Trauma-Focused Early Intensive Cognitive Behavioral Intervention (TF-EICBI) in children and adolescent survivors of suicide bombing attacks (SBAs). A preliminary study

Authors

  • Agnes Leor, MD
  • Orna T. Dolberg, MD
  • Shira Pagorek Eshel, PhD
  • Yaron Yagil, PhD
  • Shaul Schreiber, MD

DOI:

https://doi.org/10.5055/ajdm.2013.0128

Keywords:

early emotional intervention, children and adolescents, acute stress response, suicide bombing attacks, trauma

Abstract

Objectives: To describe and evaluate the impact of an early intervention (Trauma-Focused Early Intensive Cognitive Behavioral Intervention, TF-EICBI) in children and adolescents who were victims of suicide bombing attacks (SBAs) in Israel.
Design: Description of an intervention and preliminary experience in its use.
Setting: An acute trauma center of a Child and Adolescent Psychiatric Unit in a Department of Psychiatry of a university-affiliated medical center.
Participants: Ten children and adolescents who were victims of SBAs and underwent early interventions (EIG) were compared to 11 adolescent victims who received no intervention (NEIG).The EIG included all the children and adolescent survivors of various SBAs that had occurred during 1 year who presented to our hospital after the TF-EICBI was implemented (June 2001). The NEIG comprised all adolescents girls <18 years of age at follow-up who survived one SBA (at the “Dolphinarium” Discotheque) before the TF-EICBI was available.
Main outcome measures: At the time of the 1-year post-SBA follow-up, all 21 subjects were assessed by the Structured Clinical Interview for Axis 1 DSMIII R Disorders (SCID), and the Child Behavior Checklist (CBCL).
Results: One (10 percent) EI subject and four (36.4 percent) NEI subjects had post-traumatic stress disorder. The mean CBCL total score and most of the mean CBCL behavior problem scores were significantly higher (p < 0.021) among the NEI group members.
Conclusions: Intervention was effective in preventing and lowering mental morbidity of children and adolescents after SBAs.

Author Biographies

Agnes Leor, MD

Child and Adolescent Acute Trauma Center, Child and Adolescent Psychiatric Unit, Department of Psychiatry, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine,Tel Aviv University, Tel-Aviv, Israel.

Orna T. Dolberg, MD

Department of Psychiatry, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.

Shira Pagorek Eshel, PhD

Department of Social Work, Zefat Academic College, Zefat, Israel; The Bob Shapell School of Social Work, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.

Yaron Yagil, PhD

Departments of Social Work and Education, Tel-Hai College, Upper Galilee 12210, Israel.

Shaul Schreiber, MD

Department of Psychiatry, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.

References

Fremont P: Childhood reactions to terrorism-induced trauma: A review of the past 10 years. J Am Acad Child Adolesc Psychiatry. 2004; 43: 381-392.

Yehuda R, McFarlane AC, Shalev AY: Predicting the development of posttraumatic stress disorder from the acute response to a traumatic event. Biol Psychiatry. 1998; 44: 1305-1313.

Laor N,Wolmer L, Cohen D: Mother’s functioning and children’s symptoms 5 years after a Scud missile attack. Am J Psychiatry. 2001; 158: 1020-1026.

Hoge CH, Pavlin JA: Psychological sequelae of September 11. N Engl J Med. 2002; 347: 443-445.

Mitsuko PS, Lonigan CJ, Finch AJ, et al.: Epidemiology of posttraumatic symptoms and symptom profiles (children exposed to disaster, part 1). J Am Acad Child Adolesc Psychiatry. 1994; 33: 80-93.

Terr LC: Childhood traumas: An outline and overview. Am J Psychiatry. 1991; 148: 10-20.

Feerick MM, Silverman GB: Children Exposed to Violence. Baltimore, MD: Paul H. Brookes Publishing, 2006.

Laor N,Wolmer L, Spirman S, et al.: Facing war, terrorism, and disaster: Toward a child-oriented comprehensive emergency care system. Child Adolesc Psychiatr Clin N Am. 2003; 12: 343-361.

Pfefferbaum B: Posttraumatic stress disorder in children: A review of the past 10 years. J Am Acad Child Adolesc Psychiatry. 1997; 36: 1503-1511.

Pynoos RS, Nader K: Psychological first aid and treatment approach to children exposed to community violence: Research implication. J Trauma Stress. 1988; 1: 445-473.

Vernberg EM, Vogel JM: Task force report. Part 2: Interventions with children after disasters. J Clin Child Psychol. 1993; 22: 485-498.

Poton LE, Bryand EC: After the earthquake: Organizing to respond to children and adolescents. Paper presented at the meeting of the American Psychological Association, San Francisco, 1991.

Mayou RA, Ehlers A, Hobbs M: A three-year follow up of psychological debriefing for road traffic accident victims. Br J Psychiatry. 2000; 176: 589-593.

Bryant RA, Sackville T, Dang ST, et al.: Treating acute stress disorder: An evaluation of cognitive behavioral therapy and supportive counseling techniques. Am J Psychiatry. 1999; 156: 1780-1786.

Foa EB, Hearst-Ikeda D, Perry KJ: Evaluation of a brief cognitive- behavioral program for the prevention of chronic PTSD in recent assault victims. J Consult Clin Psychol. 1995; 63: 948-955.

Thabet AA, Vostanis P, Karim K: Group crisis intervention for children during ongoing war conflict. Eur Child Adolesc Psychiatry. 2005; 14: 262-269.

Stallard P, Law F: Screening and psychological debriefing of adolescent survivors of life threatening events. Br J Psychiatry. 1993; 163: 660-665.

Chemtob CM, Nakashima JP, Hamada RS: Psychosocial intervention for postdisaster trauma symptoms in elementary school children. Arch Pediatr Adolesc Med. 2002; 156: 211-216.

Cohen JA: Treating acute posttraumatic reactions in children and adolescents. Biol Psychiatry. 2003; 53: 827-833.

Cohen JA, Mannarino AP: Treatment outcome study for sexually abused preschool children: Initial findings. J Am Acad Child Adolesc Psychiatry. 1996; 35: 42-50.

Trowell J,Kelvin I,Weeramanthi T, et al.: Psychotherapy for sexually abused girls: Psychopathological outcome findings and patterns of change. Br J Psychiatry. 2002; 160: 234-247.

Slater L: Repress yourself. NY Times. February 23, 2003.

Paylo SA, Beck JG: Is the concept of “repression” useful for the understanding chronic PTSD? Behav Res Ther. 2005; 43(1): 55-68.

Solomon Z, Ben Benishty R: The role of proximity, immediacy, and expectancy in frontline treatment of combat stress reaction among Israelis in the Lebanon War. Am J Psychiatry. 1986; 143: 613- 617.

Salmon TS:War neuroses and their lesson. N Y Med J. 1919; 108: 993-994.

Spitzer RL,Williams J, Gibbon M: Instruction manual for the structural clinical interview DSMIII-R. Arch Gen Psychiatry. 1992; 49: 629-636.

Achenbach TM: Empirically Based Assessment of Child and Adolescent Psychopathology: Practical Applications. Newbury Park, CA: Sage, 1987.

Achenbach TM: Manuel for the Child Behavior Checklist/4-18 and 1991 Profile. Burlington, VT: University of Vermont, Department of Psychiatry, 1991.

Siegel S, Castellan JN Jr: Nonparametric Statistics for the Behavioral Sciences. New York: McGraw Hill International Editions, 1989.

Romesburg HC: Cluster Analysis for Researchers. Raleigh, NC: Lulu Press, 2004.

Van Der Kolk BA: Trauma and memory. Psyc Clinic Neurosc. 1998; 52: 52-64.

Sherin JA, Nemeroff CB: Post-traumatic stress disorder: The neurobiological impact of psychological trauma. Dialogues Clin Neurosci. 2011; 13(3): 263-278.

Breslau N: Gender differences in trauma and posttraumatic stress disorder. J Gend Specif Med. 2002; 5(1): 34-40.

Published

09/01/2013

How to Cite

Leor, MD, A., O. T. Dolberg, MD, S. P. Eshel, PhD, Y. Yagil, PhD, and S. Schreiber, MD. “Trauma-Focused Early Intensive Cognitive Behavioral Intervention (TF-EICBI) in Children and Adolescent Survivors of Suicide Bombing Attacks (SBAs). A Preliminary Study”. American Journal of Disaster Medicine, vol. 8, no. 4, Sept. 2013, pp. 227-34, doi:10.5055/ajdm.2013.0128.

Issue

Section

Articles

Most read articles by the same author(s)