Systematic review and meta-analysis: do best-evidenced trauma-focused interventions for children and young people with PTSD lead to changes in social and interpersonal domains?

Objective: Young people with post-traumatic stress disorder experience difficulties in social and interpersonal domains. We examined whether the best-evidenced treatments of PTSD for children and young people (Trauma-focussed Cognitive Behavioural Therapy or Eye Movement Desensitisation and Reprocessing; aged 5-25) improve social or interpersonal factors in randomised controlled trials, compared to a comparator condition.Method: The review was preregistered on PROSPERO (CRD42023455615; 18th August 2023). Web of Science Core Collection, EMBASE, CINAHL, Pubmed, PsycINFO, Cochrane Central Register of Controlled Trials and PTSDPubs were searched, and data were extracted for social and interpersonal outcomes post treatment. A random effect meta-analysis was conducted to obtain between-group pooled effect size estimates.Results: The search resulted in 792 studies, of which 17 met our inclusion criteria (N = 2498). Our meta-analysis included 13 studies which investigated social skills and functioning, revealing a small but non-significant effect favouring the evidence-based treatment versus comparison (g = .20, 95% CI [-0.03, 0.44], p = .09). We narratively synthesised six studies which reported other social-related outcomes (e.g. perceptions of social support), and four out of six reported improved social domain outcomes for the evidence-based PTSD treatment condition. There was a large amount of heterogeneity, with no evidence that this could be explained by moderators.Conclusion: Few trials report on social and interpersonal outcomes, and where they are reported the evidence is mixed. It may be that trauma-focused therapies for PTSD need to be adapted in some circumstances, so that they address social and interpersonal deficits often seen in children and young people with PTSD. Objetivo: Los j & oacute;venes con trastorno de estr & eacute;s postraum & aacute;tico experimentan dificultades en los dominios sociales e interpersonales. Examinamos si los tratamientos con mejor evidencia para el TEPT para ni & ntilde;os y j & oacute;venes (terapia cognitivo-conductual centrada en el trauma o desensibilizaci & oacute;n y reprocesamiento por movimientos oculares; de 5 a 25 a & ntilde;os) mejoran los factores sociales o interpersonales en ensayos controlados aleatorizados, en contraste con una condici & oacute;n de comparaci & oacute;n.M & eacute;todo: La revisi & oacute;n se registr & oacute; previamente en PROSPERO (CRD42023455615; 18 de agosto de 2023). Se realizaron b & uacute;squedas en Web of Science Core Collection, EMBASE, CINAHL, Pubmed, PsycINFO, Cochrane Central Register of Controlled Trials y PTSDPubs, y se extrajeron datos de los resultados sociales e interpersonales posteriores al tratamiento. Se realiz & oacute; un metaan & aacute;lisis de efectos aleatorios para obtener estimaciones del tama & ntilde;o del efecto agrupado entre grupos.Resultados: La b & uacute;squeda arroj & oacute; 792 estudios, de los cuales 17 cumplieron con nuestros criterios de inclusi & oacute;n (N = 2.498). Nuestro metaan & aacute;lisis incluy & oacute; 13 estudios que investigaron las habilidades y funcionamiento social, revelando un efecto peque & ntilde;o, pero no significativo a favor del tratamiento basado en evidencia versus la comparaci & oacute;n (g = .20, IC del 95% [-0.03, 0.44], p = .09). Sintetizamos narrativamente seis estudios que reportaron otros resultados relacionados con lo social (p. e., percepciones de apoyo social), y cuatro de seis reportaron mejores resultados en el dominio social para la condici & oacute;n de tratamiento del TEPT basado en evidencia. Hubo una gran cantidad de heterogeneidad, sin evidencia de que esto pudiera explicarse por moderadores.Conclusi & oacute;n: Pocos ensayos reportan resultados sociales e interpersonales, y cuando se reportan, la evidencia es mixta. Es posible que las terapias centradas en el trauma para el TEPT deban adaptarse en algunas circunstancias, de modo que aborden los d & eacute;ficits sociales e interpersonales que suelen observarse en ni & ntilde;os y j & oacute;venes con TEPT.