Treatment Response of Affect Regulation Group Therapy for Recently Traumatized School Children / 신경정신의학

OBJECTIVES: The aim of this study was to investigate the treatment effect and predictors of response of affect regulation group therapy (ARGT) delivered to a group of recently traumatized children. METHODS: A total of 464 school children, who had witnessed or confronted a tragic accident at school, were given a single-session of affect regulation group therapy, that which included psychoeducation and affect regulation elements from eye movement desensitization and reprocessing. Of 213 children whose with initial score of Subject Unit of Disturbance Scale (SUDS) score over 4, we compared pre- and post-treatment scores and performed conducted the responder vs. non-responder comparison. The pPost-traumatic disorder (PTSD) symptom scores measured by using Child Reaction to Traumatic Events Scale-Revised (CRTES-R), demographic variables, and clinical variables were considered. RESULTS: Affect regulation group therapy was effective for children who had experienced an acute traumatic event (t=16.3, p<0.001). Baseline SUDS score of for non-responder were was significantly higher (t=-2.89, p<0.001) and CRTES-R score approached a level of significance level (t=-1.72, p=0.09). However, results of logistic regression analysis identified showed that the pretreatment SUDS score was the only significant predictor of non-response. CONCLUSION: Affect regulation group therapy appeared to be effective for children who had undergone experienced an acute traumatic event. And in addition, the survivors' subjective distress was more important to treatment response than severity of PTSD symptoms severity.

Factorial Validity and Psychometric Properties of the Korean Version of the Children's Response to Traumatic Events Scale-Revised in Recently Traumatized School Children / 신경정신의학

OBJECTIVES: Posttraumatic stress disorder (PTSD) in children is prevalent and often persists for many years after the trauma. Therefore, screening and early detection using psychometrically sound instruments is a pivotal element of appropriate management. This study tested the reliability and validity of a Korean version of the Child Reaction to Traumatic Events Scale-Revised (K-CRTES-R) in a sample of recently traumatized school children. METHODS: The K-CRTES was administered to a total of 464 school children aged ten to twelve who had witnessed or had been confronted with a tragic accident involving three deaths. Internal consistency, two week test-retest reliability, and construct validity were assessed. A non-random portion of participants also completed the State Anxiety Inventory and the Subjective Unit of Distress Scale for testing convergent validity. Exploratory factor analysis was conducted for a random half of participants (n=232), and, for the remaining half, we tested the model fit by performance of confirmatory factor analysis. RESULTS: Two week test-retest reliability was high (r=0.85), and internal consistency was excellent (Cronbach alpha=0.92). The total score for the K-CRTES-R showed significant correlation with state anxiety and subjective level of anxiety, thus confirming its convergent validity. In addition, the K-CRTES-R distinguished between direct exposure and indirect confrontation, demonstrating the discriminant validity of the scale. In addition, we confirmed the factorial validity by identifying a two-factor structure (intrusion-hyperarousal and avoidance) that explained 56% of the total variance. This two factor solution and other previously suggested PTSD models showed fit indices that were within an acceptable range. CONCLUSION: Findings of our study indicate that the K-CRTES-R is a good measure of reliability and validity that can be used to assess the impact of trauma in Korean speaking children.