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基于人格的、教师实施的干预对青少年内化和外化问题的两年影响:一项聚类随机试验。

Two-year impact of personality-targeted, teacher-delivered interventions on youth internalizing and externalizing problems: a cluster-randomized trial.

机构信息

McGill University.

出版信息

J Am Acad Child Adolesc Psychiatry. 2013 Sep;52(9):911-20. doi: 10.1016/j.jaac.2013.05.020. Epub 2013 Jul 31.

Abstract

OBJECTIVE

To assess the 2-year impact of teacher-delivered, brief, personality-targeted interventions on internalizing and externalizing symptoms in an adolescent U.K. sample.

METHOD

This cluster-randomized trial was run in 19 London schools (N = 1,024 adolescents). Trained school-based professionals delivered two 90-minute, CBT-based group interventions targeting 1 of 4 personality-risk profiles: anxiety sensitivity, hopelessness, impulsivity, or sensation seeking. Self-report depression, anxiety, and conduct disorder symptoms were assessed at 6-month intervals.

RESULTS

Interventions were associated with significantly reduced depressive, anxiety, and conduct symptoms (p < .05) over 2 years in the full sample, reduced odds of severe depressive symptoms (odds ratio [OR] = 0.74, CI = 0.58-0.96), and conduct problems (OR = 0.79, CI = 0.65-0.96), and a nonsignificant reduction in severe anxiety symptoms (OR = 0.79, CI = 0.59-1.05). Evaluating a priori personality-specific hypotheses revealed strong evidence for impulsivity-specific effects on severe conduct problems, modest evidence of anxiety sensitivity-specific effects on severe anxiety, and no evidence for hopelessness-specific effects on severe depressive symptoms.

CONCLUSIONS

Brief, personality-targeted interventions delivered by educational professionals can have a clinically significant impact on mental health outcomes in high-risk youth over 2 years, as well as personality-specific intervention effects in youth most at risk for a particular problem, particularly for youth with high levels of impulsivity. Clinical trial registration information-Adventure: The Efficacy of Personality-Targeted Interventions for Substance Misuse and Other Risky Behaviors as Delivered by Educational Professionals.

摘要

目的

评估教师实施的、简短的、针对个性的干预措施对英国青少年内化和外化症状的 2 年影响。

方法

这项聚类随机试验在伦敦的 19 所学校(N=1024 名青少年)进行。经过培训的学校专业人员提供了两种 90 分钟的、基于认知行为疗法的小组干预措施,针对 4 种个性风险特征中的 1 种:焦虑敏感、绝望、冲动或寻求刺激。使用自我报告的抑郁、焦虑和品行障碍症状在 6 个月的间隔时间进行评估。

结果

在整个样本中,干预措施与抑郁、焦虑和品行障碍症状在 2 年内显著降低(p<.05),严重抑郁症状(优势比[OR] = 0.74,CI = 0.58-0.96)和品行问题(OR = 0.79,CI = 0.65-0.96)的发生几率降低,严重焦虑症状(OR = 0.79,CI = 0.59-1.05)略有降低。评估预先设定的个性特定假设显示,冲动个性特异性对严重品行问题有很强的证据,焦虑敏感个性特异性对严重焦虑有适度的证据,而绝望个性特异性对严重抑郁症状没有证据。

结论

由教育专业人员提供的简短、针对个性的干预措施在 2 年内对高危青少年的心理健康结果有显著的影响,并且对最有可能出现特定问题的青少年具有个性特异性干预效果,特别是对冲动水平较高的青少年。临床试验注册信息-冒险:教育专业人员提供的针对物质滥用和其他风险行为的个性靶向干预的疗效。

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