Chu Brian C, Harrison Tara L
Department of Psychology, Rutgers, The State University of New Jersey, 152 Frelinghuysen Road, Piscataway, NJ 08854, USA.
Clin Child Fam Psychol Rev. 2007 Dec;10(4):352-72. doi: 10.1007/s10567-007-0028-2.
The commonalities between anxiety and depression have been discussed before, but few have delineated the potentially different mechanisms through which treatments work for these populations. The current study conducted a comprehensive review of child and adolescent randomized clinical trials that tested cognitive-behavioral therapy (CBT) for anxiety or depression. All studies were required to have assessed both treatment outcomes and at least one theory-specific process target, including behavioral, physiological, cognitive, and coping variables. Using a meta-analytic approach, CBT demonstrated positive treatment gains across anxiety, depression, and general functioning outcomes. CBT for anxiety also produced moderate to large effects across behavioral, physiological, cognitive, and coping processes, with behavioral targets demonstrating potentially the greatest change. CBT for depression produced small effects for cognitive processes but nonsignificant effects for behavioral and coping variables. Findings were generally consistent with CB theory but suggest potentially different mediators in the treatment of anxiety and depression. Results are discussed in terms of implications for mechanisms research, theories of change, and treatment development.
焦虑症和抑郁症之间的共性此前已有讨论，但很少有人描述过针对这些人群的治疗方法可能存在的不同作用机制。当前的研究对测试认知行为疗法（CBT）治疗儿童和青少年焦虑症或抑郁症的随机临床试验进行了全面综述。所有研究都必须评估治疗结果以及至少一个特定理论的过程目标，包括行为、生理、认知和应对变量。采用荟萃分析方法，认知行为疗法在焦虑症、抑郁症和总体功能结果方面均显示出积极的治疗效果。针对焦虑症的认知行为疗法在行为、生理、认知和应对过程中也产生了中度到较大的效果，行为目标显示出可能最大的变化。针对抑郁症的认知行为疗法对认知过程产生了较小的效果，但对行为和应对变量没有显著影响。研究结果总体上与认知行为理论一致，但表明在焦虑症和抑郁症的治疗中可能存在不同的中介因素。将从对机制研究、改变理论和治疗发展的影响方面对结果进行讨论。
