The Efficacy of Psychological Interventions for Complex Trauma: A Systematic Review and Meta-Analysis

Choi, Hyunjung; Lee, Woo-Yeol; Heo, Simyang; Kim, Jahye

doi:10.15842/kjcp.2020.39.2.007

Cited by 4 publications

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“…According to Holmes et al ( 2022 ) discussing that poverty and PTSD affect each other, we may anticipate that chronic CPTSD would hinder the effectiveness of monetary interventions and that living conditions that perpetuate poverty would worsen CPTSD. The results of a previous meta-analysis have shown that the efficacy for ameliorating symptoms related to complex trauma is stronger when receiving intensive empirically supported treatments rather than other psychosocial interventions, even for people with low resources, thus highlighting the importance of bringing efforts to provide effective CPTSD treatments to people with low access to such interventions (Choi et al, 2020 ). This is also expected to be true for childhood IM survivors with less resources, such as those experiencing poverty.…”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, an effectiveness study of a multidisciplinary intervention implemented in northern Kosovo which included cognitive behavioural therapy targeting PTSD symptoms was shown to bring about economic improvement in both employment and wage (Wang et al, 2016 ), thus indicating that such interventions may create positive upward spirals. While psychological interventions for PTSD are expected to be efficacious for CPTSD (Choi et al, 2020 ; Karatzias et al, 2019 ), these multidisciplinary approaches should be further examined to assess whether they are also effective for CPTSD.…”

Section: Discussionmentioning

confidence: 99%

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The effect of complex posttraumatic stress and poverty on quality of life among adult survivors of childhood institutional maltreatment: evidence from survivors of the ‘Hyeongje Welfare Institution’ in South Korea

Kim,

Nam,

Choi

2024

European Journal of Psychotraumatology

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Background: Childhood institutional maltreatment (IM) is associated with both complex posttraumatic stress disorder (CTPSD) and poverty in adulthood life, each of which may impact an individual’s quality of life (QoL). To find implications for clinical practice and policy making for adult survivors with childhood IM experiences, it is necessary to conduct research examining their current QoL and identifying related factors. Objective: By applying the model of the conservation of resources theory, we focused on how adulthood QoL can be indicated by childhood IM as well as the life outcomes of IM such as additional lifetime trauma, CPTSD, and poverty. Methods: In a cross-sectional study, self-report data were collected from 127 adults who were survivors of the ‘Hyeongje’ childhood IM in South Korea. We conducted regression analyses of childhood IM experiences, trauma experiences after escape from the institution, current CPTSD symptoms, and current poverty experiences on current QoL. Results: The duration of placement at the ‘Hyeongje’ ( β = .24, p = .009) was associated with trauma experiences after escape from the institution. Trauma experiences after escape from the institution ( β = .25, p = .007) were associated with CPTSD symptoms. CPTSD symptoms ( β = .26, p = .005) were associated with poverty, and both CPTSD symptoms ( β = −.52, p < .001) and poverty ( β = −.26, p = .003) were negatively associated with current QoL. Conclusions: Prolonged childhood IM brings about loss spirals by increasing an individual’s exposure to experiences of further cumulative trauma, CPTSD, and poverty. There is a need for due diligence-based policy making and public support from the government to help create upward spirals for QoL. This may include the imminent detection and rescue of children as well as providing a safe environment, offering multidisciplinary interventions including evidence-based treatment for CPTSD, and considering economic support including collective reparations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The effect of complex posttraumatic stress and poverty on quality of life among adult survivors of childhood institutional maltreatment: evidence from survivors of the ‘Hyeongje Welfare Institution’ in South Korea

Kim,

Nam,

Choi

2024

European Journal of Psychotraumatology

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“…Finally, therapeutic, trauma‐focused interventions can improve symptoms of PMTS (Christian‐Brandt et al, 2019 ; Sabnis et al, 2019 ) and other forms of complex trauma (Choi et al, 2020 ). Interventions that are delivered to families in an acute setting, such as the NICU (Sabnis et al, 2019 ), or immediately following a medically traumatic event (Christian‐Brandt et al, 2019 ) show moderate effects on medium to long term PTSS.…”

Section: Discussionmentioning

confidence: 99%

Experiences of medical traumatic stress in parents of children with medical complexity

Dewan

Birnie

Drury³

et al. 2022

Child

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Background and Objectives Parents of children with medical complexity (CMC) experience high levels of stress and adverse mental health outcomes. Pediatric medical traumatic stress (PMTS) could be an important contributor that has not yet been explored. PMTS describes parents' reactions to their child's illness and medical treatment and can lead to post‐traumatic stress symptoms. This is the first study to describe the experiences and impact of PMTS among parents of CMC. Methods We conducted semi‐structured interviews with 22 parents of CMC. Reflexive thematic analysis was used to generate themes that described the experiences of PMTS and potential contributing factors in the healthcare setting. Themes were validated by study participants. Results Parents experienced a spectrum of events and circumstances that impacted PMTS. These corresponded to three major themes: (a) the distinctive context of being the parent of a CMC, (b) interactions with healthcare providers that can hurt or heal and (c) system factors that set the stage for trauma. The consequences of repeated PMTS were a common point of emphasis among all the themes. Parents identified numerous changes that could mitigate PMTS such as acknowledgement of trauma and provision of proactive mental health support. Conclusions Our study highlights the issue of PMTS among parents of CMC and presents opportunities to mitigate their traumatic experiences. Supporting the integration of trauma‐informed care practices, increasing awareness of PMTS and advocating for parental mental health services could better support parents and families.

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“…Moreover, it is crucial to highlight that traumatized youth, although they may present other associated psychiatric disorders, often manifest disturbances in their self-organization, severe emotion dysregulation, and high levels of guilt, shame, self-harm and interpersonal problems. Thus, they require specific forms of intervention [80][81][82][83].…”

Section: Discussionmentioning

confidence: 99%

Risk of Suicidal Behavior in Children and Adolescents Exposed to Maltreatment: The Mediating Role of Borderline Personality Traits and Recent Stressful Life Events

Marqués-Feixa

Moya-Higueras

Romero

et al. 2021

JCM

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Childhood maltreatment (CM) is associated with increased non-suicidal self-injury (NSSI) and suicidal behavior (SB), independently of demographic and mental health conditions. Self-Trauma Theory and Linehan’s Biopsychosocial Model might explain the emergence of Borderline Personality Disorder (BPD) symptoms as mediators of the association between CM and the risk of SB. However, little is known regarding such relationships when the exposure is recent for young persons. Here, we study 187 youths aged 7–17, with or without mental disorders. We explore CM experiences (considering the severity and frequency of different forms of neglect and abuse), recent stressful life events (SLEs), some BPD traits (emotion dysregulation, intense anger and impulsivity), and the risk of SB (including NSSI, suicide threat, suicide ideation, suicide plan and suicide attempt). We study the direct and mediating relationships between these variables via a structural equation analysis using the statistical software package EQS. Our findings suggest that youths exposed to more severe/frequent CM have more prominent BPD traits, and are more likely to have experienced recent SLEs. In turn, BPD traits increase the risk of SLEs. However, only emotion dysregulation and recent SLEs were found to be correlated with SB. Therefore, targeted interventions on emotion dysregulation are necessary to prevent NSSI or SB in children and adolescents exposed to CM, as is the minimization of further SLEs.

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The Efficacy of Psychological Interventions for Complex Trauma: A Systematic Review and Meta-Analysis

Cited by 4 publications

References 0 publications

The effect of complex posttraumatic stress and poverty on quality of life among adult survivors of childhood institutional maltreatment: evidence from survivors of the ‘Hyeongje Welfare Institution’ in South Korea

The effect of complex posttraumatic stress and poverty on quality of life among adult survivors of childhood institutional maltreatment: evidence from survivors of the ‘Hyeongje Welfare Institution’ in South Korea

Experiences of medical traumatic stress in parents of children with medical complexity

Risk of Suicidal Behavior in Children and Adolescents Exposed to Maltreatment: The Mediating Role of Borderline Personality Traits and Recent Stressful Life Events

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