South London and Maudsley NHS Trust, UK.
Behav Cogn Psychother. 2013 May;41(3):344-58. doi: 10.1017/S1352465812000343. Epub 2012 Jul 5.
Over half of children in the general population report unusual or "psychotic-like" experiences (PLEs). The development of a later at-risk mental state is associated with persistent, distressing, PLEs, which are appraised negatively and hard to cope with. We have designed a novel, manualized, cognitive behavioural intervention for children aged 9 to 14 years, which aims to reduce emotional problems, improve coping and resilience, and help children manage PLEs, before an identifiable psychosis risk develops. We report on the feasibility, acceptability and clinical impact of the intervention.
Four children who reported PLEs and emotional problems in a community survey completed the intervention, and gave detailed feedback. Clinical outcomes were assessed before, during, and after therapy.
Emotional problems, PLE frequency, and PLE impact all decreased during the intervention. Child and therapist satisfaction with the treatment was high.
It is feasible, acceptable and helpful to offer psychological interventions to children who report emotional distress and PLEs, prior to the emergence of clear risk factors. Our intervention has the potential to increase resilience to the development of future mental health problems. A larger, randomized controlled evaluation is underway.
超过一半的普通儿童报告出现异常或“类精神病”体验(PLE)。与持续存在、令人痛苦的 PLE 相关的是以后出现高危精神状态,这些体验被负面评估且难以应对。我们为 9 至 14 岁的儿童设计了一种新颖的、规范化的认知行为干预措施,旨在减少情绪问题,提高应对能力和韧性,并帮助儿童在出现可识别的精神病风险之前管理 PLE。我们报告了干预措施的可行性、可接受性和临床效果。
在社区调查中报告出现 PLE 和情绪问题的 4 名儿童完成了干预措施,并提供了详细的反馈。在治疗前、治疗中和治疗后评估临床结果。
情绪问题、PLE 频率和 PLE 影响在干预过程中均有所下降。儿童和治疗师对治疗的满意度很高。
在出现明确的风险因素之前,为出现情绪困扰和 PLE 的儿童提供心理干预是可行、可接受且有益的。我们的干预措施有可能提高对未来心理健康问题发展的韧性。一项更大的随机对照评估正在进行中。