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Peer-reviewedCC BYPsychotherapy and psychosomatics

Dismantling Psychological Interventions for Youth with Complex Trauma: A Systematic Review and Component Network Meta-Analysis.

  • Yu Li1
  • Junkai Feng1
  • Wanyan Hu1
  • Zhuo Zeng2
  • Qian Pan2
  • Jun Wang1
  • Muyang Li1
  • Thomas Elbert3
  • Anke Karl4
  • Yinyin Zang5
5 affiliations
  1. 1School of Psychological and Cognitive Sciences, Peking University, Key Laboratory of Machine Perception (Ministry of Education), and Beijing Key Laboratory of Brain-Computer Interface and Mental Health Modulation, Beijing, China.
  2. 2School of Health Humanities, Peking University, Beijing, China.
  3. 3Department of Psychology, University of Konstanz, Konstanz, Germany.
  4. 4Department of Psychology, University of Exeter, Exeter, UK.
  5. 5School of Psychological and Cognitive Sciences, Peking University, Key Laboratory of Machine Perception (Ministry of Education), and Beijing Key Laboratory of Brain-Computer Interface and Mental Health Modulation, Beijing, China, [email protected].
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Abstract

Introduction

Complex trauma-related posttraumatic stress disorder (PTSD) and comorbidities pose a significant mental health burden in children. However, the comparative effectiveness of psychological interventions and shared therapeutic components remains unclear.Methods

We conducted a systematic review, network, and component network meta-analysis of randomized controlled trials of psychological interventions for children and adolescents with complex trauma. PubMed, Embase, Web of Science, PsycINFO, and Cochrane Library were searched up to September 2024. PTSD was the primary outcome; retention and comorbid symptoms (depression, anxiety, dissociation, externalizing problems) were secondary outcomes.Results

Forty-eight studies (6,017 participants) were included in this review. Multimodal group interventions (SMD -1.68, 95% confidence interval [CI] -3.04 to -0.32), phase-based trauma-focused cognitive behavioral therapy (TF-CBT) with parental involvement (-1.12, -1.53 to -0.70), TF-CBT (-1.06, -1.59 to -0.52), non-TF-CBT with parental involvement (-0.93, -1.70 to -0.17), eye movement desensitization and reprocessing (-0.85, -1.60 to -0.10), and phase-based TF-CBT (-0.79, -1.20 to -0.39) significantly reduced PTSD. Exposure emerged as the only significantly effective component for PTSD (-0.85, 95% credible interval [CrI] -1.60 to -0.06). Efficient component combinations included affective modulation with a therapeutic foundation of psychoeducation and nonspecific elements for PTSD (-0.97, 95% CrI -1.92 to -0.01) and exposure plus parental involvement with the same foundation for depression (-2.11, 95% CrI -4.06 to -0.20).Conclusion

Trauma-focused approaches were the most effective treatments for pediatric PTSD and emotional comorbidities related to complex trauma. A more cost-effective intervention approach may prioritize exposure techniques, incorporate affective modulation, and include parental involvement when feasible.

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Cite

BibTeXRIS
BibTeX
@article{li2026dismantling,
  title = {{Dismantling Psychological Interventions for Youth with Complex Trauma: A Systematic Review and Component Network Meta-Analysis.}},
  author = {Yu Li and Junkai Feng and Wanyan Hu and Zhuo Zeng and Qian Pan and Jun Wang and Muyang Li and Thomas Elbert and Anke Karl and Yinyin Zang},
  journal = {Psychotherapy and psychosomatics},
  year = {2026},
  month = oct,
  doi = {10.1159/pps/aemag009},
  url = {https://europepmc.org/article/MED/42858309},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Dismantling Psychological Interventions for Youth with Complex Trauma: A Systematic Review and Component Network Meta-Analysis.
AU  - Yu Li
AU  - Junkai Feng
AU  - Wanyan Hu
AU  - Zhuo Zeng
AU  - Qian Pan
AU  - Jun Wang
AU  - Muyang Li
AU  - Thomas Elbert
AU  - Anke Karl
AU  - Yinyin Zang
PY  - 2026
DA  - 2026/10/10
JO  - Psychotherapy and psychosomatics
DO  - 10.1159/pps/aemag009
UR  - https://europepmc.org/article/MED/42858309
AB  - Introduction  Complex trauma-related posttraumatic stress disorder (PTSD) and comorbidities pose a significant mental health burden in children. However, the comparative effectiveness of psychological interventions and shared therapeutic components remains unclear.Methods  We conducted a systematic review, network, and component network meta-analysis of randomized controlled trials of psychological interventions for children and adolescents with complex trauma. PubMed, Embase, Web of Science, PsycINFO, and Cochrane Library were searched up to September 2024. PTSD was the primary outcome; retention and comorbid symptoms (depression, anxiety, dissociation, externalizing problems) were secondary outcomes.Results  Forty-eight studies (6,017 participants) were included in this review. Multimodal group interventions (SMD -1.68, 95% confidence interval [CI] -3.04 to -0.32), phase-based trauma-focused cognitive behavioral therapy (TF-CBT) with parental involvement (-1.12, -1.53 to -0.70), TF-CBT (-1.06, -1.59 to -0.52), non-TF-CBT with parental involvement (-0.93, -1.70 to -0.17), eye movement desensitization and reprocessing (-0.85, -1.60 to -0.10), and phase-based TF-CBT (-0.79, -1.20 to -0.39) significantly reduced PTSD. Exposure emerged as the only significantly effective component for PTSD (-0.85, 95% credible interval [CrI] -1.60 to -0.06). Efficient component combinations included affective modulation with a therapeutic foundation of psychoeducation and nonspecific elements for PTSD (-0.97, 95% CrI -1.92 to -0.01) and exposure plus parental involvement with the same foundation for depression (-2.11, 95% CrI -4.06 to -0.20).Conclusion  Trauma-focused approaches were the most effective treatments for pediatric PTSD and emotional comorbidities related to complex trauma. A more cost-effective intervention approach may prioritize exposure techniques, incorporate affective modulation, and include parental involvement when feasible.
SN  - 0033-3190
SN  - 1423-0348
ER  -