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针对儿童和青少年强迫症的循证心理社会治疗方法。

Evidence-based psychosocial treatments for child and adolescent obsessive-compulsive disorder.

作者信息

Barrett Paula M, Farrell Lara, Pina Armando A, Peris Tara S, Piacentini John

机构信息

The University of Queensland, Pathways Health and Research Centre, Brisbane.

出版信息

J Clin Child Adolesc Psychol. 2008 Jan;37(1):131-55. doi: 10.1080/15374410701817956.

Abstract

Child and adolescent obsessive-compulsive disorder (OCD) is a chronic and debilitating condition associated with a wide range of impairments. This article briefly discusses the phenomenology of OCD, the theory underlying current treatment approaches, and the extant psychosocial treatment literature for child and adolescent OCD relative to the criteria for classification as an evidence-based intervention. Studies were evaluated for methodological rigor according to the classification system of Nathan and Gorman (2002) and then were assessed relative to the criteria for evidence-based treatments specified by Chambless et al. (1998), Chambless et al. (1996), and Chambless and Hollon (1998). Results from exposure-based cognitive behavioral therapy (CBT) trials with children and adolescents have been consistent, with remission rates of the disorder ranging from 40% to 85% across studies. Findings from this review indicate that individual exposure-based CBT for child and adolescent OCD can be considered as a probably efficacious treatment. CBT delivered in a family-focused individual or group format can be considered as a possibly efficacious treatment. Moderators, mediators, and predictors of treatment outcome are discussed, as are implications and generalizability of extant findings to real-world settings. We conclude with recommendations for best practice and future research directions.

摘要

儿童和青少年强迫症(OCD)是一种慢性且使人衰弱的疾病,与多种损害相关。本文简要讨论了强迫症的现象学、当前治疗方法的理论基础,以及相对于循证干预分类标准而言,现有的关于儿童和青少年强迫症的心理社会治疗文献。根据内森和戈尔曼(2002年)的分类系统对研究的方法严谨性进行了评估,然后根据钱布利斯等人(1998年)、钱布利斯等人(1996年)以及钱布利斯和霍伦(1998年)规定的循证治疗标准进行了评估。针对儿童和青少年的基于暴露的认知行为疗法(CBT)试验结果一直较为一致,各项研究中该疾病的缓解率在40%至85%之间。本次综述的结果表明,针对儿童和青少年强迫症的个体基于暴露的CBT可被视为一种可能有效的治疗方法。以家庭为重点的个体或团体形式提供的CBT可被视为一种可能有效的治疗方法。文中讨论了治疗结果的调节因素、中介因素和预测因素,以及现有研究结果对现实世界环境的影响和普遍性。我们最后提出了最佳实践建议和未来研究方向。

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