Liu Junyu,Wang Jianjian,Luo Yuan,Zhao Liping,Liu Zhijing,Effectiveness of narrative exposure therapy for post-traumatic stress disorder in children and adolescents: a Meta-analysis[J].SICHUAN MENTAL HEALTH,2024,37(2):179-186
Effectiveness of narrative exposure therapy for post-traumatic stress disorder in children and adolescents: a Meta-analysis
DOI:10.11886/scjsws20230222007
English keywords:Narrative exposure therapy  Post-traumatic stress disorder  Children  Adolescents  Meta-analysis
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Author NameAffiliationPostcode
Liu Junyu Xiangya Nursing School of Central South University Changsh 410013 China
The Second Xiangya Hospital of Central South University Changsha 410011 China 
410011
Wang Jianjian The Second Xiangya Hospital of Central South University Changsha 410011 China 410011
Luo Yuan Xiangya Nursing School of Central South University Changsh 410013 China 410013
Zhao Liping The Second Xiangya Hospital of Central South University Changsha 410011 China 410011
Liu Zhijing* The Fourth Hospital of Changsha/Changsha Hospital of Hunan Normal University Changsha 410006 China 410006
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English abstract:
      Background Narrative exposure therapy (NET), an integration of narrative therapy and exposure therapy, has been shown to be effective in relieving the symptoms of post-traumatic stress disorder (PTSD), which can help patients gain a deeper understanding of their trauma and is also considered to be quite safe. PTSD is highly prevalent in children and adolescents, while the effectiveness of NET intervention varies among the subjects.Objective To systematically evaluate the effectiveness of NET for PTSD in children and adolescents, so as to provide references for the clinical application of NET.Methods On August 1, 2022, the Cochrane Library, PubMed, Web of Science, CINAHL, China National Knowledge Infrastructure (CNKI), SinoMed, VIP and Wanfang database were searched from their inception to June 2022. Search was conducted with the use of a combination of medical subject heading and free text terms, and randomized controlled trials relevant to NET for PTSD in children and adolescents were collected. Then the quality of the controlled trials was evaluated according to the Cochrane Collaboration's tool for assessing risk of bias (2011), and Meta-analysis was performed using RevMan 5.4 software.Results Nine randomized controlled trials involving 394 children and adolescents with PTSD were included. Meta-analysis showed that NET and relaxation therapy reported comparable symptom relief in PTSD patients within 1 to 3 months after intervention (SMD=0.22, 95% CI: -0.84~1.28) and at 6 months after intervention (SMD=0.21, 95% CI: -0.75~1.17), while NET provided greater PTSD symptom relief than routine therapy both within 1 to 3 months after intervention (SMD=-0.66, 95% CI: -1.04~-0.27) and at 6 months after intervention (SMD=-0.77, 95% CI: -1.36~-0.19), with statistically significant differences. Regarding the alleviation of depressive symptoms, the effect was similar between NET and routine therapy within 1 to 3 months after intervention (SMD=-0.39, 95% CI: -0.98~0.21) and at 6 months after intervention (SMD=-0.74, 95% CI: -2.23~0.75). No statistical difference was demonstrated between NET and routine therapy in relieving psychological distress (SMD=-0.54, 95% CI: -2.14~1.07) and suppressing hyperorexia (SMD=-0.17, 95% CI: -0.54~0.19) 1 to 3 months after intervention.Conclusion NET yields a better outcome and a medium- and long-term effectiveness in alleviating symptoms of PTSD in children and adolescents compared with routine therapy, while it does not offer any significant advantages in improving depression symptoms, psychological distress and hyperorexia.
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