Psychological Treatment for Children Suffering From Post Traumatic Stress Symptoms and Mild Traumatic Brain Injury (TBI)

• Percentage of participants with PTSD diagnosis as a measure of recovery rates [ Time Frame: After up to 18 weeks of PE treatment ] [ Designated as safety issue: No ]
  Psychological evaluation using the Hebrew translation of the Childhood version of the Schedule for Affective Disorders and Schizophrenia (Apter et al., 1989).
  
  

• Change from Baseline in Neuropsychological Functioning at Treatment Completion [ Time Frame: After up to 18 weeks of treatment ] [ Designated as safety issue: No ]

  Subjects will take paper and pencil and computer tests to evaluate memory, learning, attention and concentration, vocabulary and naming.

  The neuropsychological testing battery includes: Raven's Progressive Matrices, BRIEF, WISC-III-Hebrew Version (Digit Span), CMS (Spatial Span), D-KEFS (Design Fluency, Sorting Test, Trails Making Test), CPT, Stroop,TOMM Effort validity test, The Connors Rating Scale- Revised Long version

  
  
• Change from Baseline in The Child PTSD Symptoms Scale at Treatment Completion [ Time Frame: At up to 18 weeks of PE treatment ] [ Designated as safety issue: No ]
  The Child PTSD Symptoms Scale (Foa et al., 2001)
  
  
• Change from Baseline in The Child PTSD Symptoms Scale at 2 weeks Follow Up [ Time Frame: 2 weeks following treatment completion ] [ Designated as safety issue: No ]
  The Child PTSD Symptoms Scale (Foa et al., 2001)
  
  
• Change from Baseline in The Child PTSD Symptoms Scale at 4 weeks Follow Up [ Time Frame: 4 weeks following treatment Completion ] [ Designated as safety issue: No ]
  The Child PTSD Symptoms Scale (Foa et al., 2001)
  
  
• Change from Baseline in The Child PTSD Symptoms Scale at 12 weeks Follow Up [ Time Frame: 12 weeks following treatment completion ] [ Designated as safety issue: No ]
  The Child PTSD Symptoms Scale (Foa et al., 2001)
  
  
• Change from Baseline in the Childrens Depression Inventory at Treatment Completion [ Time Frame: After up to 18 weeks of PE treatment ] [ Designated as safety issue: No ]
  Childrens Depression Inventory, Kovacs, 1992
  
  
• Change from Baseline in the Children's Global Assessment Scale at Treatment Completion [ Time Frame: After up to 18 weeks of PE treatment ] [ Designated as safety issue: No ]
  
• Change from Baseline in The State-Trait Anxiety Inventory for Children at Treatment Completion [ Time Frame: After up to 18 weeks of PE Treatment ] [ Designated as safety issue: No ]
  The State-Trait Anxiety Inventory for Children, Spielberger et al.
  
  
• Change from Baseline in The Well-Being Questionnaire at Treatment Completion [ Time Frame: After up to 18 weeks of PE treatment ] [ Designated as safety issue: No ]
  WHO-5 (Bech, 1998)
  
  

Motor vehicle accidents account for a majority of TBI cases and are a leading cause for Post Traumatic Stress Disorder (PTSD) among children. The vast majority of these cases involve mild TBI (mTBI) with persistent post concussion syndromes. However, the empirical data on treatment in this field is scarce. Few studies demonstrated that cognitive behavioral therapies can be effective for adults with mild TBI suffering from Acute Stress Disorder, but no research, to date, addressed this question in pediatric population. In the current research we intend to examine the effectiveness of PE in reducing post-traumatic stress symptoms in children and adolescents with m-TBI caused by motor vehicle accident, in comparison to children and adolescents without brain injury.

Sixty children age 6 to 18 attending the Anxiety clinic in Schneider Children's Medical Center of Israel will be included. All subjects will be treated with a manualized 12-18 week Prolonged Exposure protocol. Participants will undergo assessments, which will include interviews, questionnaires and neuropsychological tests concerning symptoms of PTSD, emotional and cognitive functioning. Ratings and neuropsychological testing will be made at baseline and following completion of treatment. Follow up will include questionnaires ratings at 2 weeks, 4 weeks and 12 weeks after completion of treatment.