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认知行为治疗中强化疗程对儿童和青少年情绪及焦虑障碍的疗效。

The effectiveness of booster sessions in CBT treatment for child and adolescent mood and anxiety disorders.

机构信息

Columbia University, 1255 Amsterdam Avenue, New York, NY 10027, USA.

出版信息

Depress Anxiety. 2013 Sep;30(9):800-8. doi: 10.1002/da.22118. Epub 2013 Apr 17.

Abstract

BACKGROUND

To investigate the effects of booster sessions in cognitive behavioral therapy (CBT) for children and adolescents with mood or anxiety disorders, whereas controlling for youth demographics (e.g., gender, age), primary diagnosis, and intervention characteristics (e.g., treatment modality, number of sessions).

METHODS

Electronic databases were searched for CBT interventions for youth with mood and anxiety disorders. Fifty-three (k = 53) studies investigating 1,937 youth met criteria for inclusion. Booster sessions were examined using two case-controlled effect sizes: pre-post and pre-follow-up (6 months) effect sizes and employing weighted least squares (WLSs) regressions.

RESULTS

Meta-analyses found pre-post studies with booster sessions had a larger effect size r = .58 (k = 15; 95% CI = 0.52-0.65; P < .01) than those without booster sessions r = .45 (k = 38; 95% CI = 0.41-0.49; P < .001). In the WLS regression analyses, controlling for demographic factors, primary diagnosis, and intervention characteristics, studies with booster sessions showed larger pre-post effect sizes than those without booster sessions (B = 0.13, P < .10). Similarly, pre-follow-up studies with booster sessions showed a larger effect size r = .64 (k = 10; 95% CI = 0.57-0.70; P < .10) than those without booster sessions r = .48 (k = 20; 95% CI = 0.42-0.53; P < .01). Also, in the WLS regression analyses, pre-follow-up studies showed larger effect sizes than those without booster sessions (B = 0.08, P < .01) after accounting for all control variables.

CONCLUSIONS

Result suggests that CBT interventions with booster sessions are more effective and the effect is more sustainable for youth managing mood or anxiety disorders than CBT interventions without booster sessions.

摘要

背景

为了研究在认知行为疗法(CBT)中为患有情绪或焦虑障碍的儿童和青少年增加强化疗程的效果,同时控制青年人口统计学因素(例如,性别、年龄)、主要诊断和干预特征(例如,治疗方式、疗程数)。

方法

电子数据库中搜索了针对患有情绪和焦虑障碍的年轻人的 CBT 干预措施。符合纳入标准的 53 项研究共纳入了 1937 名年轻人。使用两种病例对照效应量来检查强化疗程:前后测和随访(6 个月)效应量,并采用加权最小二乘法(WLS)回归。

结果

荟萃分析发现,有强化疗程的前后测研究的效应量 r 为.58(k=15;95%置信区间为 0.52-0.65;P<.01),比没有强化疗程的研究 r 为.45(k=38;95%置信区间为 0.41-0.49;P<.001)更大。在 WLS 回归分析中,在控制人口统计学因素、主要诊断和干预特征的情况下,有强化疗程的研究显示出比没有强化疗程的研究更大的前后测效应量(B=0.13,P<.10)。同样,有强化疗程的随访前研究的效应量 r 为.64(k=10;95%置信区间为 0.57-0.70;P<.10)大于没有强化疗程的 r 为.48(k=20;95%置信区间为 0.42-0.53;P<.01)。此外,在 WLS 回归分析中,在考虑了所有控制变量后,随访前研究显示出比没有强化疗程的研究更大的效应量(B=0.08,P<.01)。

结论

结果表明,与没有强化疗程的 CBT 干预相比,有强化疗程的 CBT 干预对患有情绪或焦虑障碍的年轻人更有效,效果更持久。

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