de Hullu Eva, Sportel B Esther, Nauta Maaike H, de Jong Peter J
Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands.
Department of Psychiatry, University Medical Center Groningen, University of Groningen P.O. Box 30.001, 9700 RB Groningen, The Netherlands; Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands.
J Behav Ther Exp Psychiatry. 2017 Jun;55:81-89. doi: 10.1016/j.jbtep.2016.11.011. Epub 2016 Nov 25.
This two-year follow-up study evaluated the long-term outcomes of two early interventions that aimed at reducing social and test anxiety in young adolescents at risk for developing social anxiety disorder.
In this RCT, moderately socially anxious adolescents (N=240, mean age 13.6 years) were randomly assigned to a 10-week internet-based multifaceted cognitive bias modification training (CBM), a 10-week school-based cognitive behavioral group training (CBT), or a no-intervention control condition. Using multiple imputation, this study examined the changes in primary and secondary outcome measures from pretest to follow-up in a repeated measures design.
Primary outcome: Self-reported social and test anxiety generally decreased from pre-test to two-year follow-up, regardless of treatment condition. The percentage of adolescents who developed a social anxiety disorder was very low (6%) and similar across conditions. Secondary outcome: There were beneficial changes in self-esteem, self-reported prosocial behaviors, and fear of negative evaluation, but none of these were related to treatment condition. Automatic social-threat associations did not significantly change. The CBM intervention was effective in changing interpretative bias as indexed by the Recognition Task but this long-term effect did not transfer to the Adolescent Interpretation and Belief Questionnaire.
There was a substantial (50%) though seemingly non-selective attrition at follow-up.
This RCT does not support the longer-term efficacy of school-based CBT or CBM as an early intervention for social and test anxiety. Rather, it emphasizes the positive 'natural' course of highly socially anxious adolescents over two years.
这项为期两年的随访研究评估了两种早期干预措施的长期效果，这两种干预措施旨在减轻有社交焦虑障碍风险的青少年的社交和考试焦虑。
在这项随机对照试验中，将中度社交焦虑的青少年（N = 240，平均年龄13.6岁）随机分配到为期10周的基于网络的多方面认知偏差矫正训练（CBM）组、为期10周的基于学校的认知行为团体训练（CBT）组或无干预对照组。本研究采用多重填补法，在重复测量设计中检验了从预测试到随访期间主要和次要结局指标的变化。
主要结局：无论治疗条件如何，自我报告的社交和考试焦虑从预测试到两年随访总体上有所下降。患社交焦虑障碍的青少年比例非常低（6%），且各条件下相似。次要结局：自尊、自我报告的亲社会行为和对负面评价的恐惧有有益变化，但这些均与治疗条件无关。自动社交威胁联想未显著改变。CBM干预在通过识别任务所索引的改变解释偏差方面是有效的，但这种长期效果未转化到青少年解释与信念问卷上。
随访时有大量（50%）但看似非选择性的失访。
这项随机对照试验不支持基于学校的CBT或CBM作为社交和考试焦虑早期干预措施的长期疗效。相反，它强调了社交高度焦虑的青少年在两年内积极的“自然”病程。
