{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T06:53:05Z","timestamp":1787986385107,"version":"build-2784847793"},"reference-count":40,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,9,20]],"date-time":"2016-09-20T00:00:00Z","timestamp":1474329600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1UL1TR001079"],"award-info":[{"award-number":["1UL1TR001079"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Child Psychology Psychiatry"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The effectiveness of mental health interventions such as trauma\u2010focused cognitive behavioral therapy (TF\u2010CBT) may vary by client, caregiver, and intervention\u2010level variables, but few randomized trials in low\u2010 and middle\u2010income countries (LMIC) have conducted moderation analyses to investigate these characteristics. This study explores moderating factors to TF\u2010CBT treatment response among a sample of orphans and vulnerable children (OVC) in Zambia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were obtained from a completed randomized trial of TF\u2010CBT among 257 OVC in Zambia. Trauma symptoms and functioning were measured at baseline and following the end of treatment. Mixed effects regression models were estimated for each moderator of interest: gender, age, number of trauma types experienced, history of sexual abuse, orphan status, primary caretaker, school status, and parental involvement in treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Treatment effectiveness was moderated by history of sexual abuse with greater reductions in both outcomes (trauma,\n                      <jats:italic>p\u00a0&lt;\u00a0<\/jats:italic>\n                      .05; functioning,\n                      <jats:italic>p\u00a0&lt;\u00a0<\/jats:italic>\n                      .01) for those that experienced sexual abuse. Primary caretaker was also a moderator with greater trauma reductions in those who identified their mother as the primary caretaker (\n                      <jats:italic>p\u00a0&lt;\u00a0<\/jats:italic>\n                      .01), and better functioning in those that identified their father as the primary caretaker (\n                      <jats:italic>p\u00a0&lt;\u00a0<\/jats:italic>\n                      .05). Nonorphans and single orphans (mother alive) showed greater reduction in functional impairment (\n                      <jats:italic>p\u00a0&lt;\u00a0<\/jats:italic>\n                      .01) compared with double orphans. There was no significant moderator effect found by gender, age, number of trauma types, school status, or caregiver participation in treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study suggests that TF\u2010CBT was effective in reducing trauma symptoms and functional impairment among trauma\u2010affected youth overall and that it may be particularly effective for survivors of child sexual abuse and children whose primary caretaker is a biological parent. Scale\u2010up of TF\u2010CBT\u00a0is\u00a0warranted given the wide range of effectiveness and prevalence of child sexual abuse. Future randomized trials of interventions in LMIC should power for moderation analyses in the study design phase when feasible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jcpp.12623","type":"journal-article","created":{"date-parts":[[2016,9,20]],"date-time":"2016-09-20T03:12:03Z","timestamp":1474341123000},"page":"1194-1202","source":"Crossref","is-referenced-by-count":29,"title":["Moderators of treatment response to trauma\u2010focused cognitive behavioral therapy among youth in Zambia"],"prefix":"10.1111","volume":"57","author":[{"given":"Jeremy C.","family":"Kane","sequence":"first","affiliation":[{"name":"Department of Mental Health Johns Hopkins Bloomberg School of Public Health Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura K.","family":"Murray","sequence":"additional","affiliation":[{"name":"Department of Mental Health Johns Hopkins Bloomberg School of Public Health Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Cohen","sequence":"additional","affiliation":[{"name":"Allegheny General Hospital Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Dorsey","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Skavenski van Wyk","sequence":"additional","affiliation":[{"name":"Department of Mental Health Johns Hopkins Bloomberg School of Public Health Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennica","family":"Galloway Henderson","sequence":"additional","affiliation":[{"name":"Department of Mental Health Johns Hopkins Bloomberg School of Public Health Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mwiya","family":"Imasiku","sequence":"additional","affiliation":[{"name":"School of Medicine University of Zambia Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Mayeya","sequence":"additional","affiliation":[{"name":"Ministry of Health Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Bolton","sequence":"additional","affiliation":[{"name":"Department of Mental Health Johns Hopkins Bloomberg School of Public Health Baltimore MD USA"},{"name":"Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,9,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.329"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2012.02.010"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta5330"},{"key":"e_1_2_8_5_1","volume-title":"Statistical power analysis for the behavioral sciences","author":"Cohen J.","year":"1988"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-200404000-00005"},{"key":"e_1_2_8_7_1","volume-title":"Treating trauma and traumatic grief in children and adolescents","author":"Cohen J.A.","year":"2006"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2010.247"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2004.12.005"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2004.tb05928.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077559596001004003"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.20744"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-014-0572-5"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2014.03.020"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1943"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2010.03.006"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e5793"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/jts.20518"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/15374416.2013.822307"},{"key":"e_1_2_8_20_1","unstructured":"Johns Hopkins Bloomberg School of Public Health(2013).The DIME Program Research Model: Design implementation monitoring and evaluation. Available fromhttp:\/\/www.jhsph.edu\/research\/centers-and-institutes\/center-for-refugee-and-disaster-response\/response_service\/AMHR\/dime\/index.html[last accessed 15 December 2015]."},{"key":"e_1_2_8_21_1","first-page":"332","article-title":"The African orphans\u2019 life: Yesterday and today","author":"Kanjanda O.","year":"2014","journal-title":"European Scientific Journal"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.59.10.877"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12094"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0123820"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.173.6.482"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/1752-4458-5-24"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/1752-4458-5-30"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2013.04.017"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.0580"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10802-011-9566-7"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2013.01.013"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v045.i04"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1080\/15374410701818293"},{"key":"e_1_2_8_34_1","volume-title":"Stata statistical software: Release 13","author":"StataCorp","year":"2013"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/jts.21780"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/med:psych\/9780199360345.003.0003"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0021348"},{"key":"e_1_2_8_38_1","unstructured":"UNAIDS(2010).UN Report on the Global AIDS Epidemic. Available fromhttp:\/\/www.unaids.org\/globalreport\/Global_report.htm[last accessed 15 March 2016]."},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.8383"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2012.11.003"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta18310"}],"container-title":["Journal of Child Psychology and Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjcpp.12623","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjcpp.12623","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acamh.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jcpp.12623","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T18:58:27Z","timestamp":1762196307000},"score":1,"resource":{"primary":{"URL":"https:\/\/acamh.onlinelibrary.wiley.com\/doi\/10.1111\/jcpp.12623"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,9,20]]},"references-count":40,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2016,10]]}},"alternative-id":["10.1111\/jcpp.12623"],"URL":"https:\/\/doi.org\/10.1111\/jcpp.12623","archive":["Portico"],"relation":{},"ISSN":["0021-9630","1469-7610"],"issn-type":[{"value":"0021-9630","type":"print"},{"value":"1469-7610","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,9,20]]}}}