Translating the Cognitive Model of PTSD to the Treatment of Very Young Children: A Single Case Study of an 8‐Year‐Old Motor Vehicle Accident Survivor

Goodall, Benjamin; Chadwick, Isobel; McKinnon, Anna; Werner‐Seidler, Aliza; Meiser‐Stedman, Richard; Smith, Patrick; Dalgleish, Tim

doi:10.1002/jclp.22449

Cited by 6 publications

(6 citation statements)

References 24 publications

(49 reference statements)

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“…The findings could be interpreted in the context of cognitive theories of PTSD that were initially developed for adults (e.g., Ehlers & Clark, 2000 ). Furthermore, they support the translation of cognitive theories into treatment strategies not only following incidental traumatic events (as proposed by Goodall et al, 2017 ) but also following maltreatment.…”

Section: Discussionsupporting

confidence: 68%

Negative Posttraumatic Cognitions in 4- to 8-year-old Children following Maltreatment

Vasileva

Fegert

Rosner

et al. 2022

Journ Child Adol Trauma

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Purpose Research has shown that children and adolescents suffering from posttraumatic stress often have negative posttraumatic cognitions such as negative appraisals of the trauma sequel that increase mental health problems. However, little is known about posttraumatic cognitions in young children. The aim of this study was to investigate negative posttraumatic cognitions in 4- to 8-year-old children following maltreatment. We also examined their association with child age and well-being as well as caregiver psychopathology. Methods The study includes N = 112 caregiver-child dyads with children’s mean age of M = 6.2 ( SD = 1.1) years. Children had experienced physical abuse, emotional abuse, neglect, sexual victimization, and/or domestic violence prior to participation. Posttraumatic cognitions were assessed using a short child interview including four items adapted from the Child Posttraumatic Cognitions Inventory (CPTCI; Meiser‐Stedman et al in Journal of Child Psychology and Psychiatry, 50(4), 432–440, 2009 ). Results Completion of the interview about posttraumatic cognitions was independent from child’s age. Higher levels of negative posttraumatic cognitions were significantly associated with a higher cumulative maltreatment score ( r = .35) and higher scores of posttraumatic stress symptoms ( r = .39). There was no significant correlation with parent variables. Conclusion These findings indicate that posttraumatic cognitions might be an important diagnostic and treatment target for 4- to 8-year-old children. Supplementary Information The online version contains supplementary material available at 10.1007/s40653-022-00455-4.

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Section: Discussionsupporting

confidence: 68%

Negative Posttraumatic Cognitions in 4- to 8-year-old Children following Maltreatment

Vasileva

Fegert

Rosner

et al. 2022

Journ Child Adol Trauma

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“…These may include: greater involvement of carers throughout including joint carer-child sessions; behaviour management training for carers; skills teaching in arousal reduction for children; and use of developmentally engaging methods to construct trauma narratives (see Scheeringa 2016). A number of promising and informative case examples have been published (Goodall et al, 2017; Scheeringa et al 2007). To date, there has been one pilot RCT evaluating developmentally adapted TF-CBT in younger children with PTSD symptoms (Scheeringa et al 2011c).…”

Section: Interventionsmentioning

confidence: 99%

Practitioner Review: Posttraumatic stress disorder and its treatment in children and adolescents

Smith

Dalgleish

Meiser‐Stedman

2018

Child Psychology Psychiatry

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Important advances in understanding traumatic stress reactions in children and young people have been made in recent years. The aim of this review is to synthesise selected recent research findings, with a focus on their relevance to clinical practice. We therefore address: findings on the epidemiology of trauma exposure and PTSD; recent changes to diagnostic classification; implications for screening and assessment of traumatic stress reactions; and treatment outcome studies including interventions for acute and chronic PTSD, dissemination of effective treatments into community settings, and early interventions. We conclude with recommendations for clinical practice, and suggestions for future areas of research.

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“…Meiser‐Stedman, Smith, et al., 2017), we were interested in whether a CBT for PTSD intervention that is more cognitive in its formulation compared to that used in extant trials may also be adaptable for this younger sample. Our trauma‐based cognitive therapy protocol for young children – CBT‐3M (Goodall et al., 2017) – includes a strong focus on three M s: cognitive restructuring of trauma Memories , challenging maladaptive cognitive appraisals ( Meanings ), and remediating unhelpful coping strategies employed by children and parents/caregivers ( Management ). The manual also includes much less of an emphasis on exposure relative to other protocols, as some therapists can be hesitant to use exposure with young children (Whiteside, Deacon, Benito, & Stewart, 2016).…”

Section: Study 2: a Randomized Controlled Proof‐of‐principle Trial Of A Trauma‐focused Cognitive Therapy For Young Children With Ptsd‐ycmentioning

confidence: 99%

“…The manual also includes much less of an emphasis on exposure relative to other protocols, as some therapists can be hesitant to use exposure with young children (Whiteside, Deacon, Benito, & Stewart, 2016). Instead, the CBT‐3M protocol focuses predominantly on restructuring and updating the trauma memory narrative (through drawings, play, and talking) with new information that challenges or contradicts the maladaptive meanings associated with the trauma that are embedded in the narrative (see Goodall et al., 2017, for a detailed case study).…”

Section: Study 2: a Randomized Controlled Proof‐of‐principle Trial Of A Trauma‐focused Cognitive Therapy For Young Children With Ptsd‐ycmentioning

confidence: 99%

The early course and treatment of posttraumatic stress disorder in very young children: diagnostic prevalence and predictors in hospital‐attending children and a randomized controlled proof‐of‐concept trial of trauma‐focused cognitive therapy, for 3‐ to 8‐year‐olds

Hitchcock

Goodall

Wright

et al. 2021

Child Psychology Psychiatry

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Background: The introduction of developmentally adapted criteria for posttraumatic stress disorder (PTSD) has improved the identification of ≤6-year-old children with clinical needs. Across two studies, we assess predictors of the development of PTSD in young children (PTSD-YC), including the adult-led acute stress disorder (ASD) diagnosis, and provide proof of principle for cognitive-focused therapy for this age range, with the aim of increasing treatment options for children diagnosed with PTSD-YC. Method: Study 1 (N = 105) assessed ASD and PTSD-YC diagnosis in 3-to 8-year-old children within one month and at around three months following attendance at an emergency room. Study 2 (N = 37) was a preregistered (www.isrctn.com/ISRCTN35018680) randomized controlled early-phase trial comparing CBT-3M, a cognitive-focused intervention, to treatment-as-usual (TAU) delivered within the UK NHS to 3to 8-year-olds diagnosed with PTSD-YC. Results: In Study 1, the ASD diagnosis failed to identify any young children. In contrast, prevalence of acute PTSD-YC (minus the duration requirement) was 8.6% in the first month post-trauma and 10.1% at 3 months. Length of hospital stay, but no other demographic or trauma-related characteristics, predicted development of later PTSD-YC. Early (within one month) diagnosis of acute PTSD-YC had a positive predictive value of 50% for later PTSD-YC. In Study 2, most children lost their PTSD-YC diagnosis following completion of CBT-3M (84.6%) relative to TAU (6.7%) and CBT-3M was acceptable to recipient families. Effect sizes were also in favor of CBT-3M for secondary outcome measures. Conclusions: The ASD diagnosis is not fit for purpose in this age-group. There was a strong and encouraging signal of putative efficacy for young children treated using a cognitive-focused treatment for PTSD, and a larger trial of CBT-3M is now warranted. Keywords: Posttraumatic stress disorder; young children; cognitive behavioral therapy; randomized control trial.Conflict of interest statement: See Acknowledgements for full disclosures.

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Translating the Cognitive Model of PTSD to the Treatment of Very Young Children: A Single Case Study of an 8‐Year‐Old Motor Vehicle Accident Survivor

Cited by 6 publications

References 24 publications

Negative Posttraumatic Cognitions in 4- to 8-year-old Children following Maltreatment

Negative Posttraumatic Cognitions in 4- to 8-year-old Children following Maltreatment

Practitioner Review: Posttraumatic stress disorder and its treatment in children and adolescents

The early course and treatment of posttraumatic stress disorder in very young children: diagnostic prevalence and predictors in hospital‐attending children and a randomized controlled proof‐of‐concept trial of trauma‐focused cognitive therapy, for 3‐ to 8‐year‐olds

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