a Department of Psychology , University of Pittsburgh.
b Department of Psychiatry , University of Pittsburgh School of Medicine.
J Clin Child Adolesc Psychol. 2018 Jul-Aug;47(4):542-554. doi: 10.1080/15374416.2016.1138408. Epub 2016 Mar 16.
This study compared individual cognitive behavioral therapy (CBT) and a supportive child-centered therapy (CCT) for child anxiety disorders on rates of treatment response and recovery at posttreatment and 1-year follow-up, as well as on real-world measures of emotional functioning. Youth (N = 133; ages 9-14) with anxiety disorders (generalized, separation, and/or social anxiety) were randomized using a 2:1 ratio to CBT (n = 90) or CCT (n = 43), which served as an active comparison. Treatment response and recovery at posttreatment and 1-year follow-up were assessed by Independent Evaluators, and youth completed ecological momentary assessment of daily emotions throughout treatment. The majority of youth in both CBT and CCT were classified as treatment responders (71.1% for CBT, 55.8% for CCT), but youth treated with CBT were significantly more likely to fully recover, no longer meeting diagnostic criteria for any of the targeted anxiety disorders and no longer showing residual symptoms (66.7% for CBT vs. 46.5% for CCT). Youth treated with CBT also reported significantly lower negative emotions associated with recent negative events experienced in daily life during the latter stages of treatment relative to youth treated with CCT. Furthermore, a significantly higher percentage of youth treated with CBT compared to CCT were in recovery at 1-year follow-up (82.2% for CBT vs. 65.1% for CCT). These findings indicate potential benefits of CBT above and beyond supportive therapy on the breadth, generalizability, and durability of treatment-related gains.
本研究比较了个体认知行为疗法(CBT)和支持性以儿童为中心的疗法(CCT)治疗儿童焦虑障碍的疗效,包括治疗后和 1 年随访时的治疗反应和恢复率,以及情绪功能的实际测量。采用 2:1 的比例,将患有广泛性、分离性和/或社交性焦虑障碍的青少年(N=133;年龄 9-14 岁)随机分配到 CBT(n=90)或 CCT(n=43)组,后者作为活性对照。由独立评估者评估治疗后和 1 年随访时的治疗反应和恢复情况,青少年在整个治疗过程中完成日常生活中情绪的生态瞬间评估。CBT 和 CCT 组中的大多数青少年都被归类为治疗反应者(CBT 组为 71.1%,CCT 组为 55.8%),但接受 CBT 治疗的青少年更有可能完全康复,不再符合任何目标焦虑障碍的诊断标准,且不再有残留症状(CBT 组为 66.7%,CCT 组为 46.5%)。与接受 CCT 治疗的青少年相比,在治疗后期,接受 CBT 治疗的青少年报告的与日常生活中最近的负面事件相关的负面情绪显著降低。此外,与 CCT 相比,接受 CBT 治疗的青少年在 1 年随访时恢复的比例显著更高(CBT 组为 82.2%,CCT 组为 65.1%)。这些发现表明,CBT 除了支持性治疗外,在治疗相关收益的广度、普遍性和持久性方面具有潜在优势。