University of California, Los Angeles, Department of Psychology, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA.
Behav Res Ther. 2013 Sep;51(9):564-72. doi: 10.1016/j.brat.2013.05.012. Epub 2013 Jun 8.
Sudden gains have been described as rapid, sizeable changes observed between treatment sessions and have been associated with improved treatment outcome in adults. The current study examined weekly sudden gains among children seeking treatment in the community mental health setting.
Participants were 161 children (age M = 10.58, SD = 1.73; 69.6% male; 47.8% Caucasian) and their parents who were randomized to one of three treatment modalities and were administered weekly and quarterly assessments throughout treatment.
When idiographic (youth- and parent-identified "top problems") and nomothetic measures (standardized checklists) were used to calculate sudden gains (i.e., gain must be large: in absolute terms, relative to prior session, and relative to changes in prior and subsequent sessions), 20-42% of participants experienced at least one sudden gain during treatment. Most sudden gains occurred early in treatment, and session content of relaxation was associated with sudden gain presence. Using a modified Bonferonni correction, sudden gains predicted overall symptom levels at final assessment (i.e., last assessment obtained following post-treatment) even after controlling for pre-treatment symptom levels and magnitude of the overall gain from pre- to post-treatment.
Suddenness of gains may have a direct effect on long-term treatment outcome among children in the community.
突获被描述为在治疗期间观察到的快速、显著的变化，并与成年人治疗效果的改善相关。本研究考察了在社区心理健康环境中寻求治疗的儿童每周的突获情况。
参与者为 161 名儿童（年龄 M = 10.58，SD = 1.73；69.6%为男性；47.8%为白种人）及其父母，他们被随机分配到三种治疗方式之一，并在整个治疗过程中接受每周和每季度的评估。
当使用特质（青年和父母确定的“首要问题”）和量质（标准化检查表）来计算突获（即，增益必须大：绝对值、相对于前一次会话，以及相对于前一次和后一次会话的变化）时，20-42%的参与者在治疗过程中至少经历了一次突获。大多数突获发生在治疗早期，放松课程的内容与突获的出现有关。使用修正后的 Bonferroni 校正，突获预测了最终评估（即，治疗后获得的最后一次评估）时的总体症状水平，即使在控制了治疗前的症状水平和从治疗前到治疗后的总体增益幅度之后也是如此。
在社区中，儿童治疗效果的突获速度可能对长期治疗结果有直接影响。
