Manassis Katharina, Mendlowitz Sandra L, Scapillato Donna, Avery David, Fiksenbaum Lisa, Freire Marlinda, Monga Suneeta, Owens Mary
Department of Psychiatry, Hospital for Sick Children, Toronto, Canada.
J Am Acad Child Adolesc Psychiatry. 2002 Dec;41(12):1423-30. doi: 10.1097/00004583-200212000-00013.
To compare the efficacy of group and individual cognitive-behavioral therapy (CBT) in children with Axis I anxiety disorders. It was hypothesized that certain subgroups would respond preferentially to one modality.
Seventy-eight children aged 8-12 years with diagnosed anxiety disorders were randomly assigned to a 12-week, manual-based program of group or individual CBT, both with parental involvement. Outcomes included child anxiety (child and parent report) and global functioning as estimated by clinicians. Repeated-measures analyses of variance (ANOVAs) were done. The sample was then dichotomized by self-reported social anxiety (high/low) and parent-reported hyperactivity (high/low) using median splits, and diagnostically by generalized anxiety disorder versus phobic disorders. ANOVAs were repeated.
Children and parents reported significantly decreased anxiety and clinicians reported significantly improved global functioning regardless of treatment modality. Children reporting high social anxiety reported greater gains in individual treatment than in group treatment (p <.01). Parent reports of hyperactivity and diagnostic differences were not associated with differential treatment response by modality.
Children with anxiety disorders appear to improve with CBT, whether administered in a group or individual format. A subgroup of children reporting high social anxiety may respond preferentially to individual treatment. Replication of these findings is indicated.
比较团体认知行为疗法（CBT）和个体认知行为疗法对患有轴I焦虑症儿童的疗效。研究假设某些亚组对其中一种治疗方式反应更佳。
78名年龄在8至12岁、被诊断患有焦虑症的儿童被随机分配到一个为期12周、基于手册的团体或个体CBT项目中，两种治疗均有家长参与。结果包括儿童焦虑（儿童和家长报告）以及临床医生评估的整体功能。进行了重复测量方差分析。然后，根据自我报告的社交焦虑（高/低）和家长报告的多动（高/低），采用中位数分割法将样本二分，同时根据广泛性焦虑症与恐惧症进行诊断性二分。重复进行方差分析。
无论治疗方式如何，儿童和家长报告焦虑显著降低，临床医生报告整体功能显著改善。报告社交焦虑高的儿童在个体治疗中的获益大于团体治疗（p<.01）。家长报告的多动情况和诊断差异与治疗方式的不同反应无关。
焦虑症儿童无论是接受团体还是个体形式的CBT治疗，似乎都会有所改善。报告社交焦虑高的儿童亚组可能对个体治疗反应更佳。这些研究结果需进一步验证。
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