创伤后青少年治疗中父母情绪反应和抑郁的变化及其中介作用：一项随机对照研究的结果。
The change and the mediating role of parental emotional reactions and depression in the treatment of traumatized youth: results from a randomized controlled study.
机构信息
Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), P.O. Box 181, Nydalen, 0409 Oslo, Norway.
Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), P.O. Box 181, Nydalen, 0409 Oslo, Norway ; Department of Psychology, University of Oslo, P.O. Box 1094, Blindern, 0317 Oslo, Norway.
出版信息
Child Adolesc Psychiatry Ment Health. 2014 Apr 8;8:11. doi: 10.1186/1753-2000-8-11. eCollection 2014.
BACKGROUND
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) has been shown to efficiently treat children and youth exposed to traumatizing events. However, few studies have looked into mechanisms that may distinguish this treatment from other treatments. The objective of this study was to investigate whether the parents' emotional reactions and depressive symptoms change over the course of therapy in the treatment conditions of TF-CBT and Therapy as Usual (TAU), and whether changes in the reactions mediate the difference between the treatment conditions on child post-traumatic stress (PTS) symptoms and child depressive symptoms.
METHOD
A sample of 135 caregivers of 135 traumatized children and youth (M age = 14.8, SD = 2.2, 80% girls) was randomly assigned to receive either TF-CBT or TAU. The parents' emotional reactions were measured using the Parental Emotional Reaction Questionnaire (PERQ), and their depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D). The children's outcomes were post-traumatic stress (PTS) reactions and depression, as measured by the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA) and Mood and Feelings Questionnaire (MFQ), respectively.
RESULTS
The parents' emotional reactions and depressive symptoms decreased significantly from pre- to post-therapy, but no significant differences between the two treatment conditions were found. The changes in reactions did not significantly mediate the treatment difference between TF-CBT and TAU on child PTS symptoms. However a mediating effect was found on child depressive symptoms.
CONCLUSION
The results showed that although the parents experienced reductions in emotional reactions and depressive symptoms when their child received therapy, this was only significantly related to the difference in outcome between TF-CBT and TAU on child depressive symptoms. Possible explanations for these results are discussed along with the implications for clinicians and suggestions for future research.
CLINICAL TRIALS IDENTIFIER
NCT00635752.
背景
创伤焦点认知行为疗法（TF-CBT）已被证明能有效地治疗经历创伤性事件的儿童和青少年。然而，很少有研究探讨可能使这种治疗方法区别于其他治疗方法的机制。本研究的目的是调查在 TF-CBT 和常规治疗（TAU）的治疗条件下，父母的情绪反应和抑郁症状是否会随着治疗过程而改变，以及反应的变化是否在治疗条件对儿童创伤后应激（PTS）症状和儿童抑郁症状的影响中起中介作用。
方法
随机抽取 135 名创伤后儿童和青少年（M 年龄=14.8，SD=2.2，80%为女孩）的 135 名照顾者作为样本，他们被分配接受 TF-CBT 或 TAU 治疗。父母的情绪反应通过父母情绪反应问卷（PERQ）进行测量，他们的抑郁症状通过流行病学研究中心抑郁量表（CES-D）进行测量。儿童的结果通过儿童青少年创伤后应激障碍临床评定量表（CAPS-CA）和心境与情感问卷（MFQ）分别测量 PTS 反应和抑郁症状。
结果
父母的情绪反应和抑郁症状从治疗前到治疗后均显著下降，但两种治疗条件之间没有发现显著差异。反应的变化对 TF-CBT 和 TAU 治疗儿童 PTS 症状的差异没有显著的中介作用。然而，在儿童抑郁症状方面发现了中介效应。
结论
结果表明，尽管儿童接受治疗时父母的情绪反应和抑郁症状有所减轻，但这仅与 TF-CBT 和 TAU 治疗儿童抑郁症状的结果差异显著相关。对这些结果的可能解释进行了讨论，并对临床医生提出了建议，同时也为未来的研究提供了思路。
临床试验标识符
NCT00635752。
Zotero 插件