a Department of Psychology and Human Development , Vanderbilt University.
b Department of Psychology , University of Vermont.
J Clin Child Adolesc Psychol. 2018 Jul-Aug;47(4):581-594. doi: 10.1080/15374416.2016.1225503. Epub 2016 Oct 21.
The current study examined effects of a preventive intervention on patterns of change in symptoms of anxiety and depression in a sample of children of depressed parents. Parents with a history of depression (N = 180) and their children (N = 242; 50% female; M = 11.38; 74% Euro-American) enrolled in an intervention to prevent psychopathology in youth. Families were randomized to a family group cognitive behavioral intervention (FGCB) or a written information (WI) control condition. Parents and youth completed the Child Behavior Checklist and Youth Self Report at baseline, 6-, 12-, 18-, and 24-month follow up. Youth in the FGCB intervention reported significantly greater declines in symptoms of both anxiety and depression at 6, 12, and 18 months compared to youth in the WI condition. Youth with higher baseline levels of each symptom (e.g., anxiety) reported greater declines in the other symptom (e.g., depression) from 0 to 6 months in the FGCB intervention only. Changes in anxiety symptoms from 0 to 6 months predicted different patterns of subsequent changes in depressive symptoms from 6 to 12 months for the two conditions, such that declines in anxiety preceded and predicted greater declines in depression for FGCB youth but lesser increases in depression for WI youth. Findings inform transdiagnostic approaches to preventive interventions for at-risk youth, suggesting that both initial symptom levels and initial magnitude of change in symptoms are important to understand subsequent patterns of change in response to intervention.
本研究考察了预防干预对抑郁父母的孩子的焦虑和抑郁症状变化模式的影响。有抑郁病史的父母(N=180)及其子女(N=242;50%为女性;M=11.38;74%为欧裔美国人)参加了预防青年精神病理学的干预措施。家庭被随机分配到家庭组认知行为干预(FGCB)或书面信息(WI)对照组。父母和青少年在基线、6、12、18 和 24 个月时完成儿童行为检查表和青少年自我报告。与 WI 条件相比,FGCB 干预组的青少年在 6、12 和 18 个月时报告的焦虑和抑郁症状显著下降。在 FGCB 干预中,每种症状(如焦虑)基线水平较高的青少年在 0 到 6 个月期间报告的另一种症状(如抑郁)下降幅度更大。仅在 FGCB 干预中,焦虑症状从 0 到 6 个月的变化预测了两种情况从 6 到 12 个月抑郁症状的后续变化模式,即焦虑症状的下降先于并预测了 FGCB 青少年抑郁症状的更大下降,而 WI 青少年抑郁症状的增加则较小。研究结果为高危青少年的预防干预提供了跨诊断方法,表明初始症状水平和症状变化的初始幅度对于理解干预后的变化模式都很重要。