Randomized Controlled Trial of the Effectiveness of Group Treatment With War-Exposed Bosnian Adolescents

Study Overview
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Brief Summary
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Context: This is the first multi-site randomized controlled study of the effectiveness of a group treatment for war-exposed adolescents delivered in-country within a public school system. Objective: To evaluate the effectiveness of a trauma/grief-focused group treatment program in reducing symptoms of posttraumatic stress disorder (PTSD), depression, and traumatic grief in war-exposed Bosnian youths attending 10 secondary schools located in Central Bosnia.

Detailed Description
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Design: A randomized controlled trial conducted during the 2000-2001 school year, with 4-month follow-up, compared group treatment to a psychoeducation/skill-based school milieu intervention. Setting and Participants: Students attending 10 Bosnian secondary schools exposed to severe trauma, traumatic loss, and severe adversity, reporting severe persisting symptoms of PTSD, depression, or traumatic grief, and functional impairment. Intervention: Students were randomly assigned to either 17-session Trauma and Grief Component Therapy (n=71), or a school milieu intervention (n=73), both conducted by trained school counselors.

Official Title
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Long-Term Post- War Adjustment in Bosnian Adolescents, Their Parents and Teachers

Conditions
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Posttraumatic Stress Disorder, Depression, Grief (Traumatic Grief and Existential Grief)

Intervention / Treatment
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* Behavioral: Trauma and Grief Component Therapy for Adolescents (Group Version)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Significant trauma exposure before, during, or after the war (e.g., serious physical injury, life threat, witnessing death or serious injury, traumatic bereavement); Significant current distress, especially severe persisting symptoms of PTSD, depression, or traumatic grief; Significant functional impairment in family or peer relationships and school performance Exclusion Criteria: Acute risk status (e.g., suicidal plans and intent) Psychosis Severe substance abuse (severe enough to interfere with engagement in treatment).

Ages Eligible for Study
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Minimum Age: 14 Years
Maximum Age: 19 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Behavioral: Trauma and Grief Component Therapy for Adolescents (Group Version)|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| UCLA PTSD Reaction Index |  | Pre-treatment, post-treatment, and at 4-month follow-up | 
| Depression Self-Rating Scale |  | Pre-treatment, post-treatment, and 4-month follow-up | 
| UCLA Grief Scale |  | Pre-treatment, post-treatment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cognitive Distortions Scale |  | Pre-treatment and post-treatment | 
| War Exposure Index |  | Pre-treatment (screening survey) | 
| Post-War Adversities Scale |  | Pre-treatment (screening survey) | 
| Trauma Reminder Screening Scale |  | Pre-treatment (screening survey) | 
| Loss Reminder Screening Scale |  | Pre-treatment (screening survey) | 
| Youth Outcome Questionnaire (Somatic and Interpersonal Problems Subscales) |  | Pre- and post-treatment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Trauma, Grief, Depression, Adolescent, War, Group, Therapy, Treatment, Intervention, School, Development