Chronis-Tuscano Andrea, Rubin Kenneth H, O'Brien Kelly A, Coplan Robert J, Thomas Sharon Renee, Dougherty Lea R, Cheah Charissa S L, Watts Katie, Heverly-Fitt Sara, Huggins Suzanne L, Menzer Melissa, Begle Annie Schulz, Wimsatt Maureen
Department of Psychology, University of Maryland, College Park.
Department of Psychology, Carleton University.
J Consult Clin Psychol. 2015 Jun;83(3):534-40. doi: 10.1037/a0039043. Epub 2015 Mar 23.
Approximately 15%-20% of young children can be classified as having a behaviorally inhibited (BI) temperament. Stable BI predicts the development of later anxiety disorders (particularly social anxiety), but not all inhibited children develop anxiety. Parenting characterized by inappropriate warmth/sensitivity and/or intrusive control predicts the stability of BI and moderates risk for anxiety among high-BI children. For these reasons, we developed and examined the preliminary efficacy of the Turtle Program: a multimodal early intervention for inhibited preschool-age children.
Forty inhibited children between the ages of 42-60 months and their parent(s) were randomized to either the Turtle Program (n = 18) or a waitlist control (WLC; n = 22) condition. Participants randomized to the Turtle Program condition received 8 weeks of concurrent parent and child group treatment. Participants were assessed at baseline and posttreatment with multisource assessments, including parent and teacher report measures of child anxiety, diagnostic interviews, and observations of parenting behavior.
The Turtle Program resulted in significant beneficial effects relative to the WLC condition on maternal-reported anxiety symptoms of medium to large magnitude; large effects on parent-reported BI; medium to large effects on teacher-rated school anxiety symptoms; and medium effects on observed maternal positive affect/sensitivity.
This study provides encouraging preliminary support for the Turtle Program for young behaviorally inhibited children. Effects of the Turtle Program generalized to the school setting. Future studies should examine whether this early intervention program improves long-term developmental outcomes for this at-risk group.
约15%-20%的幼儿可被归类为具有行为抑制（BI）气质。稳定的BI预示着后期焦虑症（尤其是社交焦虑症）的发展，但并非所有抑制型儿童都会发展为焦虑症。以不适当的温暖/敏感性和/或侵入性控制为特征的养育方式预示着BI的稳定性，并调节高BI儿童患焦虑症的风险。基于这些原因，我们开发并检验了海龟计划的初步疗效：这是一项针对抑制型学龄前儿童的多模式早期干预措施。
40名年龄在42至60个月之间的抑制型儿童及其父母被随机分为海龟计划组（n = 18）或等待名单对照组（WLC；n = 22）。随机分配到海龟计划组的参与者接受为期8周的亲子小组联合治疗。在基线和治疗后通过多源评估对参与者进行评估，包括父母和教师对儿童焦虑的报告测量、诊断访谈以及养育行为观察。
与WLC组相比，海龟计划对母亲报告的中度至重度焦虑症状产生了显著的有益影响；对父母报告的BI产生了很大影响；对教师评定的学校焦虑症状产生了中度至很大影响；对观察到的母亲积极情感/敏感性产生了中度影响。
本研究为针对行为抑制型幼儿的海龟计划提供了令人鼓舞的初步支持。海龟计划的效果推广到了学校环境。未来的研究应检验这一早期干预计划是否能改善这一高危群体的长期发展结果。
