Afshari Afrooz, Neshat-Doost Hamid Taher, Maracy Mohammad Reza, Ahmady Mozhgan Kar, Amiri Shole
Ph.D. Student of Psychology, Department of Psychology, University of Isfahan, Isfahan, Iran.
Department of Epidemiology, Isfahan University of Medical Science, Isfahan, Iran.
J Res Med Sci. 2014 Mar;19(3):221-7.
Emotion-focused cognitive behavioral therapy (ECBT) is a new form of CBT with emotion regulation components. This form of treatment is suggested to be employed to improve dysregulation of anxiety and other kind of emotions in anxious children. This study observed and compared the effectiveness of CBT and ECBT on anxiety symptoms; sadness and anger management; and cognitive emotion regulation strategies in children with separation anxiety disorder (SAD).
This study is a randomized clinical trial. Subjects were 30 children from 9 to 13-years-old (15 girls and 15 boys) with diagnosis of SAD, being randomly assigned to CBT, ECBT, and control groups (five girls and five boys in each group). Subject children in CBT group participated in 10-h weekly sessions within Coping Cat manual; whereas, subject children in ECBT group contributed in 12-h weekly sessions within ECBT. The control group received no treatment. The Screen for Child Anxiety Related Emotional Disorders (SCARED; child and parent forms), Children's Emotion Management Scale (CEMS; anger and sadness forms), and Cognitive Emotion Regulation Questionnaire (CERQ) tests administered to all subjects in pretest, posttest, and the follow-up measurement (3 months later). Analysis of covariance (ANCOVA) repeated measure and Kruskal-Wallis were applied to analyze data by Statistical Package for Social Sciences (SPSS) software package (v. 20).
CBT and ECBT; demonstrated no significant difference in reducing separation anxiety and total anxiety symptoms from parent and children's reports. ECBT effectively increased anger coping and decreased negative cognitive strategies and dysregulation of anger in children, both in posttest and follow-up. Also, ECBT reduced sadness dysregulation and increased sadness coping, though these significant advantages were lost in 3 months later follow-up. CBT reduced negative cognitive strategies in follow-up and increased sadness coping in posttest. None of treatments affected on anger and sadness inhibition and positive cognitive coping in separation anxious children.
ECBT, in comparison with CBT; effectively improved emotion regulation strategies in children with separation anxiety.
以情绪为中心的认知行为疗法（ECBT）是一种具有情绪调节成分的新型认知行为疗法。建议采用这种治疗形式来改善焦虑儿童的焦虑失调和其他情绪失调。本研究观察并比较了认知行为疗法（CBT）和以情绪为中心的认知行为疗法（ECBT）对分离焦虑症（SAD）儿童焦虑症状、悲伤和愤怒管理以及认知情绪调节策略的有效性。
本研究为随机临床试验。研究对象为30名9至13岁的儿童（15名女孩和15名男孩），诊断为分离焦虑症，随机分为认知行为疗法组、以情绪为中心的认知行为疗法组和对照组（每组5名女孩和5名男孩）。认知行为疗法组的受试儿童按照《应对猫手册》参加每周10小时的课程；而以情绪为中心的认知行为疗法组的受试儿童参加每周12小时的以情绪为中心的认知行为疗法课程。对照组未接受治疗。在预测试、后测试和随访测量（3个月后）对所有受试者进行儿童焦虑相关情绪障碍筛查量表（SCARED；儿童版和家长版）、儿童情绪管理量表（CEMS；愤怒和悲伤版）以及认知情绪调节问卷（CERQ）测试。采用协方差分析（ANCOVA）重复测量和Kruskal-Wallis检验，通过社会科学统计软件包（SPSS）软件包（版本20）对数据进行分析。
认知行为疗法和以情绪为中心的认知行为疗法在减轻家长和儿童报告中的分离焦虑和总焦虑症状方面无显著差异。以情绪为中心的认知行为疗法在测试后和随访中均有效提高了儿童的愤怒应对能力，减少了消极认知策略和愤怒失调。此外，以情绪为中心的认知行为疗法减少了悲伤失调，提高了悲伤应对能力，尽管这些显著优势在3个月后的随访中消失。认知行为疗法在随访中减少了消极认知策略，在测试后提高了悲伤应对能力。没有一种治疗方法对分离焦虑儿童的愤怒和悲伤抑制以及积极认知应对有影响。
与认知行为疗法相比，以情绪为中心的认知行为疗法有效改善了分离焦虑儿童的情绪调节策略。
