Skip to main content
Top
Published in: BMC Psychiatry 1/2015

Open Access 01-12-2015 | Study protocol

Narrative exposure therapy for immigrant children traumatized by war: study protocol for a randomized controlled trial of effectiveness and mechanisms of change

Authors: Samuli Kangaslampi, Ferdinand Garoff, Kirsi Peltonen

Published in: BMC Psychiatry | Issue 1/2015

Login to get access

Abstract

Background

Millions of children worldwide suffer from posttraumatic stress disorder (PTSD) symptoms and other mental health problems due to repeated exposure to war or organized violence. Forms of cognitive-behavioral therapy (CBT) are the most commonly used treatment for PTSD and appear to be effective for children as well, but little is known about the mechanisms of change through which they achieve their effectiveness. Here we present the study protocol of a randomized controlled trial (RCT) studying the effectiveness and mechanisms of change of Narrative Exposure Therapy (NET), a CBT-based, manualized, short-term intervention for PTSD symptoms resulting from repeated traumatization, in immigrant children traumatized by war.

Methods/Design

We are conducting a multicentre, pragmatic RCT in a usual care setting. Up to 80 9–17-year-old immigrant children who have experienced war and suffer from PTSD symptoms will be randomized into intervention (NET) and control (treatment as usual, TAU) groups of equal sizes. The effectiveness of NET treatment will be compared to both a waiting list and the parallel TAU positive control group, on the primary outcomes of PTSD and depressive symptoms, psychological distress, resilience, and level of cognitive performance. The effects of the intervention on traumatic memories and posttraumatic cognitions will be studied as potential mechanisms of change mediating overall treatment effectiveness. The possible moderating effects of peritraumatic dissociation, level of cognitive performance, and gender on treatment effectiveness will also be considered. We hypothesize that NET will be more effective than a waitlist condition or TAU in reducing PTSD and other symptoms and improving resilience, and that these effects will be mediated by changes in traumatic memories and posttraumatic cognitions.

Discussion

The results of this trial will provide evidence for the effectiveness of NET in treating trauma-related symptoms in immigrant children affected by war. The trial will also generate insights into the complex relationships between PTSD, memory functions, posttraumatic cognitions and cognitive performance in children, and help guide the future development and implementation of therapeutic interventions for PTSD in children.

Trial registration

ClinicalTrials.gov NCT02425280. Registered 15 April 2015.
Literature
2.
3.
go back to reference Murthy RS, Lakshminarayana RL. Mental health consequences of war: A brief review of research findings. World Psychiatry. 2006;5(1):25–30.PubMedPubMedCentral Murthy RS, Lakshminarayana RL. Mental health consequences of war: A brief review of research findings. World Psychiatry. 2006;5(1):25–30.PubMedPubMedCentral
4.
go back to reference Fazel M, Wheeler J, Danesh J. Prevalence of serious mental disorder in 7000 refugees resettled in western countries: A systematic review. Lancet. 2005;365:1309–14.CrossRefPubMed Fazel M, Wheeler J, Danesh J. Prevalence of serious mental disorder in 7000 refugees resettled in western countries: A systematic review. Lancet. 2005;365:1309–14.CrossRefPubMed
5.
go back to reference Ruf M, Schauer M, Elbert T. Prävalenz von traumatischen Stresserfahrungen und seelischen Erkrankungen bei in Deutschland lebenden Kindern von Asylbewerbern. Z Klin Psychol Psychother. 2010;39(3):151–60.CrossRef Ruf M, Schauer M, Elbert T. Prävalenz von traumatischen Stresserfahrungen und seelischen Erkrankungen bei in Deutschland lebenden Kindern von Asylbewerbern. Z Klin Psychol Psychother. 2010;39(3):151–60.CrossRef
6.
go back to reference Sack WH, Him C, Dickson D. Twelve-year follow-up study of Khmer youths who suffered massive war trauma as children. J Am Acad Child Adolesc Psychiatry. 1999;38:1173–9.CrossRefPubMed Sack WH, Him C, Dickson D. Twelve-year follow-up study of Khmer youths who suffered massive war trauma as children. J Am Acad Child Adolesc Psychiatry. 1999;38:1173–9.CrossRefPubMed
7.
go back to reference Kuwert P, Spitzer C, Dudeck M, Vogel M, Freyberger HJ, Ermann H. Psychische Beschwerden, interpersonelle Probleme, Lebensqualität und Kohärenzgefühl bei ehemaligen deutschen Kriegskindern. Psychotherapie, Psychosomatik und Medizinische Psychologie. 2008;58:257–63.CrossRef Kuwert P, Spitzer C, Dudeck M, Vogel M, Freyberger HJ, Ermann H. Psychische Beschwerden, interpersonelle Probleme, Lebensqualität und Kohärenzgefühl bei ehemaligen deutschen Kriegskindern. Psychotherapie, Psychosomatik und Medizinische Psychologie. 2008;58:257–63.CrossRef
8.
go back to reference Glaesmer H, Brähler E, Gündel H, Riedel-Heller S. The association of traumatic experiences and posttraumatic stress disorder with physical morbidity in old age: A German population-based study. Psychosom Med. 2011;73(5):401–6.CrossRefPubMed Glaesmer H, Brähler E, Gündel H, Riedel-Heller S. The association of traumatic experiences and posttraumatic stress disorder with physical morbidity in old age: A German population-based study. Psychosom Med. 2011;73(5):401–6.CrossRefPubMed
9.
go back to reference Saltzman KM, Weems CF, Carrion VG. IQ and posttraumatic stress symptoms in children exposed to interpersonal violence. Child Psychiatry Hum Dev. 2006;36(3):261–72.CrossRefPubMed Saltzman KM, Weems CF, Carrion VG. IQ and posttraumatic stress symptoms in children exposed to interpersonal violence. Child Psychiatry Hum Dev. 2006;36(3):261–72.CrossRefPubMed
10.
go back to reference Yasik A, Saigh PA, Oberfield R, Halamandaris P. Posttraumatic stress disorder: memory and learning performance in children and adolescents. Biol Psychiatry. 2007;61:382–8.CrossRefPubMed Yasik A, Saigh PA, Oberfield R, Halamandaris P. Posttraumatic stress disorder: memory and learning performance in children and adolescents. Biol Psychiatry. 2007;61:382–8.CrossRefPubMed
11.
go back to reference Saigh PA, Mroueh A, Bremner JD. Scholastic impairments among traumatized adolescents. Behav Res Ther. 1997;35:429–36.CrossRefPubMed Saigh PA, Mroueh A, Bremner JD. Scholastic impairments among traumatized adolescents. Behav Res Ther. 1997;35:429–36.CrossRefPubMed
12.
go back to reference Saigh PA, Yasik AE, Oberfield RA, Halamandaris PV, Bremner JD. The Intellectual performance of traumatized children and adolescents with or without posttraumatic stress disorder. J Abnorm Psychol. 2006;115(2):332–40.CrossRefPubMedPubMedCentral Saigh PA, Yasik AE, Oberfield RA, Halamandaris PV, Bremner JD. The Intellectual performance of traumatized children and adolescents with or without posttraumatic stress disorder. J Abnorm Psychol. 2006;115(2):332–40.CrossRefPubMedPubMedCentral
13.
go back to reference Eagle M. House of Commons Written Answers 27 May 2004. London, UK: Stationery Office; 2004. p. 421–595:1792W. Eagle M. House of Commons Written Answers 27 May 2004. London, UK: Stationery Office; 2004. p. 421–595:1792W.
14.
go back to reference Schauer M, Neuner F, Elbert T. Narrative Exposure Therapy: A short-term treatment for traumatic stress disorders. 2nd ed. Göttingen, Germany: Hogrefe; 2011. Schauer M, Neuner F, Elbert T. Narrative Exposure Therapy: A short-term treatment for traumatic stress disorders. 2nd ed. Göttingen, Germany: Hogrefe; 2011.
15.
go back to reference Schulz KF, Altman DG, Moher D. the CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Trials. 2010;11:32.CrossRefPubMedPubMedCentral Schulz KF, Altman DG, Moher D. the CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Trials. 2010;11:32.CrossRefPubMedPubMedCentral
16.
go back to reference Cohen JA, Berliner L, Mannarino A. Treating traumatized children: A research review and synthesis. Trauma Violence Abuse. 2000;1:29–46.CrossRef Cohen JA, Berliner L, Mannarino A. Treating traumatized children: A research review and synthesis. Trauma Violence Abuse. 2000;1:29–46.CrossRef
17.
go back to reference Gillies D, Taylor F, Gray C, O’Brien L, D’Abrew N. Psychological therapies for the treatment of posttraumatic stress disorder in children and adolescents. Cochrane Database Syst Rev. 2012;12, CD006726.PubMed Gillies D, Taylor F, Gray C, O’Brien L, D’Abrew N. Psychological therapies for the treatment of posttraumatic stress disorder in children and adolescents. Cochrane Database Syst Rev. 2012;12, CD006726.PubMed
18.
go back to reference Stallard P. Psychological interventions for post-traumatic reactions in children and young people: A review of randomised controlled trials. Clin Psychol Rev. 2006;26(7):895–911.CrossRefPubMed Stallard P. Psychological interventions for post-traumatic reactions in children and young people: A review of randomised controlled trials. Clin Psychol Rev. 2006;26(7):895–911.CrossRefPubMed
19.
go back to reference National Institute for Health and Clinical Excellence. Post-traumatic stress disorder (PTSD): The management of PTSD in adults and children in primary and secondary care. NICE Guidelines CG26. 2005. http://www.nice.org.uk/CG26. Accessed Apr 10 2015. National Institute for Health and Clinical Excellence. Post-traumatic stress disorder (PTSD): The management of PTSD in adults and children in primary and secondary care. NICE Guidelines CG26. 2005. http://​www.​nice.​org.​uk/​CG26. Accessed Apr 10 2015.
21.
go back to reference Jordans MJD, Tol WA, Komproe IH, De Jong JVTM. Systematic review of evidence and treatment approaches: Psychosocial and mental health care for children in war. Child Adolesc Mental Health. 2009;14(1):2–14.CrossRef Jordans MJD, Tol WA, Komproe IH, De Jong JVTM. Systematic review of evidence and treatment approaches: Psychosocial and mental health care for children in war. Child Adolesc Mental Health. 2009;14(1):2–14.CrossRef
22.
go back to reference Peltonen K, Punamäki R-L. Preventive interventions among children exposed to trauma of armed conflict: A literature review. Aggress Behav. 2010;36:95–116.CrossRefPubMed Peltonen K, Punamäki R-L. Preventive interventions among children exposed to trauma of armed conflict: A literature review. Aggress Behav. 2010;36:95–116.CrossRefPubMed
23.
go back to reference Persson TJ, Rousseau C. School-based interventions for minors in war-exposed countries: A review of targeted and general programmes. Torture. 2009;19:88–101.PubMed Persson TJ, Rousseau C. School-based interventions for minors in war-exposed countries: A review of targeted and general programmes. Torture. 2009;19:88–101.PubMed
24.
go back to reference Metcalfe J, Jacobs W. A hot-system/cool-system view of memory under stress. PTSD Research Quarterly. 1996;7:1–3. Metcalfe J, Jacobs W. A hot-system/cool-system view of memory under stress. PTSD Research Quarterly. 1996;7:1–3.
25.
go back to reference Brewin CR, Dalgleish T, Joseph S. A dual representation theory of posttraumatic stress disorder. Psychol Rev. 1996;103:670–86.CrossRefPubMed Brewin CR, Dalgleish T, Joseph S. A dual representation theory of posttraumatic stress disorder. Psychol Rev. 1996;103:670–86.CrossRefPubMed
26.
go back to reference Brewin CR. Episodic memory, perceptual memory, and their interaction: Foundations for a theory of posttraumatic stress disorder. Psychol Bull. 2014;140:69–97.CrossRefPubMed Brewin CR. Episodic memory, perceptual memory, and their interaction: Foundations for a theory of posttraumatic stress disorder. Psychol Bull. 2014;140:69–97.CrossRefPubMed
27.
go back to reference Foa EB, Kozak MJ. Emotional processing of fear: Exposure to corrective information. Psychol Bull. 1986;99:20–35.CrossRefPubMed Foa EB, Kozak MJ. Emotional processing of fear: Exposure to corrective information. Psychol Bull. 1986;99:20–35.CrossRefPubMed
28.
go back to reference Brewin CR, Gregory JD, Lipton M, Burgess N. Intrusive images in psychological disorders: Characteristics, neural mechanisms, and treatment implications. Psychol Rev. 2010;117:210–32.CrossRefPubMedPubMedCentral Brewin CR, Gregory JD, Lipton M, Burgess N. Intrusive images in psychological disorders: Characteristics, neural mechanisms, and treatment implications. Psychol Rev. 2010;117:210–32.CrossRefPubMedPubMedCentral
29.
go back to reference McPherson J. Does narrative exposure therapy reduce PTSD in survivors of mass violence? Res Soc Work Pract. 2012;22(1):29–42.CrossRef McPherson J. Does narrative exposure therapy reduce PTSD in survivors of mass violence? Res Soc Work Pract. 2012;22(1):29–42.CrossRef
30.
go back to reference Catani C, Kohiladevy M, Ruf M, Schauer E, Elbert T, Neuner F. Treating children traumatized by war and tsunami: A comparison between exposure therapy and meditation relaxation in North-East Sri Lanka. BMC Psychiatry. 2009;9:22.CrossRefPubMedPubMedCentral Catani C, Kohiladevy M, Ruf M, Schauer E, Elbert T, Neuner F. Treating children traumatized by war and tsunami: A comparison between exposure therapy and meditation relaxation in North-East Sri Lanka. BMC Psychiatry. 2009;9:22.CrossRefPubMedPubMedCentral
31.
go back to reference Ertl V, Pfeiffer A, Schauer E, Elbert T, Neuner F. Community-implemented trauma therapy for former child soldiers in Northern Uganda: A randomized controlled trial. JAMA. 2011;306(5):503–12.CrossRefPubMed Ertl V, Pfeiffer A, Schauer E, Elbert T, Neuner F. Community-implemented trauma therapy for former child soldiers in Northern Uganda: A randomized controlled trial. JAMA. 2011;306(5):503–12.CrossRefPubMed
32.
go back to reference Zwarenstein M, Treweek S, Gagnier JJ, Altman DG, Tunis S, Haynes B, et al. Improving the reporting of pragmatic trials: an extension of the CONSORT statement. BMJ. 2008;337:a2390.CrossRefPubMedPubMedCentral Zwarenstein M, Treweek S, Gagnier JJ, Altman DG, Tunis S, Haynes B, et al. Improving the reporting of pragmatic trials: an extension of the CONSORT statement. BMJ. 2008;337:a2390.CrossRefPubMedPubMedCentral
33.
go back to reference Ehlers A, Clark DM. A cognitive model of posttraumatic stress disorder. Behavior Research and Therapy. 2000;38:319–45.CrossRef Ehlers A, Clark DM. A cognitive model of posttraumatic stress disorder. Behavior Research and Therapy. 2000;38:319–45.CrossRef
34.
go back to reference Bryant R, Salmon K, Sinclair E, Davidson P. A prospective study of appraisals in childhood posttraumatic stress disorder. Behav Res Ther. 2007;45:2502–7.CrossRefPubMed Bryant R, Salmon K, Sinclair E, Davidson P. A prospective study of appraisals in childhood posttraumatic stress disorder. Behav Res Ther. 2007;45:2502–7.CrossRefPubMed
35.
go back to reference Meiser-Stedman R, Dalgleish T, Glucksman E, Yule W, Smith P. Maladaptive cognitive appraisals mediate the evolution of posttraumatic stress reactions: A 6-month follow-up of child and adolescent assault and motor vehicle accident survivors. J Abnorm Psychol. 2009;118:778–87.CrossRefPubMed Meiser-Stedman R, Dalgleish T, Glucksman E, Yule W, Smith P. Maladaptive cognitive appraisals mediate the evolution of posttraumatic stress reactions: A 6-month follow-up of child and adolescent assault and motor vehicle accident survivors. J Abnorm Psychol. 2009;118:778–87.CrossRefPubMed
36.
go back to reference Zalta AK, Gillihan SJ, Fisher AJ, Mintz J, McLean CP, Yehuda R, et al. Change in negative cognitions associated with PTSD predicts symptom reduction in prolonged exposure. J Consult Clin Psychol. 2014;82(1):171–5.CrossRefPubMed Zalta AK, Gillihan SJ, Fisher AJ, Mintz J, McLean CP, Yehuda R, et al. Change in negative cognitions associated with PTSD predicts symptom reduction in prolonged exposure. J Consult Clin Psychol. 2014;82(1):171–5.CrossRefPubMed
37.
go back to reference Iverson KM, King MW, Cunningham KC, Resick PA. Rape survivors’ trauma-related beliefs before and after cognitive processing therapy: Associations with PTSD and depression symptoms. Behav Res Ther. 2015;66:49–55.CrossRefPubMed Iverson KM, King MW, Cunningham KC, Resick PA. Rape survivors’ trauma-related beliefs before and after cognitive processing therapy: Associations with PTSD and depression symptoms. Behav Res Ther. 2015;66:49–55.CrossRefPubMed
38.
39.
go back to reference Qouta SR, Palosaari E, Diab M, Punamäki R-L. Intervention effectiveness among war-affected children: a cluster randomized controlled trial in improving mental health. J Trauma Stress. 2012;25(3):288–98.CrossRefPubMed Qouta SR, Palosaari E, Diab M, Punamäki R-L. Intervention effectiveness among war-affected children: a cluster randomized controlled trial in improving mental health. J Trauma Stress. 2012;25(3):288–98.CrossRefPubMed
40.
go back to reference Halvorsen JØ, Stenmark H, Neuner F, Nordahl HM. Does dissociation moderate treatment outcomes of narrative exposure therapy for PTSD? A secondary analysis from a randomized controlled clinical trial. Behav Res Ther. 2014;57:21–8.CrossRefPubMed Halvorsen JØ, Stenmark H, Neuner F, Nordahl HM. Does dissociation moderate treatment outcomes of narrative exposure therapy for PTSD? A secondary analysis from a randomized controlled clinical trial. Behav Res Ther. 2014;57:21–8.CrossRefPubMed
41.
go back to reference Aupperle RL, Melrose AJ, Stein MB, Paulus MP. Executive function and PTSD: Disengaging from trauma. Neuropharmacology. 2012;62(2):686–94.CrossRefPubMed Aupperle RL, Melrose AJ, Stein MB, Paulus MP. Executive function and PTSD: Disengaging from trauma. Neuropharmacology. 2012;62(2):686–94.CrossRefPubMed
42.
go back to reference Thabet A, Abed Y, Vostanis P. Comorbidity of PTSD and depression among refugee children during war conflict. J Child Psychol Psychiatry. 2004;45(3):533–42.CrossRefPubMed Thabet A, Abed Y, Vostanis P. Comorbidity of PTSD and depression among refugee children during war conflict. J Child Psychol Psychiatry. 2004;45(3):533–42.CrossRefPubMed
43.
go back to reference McLean CP, Su Y-J, Carpenter JK, Foa EB. Changes in PTSD and depression during prolonged exposure and client-centered therapy for PTSD in adolescents. Journal of Clinical Child and Adolescent Psychology. 2015:doi:10.1080/15374416.2015.1012722 McLean CP, Su Y-J, Carpenter JK, Foa EB. Changes in PTSD and depression during prolonged exposure and client-centered therapy for PTSD in adolescents. Journal of Clinical Child and Adolescent Psychology. 2015:doi:10.​1080/​15374416.​2015.​1012722
44.
go back to reference Aderka IM, Foa EB, Applebaum E, Shafran N, Gilboa-Schechtman E. Direction of influence between posttraumatic and depressive symptoms during prolonged exposure therapy among children and adolescents. J Consult Clin Psychol. 2011;79(3):421–5.CrossRefPubMedPubMedCentral Aderka IM, Foa EB, Applebaum E, Shafran N, Gilboa-Schechtman E. Direction of influence between posttraumatic and depressive symptoms during prolonged exposure therapy among children and adolescents. J Consult Clin Psychol. 2011;79(3):421–5.CrossRefPubMedPubMedCentral
45.
go back to reference Polak AR, Witteveen AB, Reitsma JB, Olff M. The role of executive function in posttraumatic stress disorder: A systematic review. J Affect Disord. 2012;141:11–21.CrossRefPubMed Polak AR, Witteveen AB, Reitsma JB, Olff M. The role of executive function in posttraumatic stress disorder: A systematic review. J Affect Disord. 2012;141:11–21.CrossRefPubMed
46.
go back to reference Qureshi SU, Long ME, Bradshaw R, Pyne JM, Magruder KM, Kimbrell T, et al. Does PTSD impair cognition beyond the effect of trauma? J Neuropsychiatry Clin Neurosci. 2011;23(1):16–28.CrossRefPubMed Qureshi SU, Long ME, Bradshaw R, Pyne JM, Magruder KM, Kimbrell T, et al. Does PTSD impair cognition beyond the effect of trauma? J Neuropsychiatry Clin Neurosci. 2011;23(1):16–28.CrossRefPubMed
47.
go back to reference Gilbertson MW, Paulus LA, Williston SK, Gurvits TV, Lasko NB, Pitman TK, et al. Neurocognitive function in monozygotic twins discordant for combat exposure: Relationship to posttraumatic stress disorder. J Abnorm Psychol. 2006;115(3):484–95.CrossRefPubMed Gilbertson MW, Paulus LA, Williston SK, Gurvits TV, Lasko NB, Pitman TK, et al. Neurocognitive function in monozygotic twins discordant for combat exposure: Relationship to posttraumatic stress disorder. J Abnorm Psychol. 2006;115(3):484–95.CrossRefPubMed
48.
go back to reference Ronconi JM, Shiner B, Watts BV. Inclusion and exclusion criteria in randomized controlled trials of psychotherapy for PTSD. J Psychiatr Pract. 2014;20(1):25–37.CrossRefPubMed Ronconi JM, Shiner B, Watts BV. Inclusion and exclusion criteria in randomized controlled trials of psychotherapy for PTSD. J Psychiatr Pract. 2014;20(1):25–37.CrossRefPubMed
49.
go back to reference Horowitz M. Stress Response Syndromes. 2nd ed. New York, NY, USA: Jason Aronson; 1986. Horowitz M. Stress Response Syndromes. 2nd ed. New York, NY, USA: Jason Aronson; 1986.
50.
go back to reference Smith P, Perrin S, Dyregrov A, Yule W. Principal components analysis of the Impact of Event Scale with children in war. Personal Individ Differ. 2003;34(2):315–22.CrossRef Smith P, Perrin S, Dyregrov A, Yule W. Principal components analysis of the Impact of Event Scale with children in war. Personal Individ Differ. 2003;34(2):315–22.CrossRef
51.
go back to reference Birleson P, Hudson I, Buchanan DG, Wolff S. Clinical evaluation of a self-rating scale for depressive disorder in childhood (depression self-rating scale). J Child Psychol Psychiatry. 1987;28:43–60.CrossRefPubMed Birleson P, Hudson I, Buchanan DG, Wolff S. Clinical evaluation of a self-rating scale for depressive disorder in childhood (depression self-rating scale). J Child Psychol Psychiatry. 1987;28:43–60.CrossRefPubMed
52.
go back to reference Goodman R. The Strengths and Difficulties Questionnaire: A research note. J Child Psychol Psychiatry. 1997;38:581–6.CrossRefPubMed Goodman R. The Strengths and Difficulties Questionnaire: A research note. J Child Psychol Psychiatry. 1997;38:581–6.CrossRefPubMed
53.
go back to reference Ungar M, Liebenberg L. Assessing resilience across cultures using mixed methods: Construction of the Child and Youth Resilience Measure. Journal of Multiple Methods Research. 2011;5(2):126–49.CrossRef Ungar M, Liebenberg L. Assessing resilience across cultures using mixed methods: Construction of the Child and Youth Resilience Measure. Journal of Multiple Methods Research. 2011;5(2):126–49.CrossRef
54.
go back to reference Liebenberg L, Ungar M, van de Vijver F. Validation of the Child and Youth Resilience Measure-28 (CYRM-28) among Canadian youth with complex needs. Research in Social Work Practices. 2012;22(2):219–26.CrossRef Liebenberg L, Ungar M, van de Vijver F. Validation of the Child and Youth Resilience Measure-28 (CYRM-28) among Canadian youth with complex needs. Research in Social Work Practices. 2012;22(2):219–26.CrossRef
55.
go back to reference Pickering SJ, Gathercole SE. Working Memory Test Battery for Children. London: Psychological Corporation Europe; 2001. Pickering SJ, Gathercole SE. Working Memory Test Battery for Children. London: Psychological Corporation Europe; 2001.
56.
go back to reference Raven J, Raven JC, Court JH. Manual for Raven’s Progressive Matrices and Vocabulary Scales. San Antonio, TX, USA: Harcourt Assessment; 2003. Raven J, Raven JC, Court JH. Manual for Raven’s Progressive Matrices and Vocabulary Scales. San Antonio, TX, USA: Harcourt Assessment; 2003.
57.
go back to reference Reitan RM. Trail Making Test results for normal and brain-damaged children. Percept Mot Skills. 1971;33:575–81.CrossRefPubMed Reitan RM. Trail Making Test results for normal and brain-damaged children. Percept Mot Skills. 1971;33:575–81.CrossRefPubMed
58.
go back to reference Meiser-Stedman R, Dalgleish T, Smith P, Yule W, Glucksman E. Diagnostic, demographic, memory quality, and cognitive variables associated with acute stress disorder in children and adolescents. J Abnorm Psychol. 2007;116(1):65–79.CrossRefPubMed Meiser-Stedman R, Dalgleish T, Smith P, Yule W, Glucksman E. Diagnostic, demographic, memory quality, and cognitive variables associated with acute stress disorder in children and adolescents. J Abnorm Psychol. 2007;116(1):65–79.CrossRefPubMed
59.
go back to reference Meiser-Stedman R, Smith P, Bryant R, Salmon K, Yule W, Dalgleish T, et al. Development and validation of the Child Post-Traumatic Cognitions Inventory (cPTCI). J Child Psychol Psychiatry. 2009;50(4):432–40.CrossRefPubMed Meiser-Stedman R, Smith P, Bryant R, Salmon K, Yule W, Dalgleish T, et al. Development and validation of the Child Post-Traumatic Cognitions Inventory (cPTCI). J Child Psychol Psychiatry. 2009;50(4):432–40.CrossRefPubMed
60.
go back to reference McAdams DP, Anyidoho NA, Brown C, Huang YT, Kaplan B, Machado MA. Traits and stories: links between dispositional and narrative features of personality. J Pers. 2004;72(4):761–84.CrossRefPubMed McAdams DP, Anyidoho NA, Brown C, Huang YT, Kaplan B, Machado MA. Traits and stories: links between dispositional and narrative features of personality. J Pers. 2004;72(4):761–84.CrossRefPubMed
61.
go back to reference McAdams DP, Reynolds J, Lewis M, Patten AH, Bowman JP. When bad things turn good and good things turn bad: Sequences of redemption and contamination in life narrative and their relation to psychosocial adaptation in midlife adults and in students. Pers Soc Psychol Bull. 2001;27:474–85.CrossRef McAdams DP, Reynolds J, Lewis M, Patten AH, Bowman JP. When bad things turn good and good things turn bad: Sequences of redemption and contamination in life narrative and their relation to psychosocial adaptation in midlife adults and in students. Pers Soc Psychol Bull. 2001;27:474–85.CrossRef
62.
go back to reference Marmar C, Weiss D, Metzler T. The Peritraumatic Dissociative Experiences Questionnaire. In: Wilson J, Marmar C, editors. Assessing psychological trauma and posttraumatic stress disorder. New York, NY, USA: The Guilford Press; 1997. p. 412–28. Marmar C, Weiss D, Metzler T. The Peritraumatic Dissociative Experiences Questionnaire. In: Wilson J, Marmar C, editors. Assessing psychological trauma and posttraumatic stress disorder. New York, NY, USA: The Guilford Press; 1997. p. 412–28.
63.
go back to reference Wolpe J. The practice of behavior therapy. New York, NY, USA: Pergamon Press; 1969. Wolpe J. The practice of behavior therapy. New York, NY, USA: Pergamon Press; 1969.
64.
go back to reference Duncan B, Miller S, Sparks J. The Child Session Rating Scale. Jensen Beach, FL, USA: Author; 2003. Duncan B, Miller S, Sparks J. The Child Session Rating Scale. Jensen Beach, FL, USA: Author; 2003.
65.
go back to reference Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behav Res Methods. 2009;41:1149–60.CrossRefPubMed Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behav Res Methods. 2009;41:1149–60.CrossRefPubMed
66.
go back to reference Robjant K, Fazel M. The emerging evidence for Narrative Exposure Therapy: A review. Clin Psychol Rev. 2010;30:1030–9.CrossRefPubMed Robjant K, Fazel M. The emerging evidence for Narrative Exposure Therapy: A review. Clin Psychol Rev. 2010;30:1030–9.CrossRefPubMed
67.
go back to reference Schulz KF, Grimes, DA. Generation of allocation sequences in randomised trials: chance, not choice. Lancet 2002;359:515–519. Schulz KF, Grimes, DA. Generation of allocation sequences in randomised trials: chance, not choice. Lancet 2002;359:515–519.
68.
go back to reference Hayes AF. Introduction to mediation, moderation and conditional process analysis. A regression-based approach. New York, NY, USA: The Guilford Press; 2013. Hayes AF. Introduction to mediation, moderation and conditional process analysis. A regression-based approach. New York, NY, USA: The Guilford Press; 2013.
69.
go back to reference MacKinnon DP. Introduction to statistical mediation analysis. New York, NY, USA: Taylor & Francis Group; 2008. MacKinnon DP. Introduction to statistical mediation analysis. New York, NY, USA: Taylor & Francis Group; 2008.
Metadata
Title
Narrative exposure therapy for immigrant children traumatized by war: study protocol for a randomized controlled trial of effectiveness and mechanisms of change
Authors
Samuli Kangaslampi
Ferdinand Garoff
Kirsi Peltonen
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2015
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-015-0520-z

Other articles of this Issue 1/2015

BMC Psychiatry 1/2015 Go to the issue