Kendall Philip C, Hudson Jennifer L, Gosch Elizabeth, Flannery-Schroeder Ellen, Suveg Cynthia
Department of Psychology, Temple University, Philadelphia, PA 19122-6085, USA.
J Consult Clin Psychol. 2008 Apr;76(2):282-97. doi: 10.1037/0022-006X.76.2.282.
This randomized clinical trial compared the relative efficacy of individual (child) cognitive-behavioral therapy (ICBT), family cognitive-behavioral therapy (FCBT), and a family-based education/support/ attention (FESA) active control for treating anxiety disordered youth ages 7-14 years (M = 10.27). Youth (N = 161; 44% female; 85% Caucasian, 9% African American, 3% Hispanic, 3% other/mixed) with a principal diagnosis of separation anxiety disorder, social phobia, or generalized anxiety disorder and their parents participated. Outcome analyses were conducted using hierarchical linear models on the intent-to-treat sample at posttreatment and 1-year follow-up using diagnostic severity, child self-reports, parent reports, and teacher reports. Chi-square analyses were also conducted on diagnostic status at post and 1-year follow-up. Children evidenced treatment gains in all conditions, although FCBT and ICBT were superior to FESA in reducing the presence and principality of the principal anxiety disorder, and ICBT outperformed FCBT and FESA on teacher reports of child anxiety. Treatment gains, when found, were maintained at 1-year follow-up. FCBT outperformed ICBT when both parents had an anxiety disorder. Implications for treatment and suggestions for research are discussed.
这项随机临床试验比较了个体（儿童）认知行为疗法（ICBT）、家庭认知行为疗法（FCBT）以及基于家庭的教育/支持/关注（FESA）这种积极对照措施，对治疗7至14岁（平均年龄10.27岁）患有焦虑症的青少年的相对疗效。患有分离焦虑症、社交恐惧症或广泛性焦虑症的主要诊断的青少年（N = 161；44%为女性；85%为白人，9%为非裔美国人，3%为西班牙裔，3%为其他/混合族裔）及其父母参与了研究。在治疗后和1年随访时，使用分层线性模型对意向性治疗样本进行结果分析，分析指标包括诊断严重程度、儿童自我报告、父母报告和教师报告。还对治疗后和1年随访时的诊断状态进行了卡方分析。所有治疗组的儿童都显示出治疗效果，尽管FCBT和ICBT在减少主要焦虑症的存在和严重性方面优于FESA，并且在教师对儿童焦虑的报告方面，ICBT的表现优于FCBT和FESA。发现的治疗效果在1年随访时得以维持。当父母双方都患有焦虑症时，FCBT的表现优于ICBT。文中讨论了对治疗的启示和研究建议。
