The Teaching Recovery Techniques Intervention for PTSD Among War-Affected Children: An Analysis of Potential Mediators and Moderators
KANGASLAMPI, SAMULI (2013)
2013
Psykologia - Psychology
Yhteiskunta- ja kulttuuritieteiden yksikkö - School of Social Sciences and Humanities
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Hyväksymispäivämäärä
2013-04-12
Julkaisun pysyvä osoite on
https://urn.fi/urn:nbn:fi:uta-1-23460
https://urn.fi/urn:nbn:fi:uta-1-23460
Tiivistelmä
Although a great number of different psychosocial interventions are being carried out all over the world to help children affected by posttraumatic stress symptoms (PTSS) due to war and armed conflict, it is still to a large extent unclear by which mechanisms interventions work when they do and which interventions suit particular children best. Recently, reviewers have called for more research into the specific mechanisms of action of interventions and for extending research into factors moderating their effectiveness.
Modern cognitive theories on PTSD would suggest that reductions in dysfunctional, excessively negative cognitive appraisals about the traumatic event and its sequelae as well as in secondary negative emotions such as guilt would be crucial to alleviating PTSS. This thesis studied the potential mediating roles of such cognitive factors in the effectiveness of a psychosocial group intervention called Teaching Recovery Techniques (TRT), implemented among 482 10–13-year-old Palestinian school children affected by war and armed conflict. The hypotheses were that taking part in the intervention would lead to greater reductions in dysfunctional cognitive appraisals and self-attributions, and that these greater reductions would in turn mediate the intervention’s effects on PTSS. The thesis further examined the possible moderating roles of comorbid depression and gender in the intervention’s direct and mediated effects.
The results suggest that though the intervention was effective in reducing children’s PTSS, reductions in dysfunctional cognitive appraisals or self-attributions did not mediate these effects. In fact, contrary to expectations, children who took part in the intervention saw smaller reductions in dysfunctional cognitive appraisals as compared to a control group. The intervention did have a positive effect on self-attributions, but this in turn was not associated with greater PTSS reduction. As regards moderating factors, it was found that children who were depressed at the start of the intervention benefitted more from the intervention and saw greater reductions in posttraumatic stress symptoms, even as they experienced smaller reductions in dysfunctional appraisals. Gender had no clear moderating effects, but girls experienced less improvement in PTSS in both the intervention and control groups as compared to boys.
The findings of this thesis show that children with comorbid depression, too, can benefit from group interventions such as TRT and may even form a target group for whom such interventions would be particularly effective and useful. They also suggest that negative cognitive appraisals may not be as central to PTSD in children traumatized by war as theory would suggest, at least in contexts similar to the one studied here.
Asiasanat:PTSD, children, war, conflict, treatment, psychosocial, intervention, TRT, CBT, group, mediation, mediator, moderator, depression, gender, appraisal, self-attribution, guilt, cognition
Modern cognitive theories on PTSD would suggest that reductions in dysfunctional, excessively negative cognitive appraisals about the traumatic event and its sequelae as well as in secondary negative emotions such as guilt would be crucial to alleviating PTSS. This thesis studied the potential mediating roles of such cognitive factors in the effectiveness of a psychosocial group intervention called Teaching Recovery Techniques (TRT), implemented among 482 10–13-year-old Palestinian school children affected by war and armed conflict. The hypotheses were that taking part in the intervention would lead to greater reductions in dysfunctional cognitive appraisals and self-attributions, and that these greater reductions would in turn mediate the intervention’s effects on PTSS. The thesis further examined the possible moderating roles of comorbid depression and gender in the intervention’s direct and mediated effects.
The results suggest that though the intervention was effective in reducing children’s PTSS, reductions in dysfunctional cognitive appraisals or self-attributions did not mediate these effects. In fact, contrary to expectations, children who took part in the intervention saw smaller reductions in dysfunctional cognitive appraisals as compared to a control group. The intervention did have a positive effect on self-attributions, but this in turn was not associated with greater PTSS reduction. As regards moderating factors, it was found that children who were depressed at the start of the intervention benefitted more from the intervention and saw greater reductions in posttraumatic stress symptoms, even as they experienced smaller reductions in dysfunctional appraisals. Gender had no clear moderating effects, but girls experienced less improvement in PTSS in both the intervention and control groups as compared to boys.
The findings of this thesis show that children with comorbid depression, too, can benefit from group interventions such as TRT and may even form a target group for whom such interventions would be particularly effective and useful. They also suggest that negative cognitive appraisals may not be as central to PTSD in children traumatized by war as theory would suggest, at least in contexts similar to the one studied here.
Asiasanat:PTSD, children, war, conflict, treatment, psychosocial, intervention, TRT, CBT, group, mediation, mediator, moderator, depression, gender, appraisal, self-attribution, guilt, cognition