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S112 IACAPAP 2012–20th World congress / Neuropsychiatrie de l’enfance et de l’adolescence 60S (2012) S64–S126 The Premiestart intervention is an extension of the MITP (Rauh et al., 1982) which showed substantial developmental benefits to 9 years of age. We spread 10 sessions across 10 weeks hospitalisation in babies born less than 30 weeks of gestation, followed by one home session. Content includes parent sensitivity training designed to help the mother minimise stress in the handling of her baby, and maximise pleasure for the baby. Reading the premature baby’s body lan- guage, kangaroo care, touch, massage and temperament The whole program is, however, much more then simply its content. The way it is implemented and deli- vered to parents is based on multiple psychological principles. Our results to date include improved development in the myelinated white matter of intervention infant brains at term equivalent. We speculate that the Premiestart intervention works at many levels, particularly in decreasing infant stress and improving early brain development and the quality of the mother-infant interactions/relationship. http://dx.doi.org/10.1016/j.neurenf.2012.05.471 New developments in treating children and adolescents with PTSD We-S-496 A school-based treatment manual for trauma-exposed youth V.G. Carrion Department of Psychiatry and Behavioral Sciences Division of Child and Adolescent Psychiatry, Stanford University, Stanford, USA Objective.– To report on results from a school-based trial studying the efficacy of the Cue-Centered Treatment Protocol (CCT) in terms of feasibility, adhe- rence and reduction of posttraumatic stress, depression, and anxiety in children chronically exposed to violence. Method.– Sixty-five youth aged 8 to 17 were recruited from 13 inner-city schools in high violence communities. Participants were randomly assigned to CCT or a waitlist control group. Both groups were evaluated at four discrete points (T1-T4). Post-traumatic stress disorder symptoms, depression and anxiety were evaluated by youth report. Caregivers self-reported on anxiety, depression and their children’s PTSD symptoms. Therapist ratings of participants’ overall improvement were obtained and CCT session level changes in PTSD symptoms were evaluated. Results.– The CCT group demonstrated significant decreases in all child symp- toms. There were larger effect sizes for the reductions compared to the waitlist group on all child outcomes: posttraumatic stress disorder (by parent and child report), anxiety, and depression symptoms. Conclusions.– The Cue-Centered Treatment Protocol (CCT), a hybrid inter- vention merging diverse theoretical backgrounds, demonstrated feasibility of implementation, ease of adherence and efficacy in reducing symptoms in youth with a history of interpersonal violence when administered in a school-setting. http://dx.doi.org/10.1016/j.neurenf.2012.05.472 We-S-497 Trauma-focused cognitive behavioral therapy (Tf-CBT) for children and adolescents after abuse and maltreatment L. Goldbeck , V. Kirsch , D.C.M. Seitz , J.M. Fegert Department of Child and Adolescent Psychiatry/psychotherapy, University Ulm, Ulm, Germany Corresponding author. Posttraumatic stress disorder (PTSD) is a common consequence of abuse and maltreatment during childhood and adolescence. There is strong evidence for the efficacy of Trauma-focused Cognitive Behavioral Therapy (Tf-CBT) after sexual abuse. This pilot study describes the feasibility and preliminary treatment effects after mixed maltreatment types including domestic violence. Fifteen participants (six females; age M = 10.5; SD = 3.7) completed Tf-CBT. PTSD symptoms are analysed after therapy. Reasons for drop out are described for three patients. After treatment, there were significantly less symptoms compared to pre-treatment (CAPS-CA total symptom severity score pre: 40.6; SD = 10.5; post: M = 15.2; SD = 14.3; P < .001; d = 1.8). Few dropouts occurred due to avoidance behaviour and stressed caregivers. In addition to previous studies with sexually abused children, this study provides preliminary evidence for the effectiveness of Tf- CBT in a sample of patients with PTSD related to mixed maltreatment types. http://dx.doi.org/10.1016/j.neurenf.2012.05.473 We-S-498 Prolonged exposure therapy for adolescents with PTSD E. Gilboa-Schechtman Psychology Department, Bar Ilan University, Ramat Gan, Israel We examined the efficacy and maintenance of developmentally adapted pro- longed Exposure (PE-A) compared to active control Time Limited Dynamic Therapy (TLDP-A) for reducing post-traumatic and depressive symptoms in adolescent victims of single event traumas. Thirty-eight adolescents (age 12–18) were randomly assigned to receive either PE-A or TLDP-A. Both treatments resulted in decreased post-traumatic stress disorder and depression, and increa- sed functioning. PE-A exhibited greater reduction of PTSD and depression symptom severity, and greater increase in global functioning than did TDLP-A. At post-treatment, 68.4% of adolescents beginning treatment with PE-A and 36.8% of those beginning treatment with TLDP-A no longer met diagnostic criteria for PTSD. Treatment gains were maintained at 6 and 17 months follow- up. Brief individual therapy is effective in reducing post-traumatic distress and behavioral trauma-focused components enhance efficacy. http://dx.doi.org/10.1016/j.neurenf.2012.05.474 We-S-499 Developmentally adapted cognitive behavioral therapy for adolescents with PTSD after sexual or physical abuse S. Matulis a,, R. Rosner b , R. Steil c a Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany b Clinical Psychology, Catholic University Eichstätt-Ingolstadt, Eichstätt, Germany c Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe-University, Frankfurt, Frankfurt, Germany Corresponding author. Introduction.– Since evidence-based psychotherapeutic interventions for adoles- cents suffering from PTSD after childhood abuse (CA) are lacking, we designed Developmentally Adapted Cognitive Behavioral Therapy (D-CBT) and investi- gated the treatment for its efficacy in youths over the age of 14. The presentation will introduce the treatment and show the results from a case series study. Objectives and methodology.– Nine participants were involved in a case series. D-CBT was applied to each of the participants. The treatment was organized into three phases: – Emotion regulation training as used in Steil et al. (2011); – Cognitive Therapy according to P.Resick (2008) administered in high fre- quency; – Therapy phase addressing developmental tasks such as career choice and romantic relationships. Outcomes were measured by structured interviews and questionnaires. Results.– The cases showed significant reduction in PTSD and many other symptoms. Discussion and conclusion.– Results suggest that D-CBT is effective in treatment of post-traumatic stress disorder in maltreated adolescents. http://dx.doi.org/10.1016/j.neurenf.2012.05.475

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Page 1: Developmentally adapted cognitive behavioral therapy for adolescents with PTSD after sexual or physical abuse

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http://dx.doi.org/10.1016/j.neurenf.2012.05.475

112 IACAPAP 2012 – 20th World congress / Neuropsychia

he Premiestart intervention is an extension of the MITP (Rauh et al., 1982)hich showed substantial developmental benefits to 9 years of age. We spread0 sessions across 10 weeks hospitalisation in babies born less than 30 weeksf gestation, followed by one home session. Content includes parent sensitivityraining designed to help the mother minimise stress in the handling of her baby,nd maximise pleasure for the baby. Reading the premature baby’s body lan-uage, kangaroo care, touch, massage and temperament The whole program is,owever, much more then simply its content. The way it is implemented and deli-ered to parents is based on multiple psychological principles. Our results to datenclude improved development in the myelinated white matter of interventionnfant brains at term equivalent. We speculate that the Premiestart interventionorks at many levels, particularly in decreasing infant stress and improving earlyrain development and the quality of the mother-infant interactions/relationship.

ttp://dx.doi.org/10.1016/j.neurenf.2012.05.471

ew developments in treating children and adolescents withTSD

e-S-496

school-based treatment manual for trauma-exposedouth.G. Carrion

Department of Psychiatry and Behavioral Sciences Division of Child anddolescent Psychiatry, Stanford University, Stanford, USA

bjective.– To report on results from a school-based trial studying the efficacyf the Cue-Centered Treatment Protocol (CCT) in terms of feasibility, adhe-ence and reduction of posttraumatic stress, depression, and anxiety in childrenhronically exposed to violence.ethod.– Sixty-five youth aged 8 to 17 were recruited from 13 inner-city

chools in high violence communities. Participants were randomly assignedo CCT or a waitlist control group. Both groups were evaluated at four discreteoints (T1-T4). Post-traumatic stress disorder symptoms, depression and anxietyere evaluated by youth report. Caregivers self-reported on anxiety, depression

nd their children’s PTSD symptoms. Therapist ratings of participants’ overallmprovement were obtained and CCT session level changes in PTSD symptomsere evaluated.esults.– The CCT group demonstrated significant decreases in all child symp-

oms. There were larger effect sizes for the reductions compared to the waitlistroup on all child outcomes: posttraumatic stress disorder (by parent and childeport), anxiety, and depression symptoms.onclusions.– The Cue-Centered Treatment Protocol (CCT), a hybrid inter-ention merging diverse theoretical backgrounds, demonstrated feasibility ofmplementation, ease of adherence and efficacy in reducing symptoms in youthith a history of interpersonal violence when administered in a school-setting.

ttp://dx.doi.org/10.1016/j.neurenf.2012.05.472

e-S-497

rauma-focused cognitive behavioral therapy (Tf-CBT) forhildren and adolescents after abuse and maltreatment. Goldbeck ∗, V. Kirsch , D.C.M. Seitz , J.M. Fegert

Department of Child and Adolescent Psychiatry/psychotherapy, Universitylm, Ulm, Germany

Corresponding author.

osttraumatic stress disorder (PTSD) is a common consequence of abuse andaltreatment during childhood and adolescence. There is strong evidence for the

fficacy of Trauma-focused Cognitive Behavioral Therapy (Tf-CBT) after sexualbuse. This pilot study describes the feasibility and preliminary treatment effectsfter mixed maltreatment types including domestic violence. Fifteen participants

six females; age M = 10.5; SD = 3.7) completed Tf-CBT. PTSD symptoms arenalysed after therapy. Reasons for drop out are described for three patients. Afterreatment, there were significantly less symptoms compared to pre-treatment

e l’enfance et de l’adolescence 60S (2012) S64–S126

CAPS-CA total symptom severity score pre: 40.6; SD = 10.5; post: M = 15.2;D = 14.3; P < .001; d = 1.8). Few dropouts occurred due to avoidance behaviournd stressed caregivers. In addition to previous studies with sexually abusedhildren, this study provides preliminary evidence for the effectiveness of Tf-BT in a sample of patients with PTSD related to mixed maltreatment types.

ttp://dx.doi.org/10.1016/j.neurenf.2012.05.473

e-S-498

rolonged exposure therapy for adolescents with PTSD. Gilboa-Schechtman

Psychology Department, Bar Ilan University, Ramat Gan, Israel

e examined the efficacy and maintenance of developmentally adapted pro-onged Exposure (PE-A) compared to active control Time Limited Dynamicherapy (TLDP-A) for reducing post-traumatic and depressive symptoms indolescent victims of single event traumas. Thirty-eight adolescents (age 12–18)ere randomly assigned to receive either PE-A or TLDP-A. Both treatments

esulted in decreased post-traumatic stress disorder and depression, and increa-ed functioning. PE-A exhibited greater reduction of PTSD and depressionymptom severity, and greater increase in global functioning than did TDLP-A.t post-treatment, 68.4% of adolescents beginning treatment with PE-A and6.8% of those beginning treatment with TLDP-A no longer met diagnosticriteria for PTSD. Treatment gains were maintained at 6 and 17 months follow-p. Brief individual therapy is effective in reducing post-traumatic distress andehavioral trauma-focused components enhance efficacy.

ttp://dx.doi.org/10.1016/j.neurenf.2012.05.474

e-S-499

evelopmentally adapted cognitive behavioral therapy fordolescents with PTSD after sexual or physical abuse. Matulis a,∗, R. Rosner b, R. Steil c

Clinical Psychology and Psychotherapy, Goethe University Frankfurt,rankfurt, GermanyClinical Psychology, Catholic University Eichstätt-Ingolstadt, Eichstätt,ermanyClinical Psychology and Psychotherapy, Institute of Psychology,oethe-University, Frankfurt, Frankfurt, Germany

Corresponding author.

ntroduction.– Since evidence-based psychotherapeutic interventions for adoles-ents suffering from PTSD after childhood abuse (CA) are lacking, we designedevelopmentally Adapted Cognitive Behavioral Therapy (D-CBT) and investi-ated the treatment for its efficacy in youths over the age of 14. The presentationill introduce the treatment and show the results from a case series study.bjectives and methodology.– Nine participants were involved in a case series.-CBT was applied to each of the participants. The treatment was organized

nto three phases:Emotion regulation training as used in Steil et al. (2011);Cognitive Therapy according to P. Resick (2008) administered in high fre-

uency;Therapy phase addressing developmental tasks such as career choice and

omantic relationships. Outcomes were measured by structured interviews anduestionnaires.esults.– The cases showed significant reduction in PTSD and many other