Clinic and Polyclinic for Psychiatry, Psychosomatic and Psychotherapy for Children and Adolescents, University of Wuerzburg, Fuechsleinstr, 15, 97080 Wuerzburg, Germany.
Child Adolesc Psychiatry Ment Health. 2011 Feb 28;5(1):5. doi: 10.1186/1753-2000-5-5.
Although literature provides support for cognitive behavioral therapy (CBT) as an efficacious intervention for social phobia, more research is needed to improve treatments for children.
Forty four Caucasian children (ages 8-14) meeting diagnostic criteria of social phobia according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; APA, 1994) were randomly allocated to either a newly developed CBT program focusing on cognition according to the model of Clark and Wells (n = 21) or a wait-list control group (n = 23). The primary outcome measure was clinical improvement. Secondary outcomes included improvements in anxiety coping, dysfunctional cognitions, interaction frequency and comorbid symptoms. Outcome measures included child report and clinican completed measures as well as a diagnostic interview.
Significant differences between treatment participants (4 dropouts) and controls (2 dropouts) were observed at post test on the German version of the Social Phobia and Anxiety Inventory for Children. Furthermore, in the treatment group, significantly more children were free of diagnosis than in wait-list group at post-test. Additional child completed and clinician completed measures support the results.
The study is a first step towards investigating whether CBT focusing on cognition is efficacious in treating children with social phobia. Future research will need to compare this treatment to an active treatment group. There remain the questions of whether the effect of the treatment is specific to the disorder and whether the underlying theoretical model is adequate.
Preliminary support is provided for the efficacy of the cognitive behavioral treatment focusing on cognition in socially phobic children. Active comparators should be established with other evidence-based CBT programs for anxiety disorders, which differ significantly in their dosage and type of cognitive interventions from those of the manual under evaluation (e.g. Coping Cat).
尽管文献支持认知行为疗法（CBT）作为社交恐惧症的有效干预措施，但仍需要更多的研究来改进儿童的治疗方法。
44 名符合《精神障碍诊断与统计手册》（第 4 版；APA，1994）社交恐惧症诊断标准的白种人儿童（年龄 8-14 岁）被随机分配到新开发的 CBT 方案中，该方案侧重于根据克拉克和威尔斯的模型进行认知（n = 21）或等待名单对照组（n = 23）。主要结局指标是临床改善。次要结局包括焦虑应对、功能失调认知、互动频率和共病症状的改善。结局指标包括儿童报告和临床医生完成的测量以及诊断访谈。
在治疗组（4 名辍学）和对照组（2 名辍学）的儿童社交恐惧症和焦虑量表德国版本的测试后，治疗参与者和对照组之间存在显著差异。此外，在治疗组中，与等待名单组相比，更多的儿童在测试后无诊断。额外的儿童完成和临床医生完成的措施支持了这些结果。
该研究是调查认知为重点的 CBT 是否对治疗社交恐惧症儿童有效。未来的研究将需要将这种治疗方法与积极治疗组进行比较。仍然存在一些问题，即治疗的效果是否特定于该疾病，以及潜在的理论模型是否足够。
初步支持认知为重点的 CBT 治疗对社交恐惧症儿童的疗效。应与其他基于证据的焦虑症 CBT 方案建立积极对照者，这些方案在剂量和认知干预类型上与正在评估的手册有显著差异（例如，Coping Cat）。
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