Metacognitive Therapy for Posttraumatic Stress Disorder in Youth: A Feasibility Study.

Metacognitive therapy (MCT) is an effective treatment for posttraumatic stress disorders (PTSD) in adults. However, there is no evidence for the feasibility, acceptability, and efficacy of MCT for PTSD in youth so far. This study is the first to utilize MCT for children and adolescents with PTSD. Twenty-one children and adolescents (aged 8-19 years) who were consecutively referred to the outpatient trauma clinic were treated with MCT. In all patients, treatment was well accepted and regularly attended. At post-treatment, MCT was associated with significant and large reductions in posttraumatic stress symptoms. Depending on the outcome measure, 95 or 85% of the patients were classified as recovered after treatment. Eighteen patients were included in the calculation of the overall outcome. Effect sizes on primary PTSD measures were large (Cohen's d = 3.42 and d = 1.92) and more than comparable to well-established treatments. Only six patients were available at follow-up, but their improvements were found to be stable. Despite the limitations of this uncontrolled study, the results suggest that MCT may be a feasible and promising treatment for traumatized children and adolescents and they justify a controlled trial evaluating the efficacy of MCT versus an already well-established intervention.

Age effects on associative memory for novel picture pairings.

Normal aging is usually accompanied by greater memory decline for associations than for single items. Though associative memory is generally supported by recollection, it has been suggested that familiarity can also contribute to associative memory when stimuli can be unitized and encoded as a single entity. Given that familiarity remains intact during healthy aging, this may be one route to reducing age-related associative deficits. The current study investigated age-related differences in associative memory under conditions that were expected to differentially promote unitization, in this case by manipulating the spatial arrangement of two semantically unrelated objects positioned relative to each other in either spatially implausible or plausible orientations. Event-related potential (ERP) correlates of item and associative memory were recorded whilst younger and older adults were required to discriminate between old, recombined and new pairs of objects. These ERP correlates of item and associative memory did not vary with plausibility, whereas behavioral measures revealed that both associative and item memory were greater for spatially plausible than implausible pair arrangements. Contrary to predictions, older adults were less able to take advantage of this memory benefit than younger participants. Potential reasons for this are considered, and these are informed by those lines of evidence which indicate older participants were less sensitive to the bottom-up spatial manipulation employed here. It is recommended that future strategies for redressing age-related associative deficits should take account of the aging brain's increasing reliance on pre-existing semantic associations.