Battagliese Gemma, Caccetta Maria, Luppino Olga Ines, Baglioni Chiara, Cardi Valentina, Mancini Francesco, Buonanno Carlo
Scuola di Psicoterapia Cognitiva S.r.l., Viale Castro Pretorio 116, 00185, Roma, Italy; Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185, Rome, Italy.
Scuola di Psicoterapia Cognitiva S.r.l., Viale Castro Pretorio 116, 00185, Roma, Italy.
Behav Res Ther. 2015 Dec;75:60-71. doi: 10.1016/j.brat.2015.10.008. Epub 2015 Nov 3.
Externalizing disorders are the most common and persistent forms of maladjustment in childhood. The aim of this study was to conduct a meta-analysis evaluating the effectiveness of Cognitive Behavioral Therapy (CBT) to reduce externalizing symptoms in two disorders: Attention Deficit Hyperactivity Disorder (ADHD) and Oppositive Defiant Disorder (ODD). The efficacy of CBT to improve social competence and positive parenting and reduce internalizing behaviors, parent stress and maternal depression was also explored. The database PsycInfo, PsycARTICLES, Medline and PubMed were searched to identify relevant studies. Twenty-one trials met the inclusion criteria. Results showed that the biggest improvement, after CBT, was in ODD symptoms (-0.879) followed by parental stress (-0.607), externalizing symptoms (-0.52), parenting skills (-0.381), social competence (-0.390) and ADHD symptoms (-0.343). CBT was also associated with improved attention (-0.378), aggressive behaviors (-0.284), internalizing symptoms (-0.272) and maternal depressive symptoms (-0.231). Overall, CBT is an effective treatment option for externalizing disorders and is also associated with reduced parental distress and maternal depressive symptoms. Multimodal treatments targeting both children and caregivers' symptoms (e.g. maternal depressive symptoms) appear important to produce sustained and generalized benefits.
外化性障碍是儿童期最常见且持续存在的适应不良形式。本研究的目的是进行一项荟萃分析，评估认知行为疗法（CBT）对减少两种障碍（注意力缺陷多动障碍（ADHD）和对立违抗障碍（ODD））外化症状的有效性。还探讨了CBT在提高社交能力、积极养育以及减少内化行为、父母压力和母亲抑郁方面的疗效。检索了数据库PsycInfo、PsycARTICLES、Medline和PubMed以识别相关研究。21项试验符合纳入标准。结果显示，接受CBT后改善最大的是ODD症状（-0.879），其次是父母压力（-0.607）、外化症状（-0.52）、养育技能（-0.381）、社交能力（-0.390）和ADHD症状（-0.343）。CBT还与注意力改善（-0.378）、攻击行为（-0.284）、内化症状（-0.272）和母亲抑郁症状（-0.231）相关。总体而言，CBT是治疗外化性障碍的有效选择，还与父母痛苦和母亲抑郁症状的减轻相关。针对儿童和照顾者症状（如母亲抑郁症状）的多模式治疗对于产生持续和广泛的益处似乎很重要。
