Department of Psychology, University of Miami, United States.
Center for Anxiety and Related Disorders, Boston University, United States.
J Anxiety Disord. 2014 Aug;28(6):511-21. doi: 10.1016/j.janxdis.2014.05.007. Epub 2014 Jun 2.
Anxiety and depressive disorders commonly co-occur during adolescence, share multiple vulnerability factors, and respond to similar psychosocial and pharmacological interventions. However, anxiety and depression may also be considered distinct constructs and differ on some underlying properties. Prior research efforts on evidence-based treatments for youth have been unable to examine the concurrent trajectories of primary anxiety and depressive concerns across the course of treatment. The advent of transdiagnostic approaches for these emotional disorders in youth allows for such examination. The present study examined the separate trajectories of adolescent anxiety and depressive symptoms over the course of a transdiagnostic intervention, the Unified Protocol for the Treatment of Emotional Disorders in Adolescence (UP-A; Ehrenreich et al., 2008), as well as up to six months following treatment. The sample included 59 adolescents ages 12-17 years old (M=15.42, SD=1.71) who completed at least eight sessions of the UP-A as part of an open trial or randomized, controlled trial across two treatment sites. Piecewise latent growth curve analyses found adolescent self-rated anxiety and depressive symptoms showed similar rates of improvement during treatment, but while anxiety symptoms continued to improve during follow-up, depressive symptoms showed non-significant improvement after treatment. Parent-rated symptoms also showed similar rates of improvement for anxiety and depression during the UP-A to those observed for adolescent self-report, but little improvement after treatment across either anxiety or depressive symptoms. To a certain degree, the results mirror those observed among other evidence-based treatments for youth with anxiety and depression, though results hold implications for future iterations of transdiagnostic treatments regarding optimization of outcomes for adolescents with depressive symptoms.
焦虑症和抑郁症在青少年时期常常同时发生，它们具有许多共同的脆弱性因素，并对相似的心理社会和药物干预措施有反应。然而，焦虑症和抑郁症也可以被视为不同的结构，在一些潜在的特征上存在差异。先前针对青少年基于证据的治疗方法的研究工作，无法在治疗过程中同时检查主要的焦虑和抑郁问题的并发轨迹。针对这些青少年情绪障碍的跨诊断方法的出现，使得这种检查成为可能。本研究考察了跨诊断干预措施——青少年情绪障碍统一治疗方案（UP-A；Ehrenreich 等人，2008 年）治疗过程中以及治疗结束后六个月内，青少年焦虑和抑郁症状的单独轨迹。该样本包括 59 名年龄在 12 至 17 岁之间的青少年（M=15.42，SD=1.71），他们在两个治疗地点的开放式试验或随机对照试验中完成了至少 8 节 UP-A 的治疗。分段潜在增长曲线分析发现，青少年自我报告的焦虑和抑郁症状在治疗期间有相似的改善速度，但在治疗后焦虑症状继续改善，而抑郁症状在治疗后没有显著改善。父母评定的症状在 UP-A 期间对焦虑和抑郁的改善率与青少年自我报告观察到的相似，但在焦虑或抑郁症状方面，治疗后改善不大。在某种程度上，这些结果与其他针对青少年焦虑和抑郁的基于证据的治疗方法观察到的结果相似，但这些结果对未来的跨诊断治疗迭代提出了优化有抑郁症状的青少年治疗结果的问题。
