title: Research methodology used in studies of child disaster mental health interventions for posttraumatic stress.
abstract: OBJECTIVE
  In the last decade, the development of community-based and clinical interventions to assist children and adolescents after a disaster has become an international priority. Clinicians and researchers have begun to scientifically evaluate these interventions despite challenging conditions. The objective of this study was to conduct a systematic review of the research methodology used in studies of child disaster mental health interventions for posttraumatic stress.
  
  
  METHODS
  This scientifically rigorous analysis used standards for methodological rigor of psychosocial treatments for posttraumatic stress disorder (PTSD) to examine 29 intervention studies.
  
  
  RESULTS
  This analysis revealed that further refinement of methodology is needed to determine if certain intervention approaches are superior to other approaches and if they provide benefit beyond natural recovery. Most studies (93.1%) clearly described the interventions being tested or used manuals to guide application and most (89.7%) used standardized instruments to measure outcomes, and many used random assignment (69.0%) and provided assessor training (65.5%). Fewer studies used blinded assessment (44.8%) or measured treatment adherence (48.3%), and sample size in most studies (82.8%) was not adequate to detect small effects generally expected when comparing two active interventions. Moreover, it is unclear what constitutes meaningful change in relation to treatment especially for the numerous interventions administered to children in the general population.
  
  
  CONCLUSIONS
  Overall, the results are inconclusive about which children, what settings, and what approaches are most likely to be beneficial.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, College of Medicine, and Terrorism and Disaster Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. Electronic address: betty-pfefferbaum@ouhsc.edu.
authors.forename: Betty
authors.initials: B
authors.lastname: Pfefferbaum
authors.forename: Elana
authors.initials: E
authors.lastname: Newman
authors.forename: Summer D
authors.initials: SD
authors.lastname: Nelson
authors.forename: Brandi D
authors.initials: BD
authors.lastname: Liles
authors.forename: Robert P
authors.initials: RP
authors.lastname: Tett
authors.forename: Vandana
authors.initials: V
authors.lastname: Varma
authors.forename: Pascal
authors.initials: P
authors.lastname: Nitiéma
mesh_terms: D002648:Child; D002665:Child Psychiatry / Q000379:methods*; D002986:Clinical Trials as Topic / Q000379:methods*; D004190:Disasters; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D012107:Research Design; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*