] effects of interventions on posttraumatic stress in children exposed to mass trauma

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Disasters and political violence, including war, political conflict, and terrorism, have devastating effects on children who are a priority for intervention [1,2]. Children’s mass trauma reactions range from transient emotional distress and behavior changes to enduring psychopathology with as many as 30% experiencing lasting impairment [3]. The most commonly studied disaster outcome is posttraumatic stress disorder (PTSD) and/or PTSD symptoms or reactions [4]. A meta-analysis found that 9.7% of children exposed to noninterpersonal trauma such as accidents and natural disasters developed the condition [5]

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