Depression, Grief (Traumatic Grief and Existential Grief), Posttraumatic Stress Disorder
Conditions
Keywords
Trauma, Grief, Depression, Adolescent, War, Group, Therapy, Treatment, Intervention, School, Development
Brief summary
Context: This is the first multi-site randomized controlled study of the effectiveness of a group treatment for war-exposed adolescents delivered in-country within a public school system. Objective: To evaluate the effectiveness of a trauma/grief-focused group treatment program in reducing symptoms of posttraumatic stress disorder (PTSD), depression, and traumatic grief in war-exposed Bosnian youths attending 10 secondary schools located in Central Bosnia.
Detailed description
Design: A randomized controlled trial conducted during the 2000-2001 school year, with 4-month follow-up, compared group treatment to a psychoeducation/skill-based school milieu intervention. Setting and Participants: Students attending 10 Bosnian secondary schools exposed to severe trauma, traumatic loss, and severe adversity, reporting severe persisting symptoms of PTSD, depression, or traumatic grief, and functional impairment. Intervention: Students were randomly assigned to either 17-session Trauma and Grief Component Therapy (n=71), or a school milieu intervention (n=73), both conducted by trained school counselors.
Interventions
BEHAVIORALTrauma and Grief Component Therapy for Adolescents (Group Version)
Sponsors
UNICEF
Brigham Young University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
14 Years to 19 Years
Healthy volunteers
Yes
Inclusion criteria
* Significant trauma exposure before, during, or after the war (e.g., serious physical injury, life threat, witnessing death or serious injury, traumatic bereavement); * Significant current distress, especially severe persisting symptoms of PTSD, depression, or traumatic grief; * Significant functional impairment in family or peer relationships and school performance
Exclusion criteria
* Acute risk status (e.g., suicidal plans and intent) * Psychosis * Severe substance abuse (severe enough to interfere with engagement in treatment).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| UCLA PTSD Reaction Index | Pre-treatment, post-treatment, and at 4-month follow-up |
| Depression Self-Rating Scale | Pre-treatment, post-treatment, and 4-month follow-up |
| UCLA Grief Scale | Pre-treatment, post-treatment |
Secondary
| Measure | Time frame |
|---|---|
| Trauma Reminder Screening Scale | Pre-treatment (screening survey) |
| Cognitive Distortions Scale | Pre-treatment and post-treatment |
| Youth Outcome Questionnaire (Somatic and Interpersonal Problems Subscales) | Pre- and post-treatment |
| Loss Reminder Screening Scale | Pre-treatment (screening survey) |
| War Exposure Index | Pre-treatment (screening survey) |
| Post-War Adversities Scale | Pre-treatment (screening survey) |
Outcome results
None listed