Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, 171 77 Stockholm, Sweden; Stockholm Health Care Services, Stockholm County Council, Sweden.
Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, 171 77 Stockholm, Sweden.
Behav Res Ther. 2017 Mar;90:67-75. doi: 10.1016/j.brat.2016.12.008. Epub 2016 Dec 14.
This study investigated the long-term outcomes of internet-delivered cognitive behavior therapy (ICBT) for children with anxiety disorders, and potential pre-treatment predictors of treatment outcome.
The sample included eighty-four children (8-12 years old) with anxiety disorders, from both a treatment group and a waitlist control (after participants had crossed over to treatment) of a previous randomized controlled study. Participants were assessed at post-treatment and three- and twelve-months after treatment using a semi-structured interview and parent ratings. Pre-treatment data were used to investigate predictors of treatment outcome at three-month follow-up.
Intention-to-treat analysis showed that treatment gains were maintained at twelve-month follow-up, including clinician rated severity of the principal anxiety disorder, parent rated anxiety symptoms and global functioning, with mainly large effect sizes (Cohen's d = 0.63-2.35). Completer analyses showed that suspected autism spectrum disorder was associated with less change in symptom severity. No other pre-treatment measures significantly predicted treatment outcome.
This study suggests that internet-delivered CBT can have long-term beneficial effects for children with anxiety disorders. Predictors of treatment outcome need to be evaluated further.
Clinicaltrials.gov; NCT01533402.
本研究调查了针对儿童焦虑障碍的互联网认知行为疗法（ICBT）的长期疗效，以及治疗结果的潜在预测因素。
样本包括来自先前一项随机对照研究的治疗组和候补对照组（参与者交叉到治疗组后）的 84 名（8-12 岁）患有焦虑障碍的儿童。参与者在治疗后、治疗后三个月和治疗后十二个月使用半结构化访谈和家长评定进行评估。使用治疗前的数据来研究三个月随访时治疗结果的预测因素。
意向性治疗分析显示，治疗增益在十二个月随访时得到维持，包括临床医生评定的主要焦虑障碍严重程度、家长评定的焦虑症状和整体功能，主要具有较大的效应大小（Cohen's d = 0.63-2.35）。完成者分析表明，疑似自闭症谱系障碍与症状严重程度的变化较小有关。其他治疗前措施均未显著预测治疗结果。
本研究表明，互联网认知行为疗法对患有焦虑障碍的儿童可能具有长期的有益效果。治疗结果的预测因素需要进一步评估。
Clinicaltrials.gov；NCT01533402。
