Centre for Emotional Health, Macquarie University, Sydney, Australia.
Centre for Emotional Health, Macquarie University, Sydney, Australia.
J Anxiety Disord. 2017 Oct;51:32-38. doi: 10.1016/j.janxdis.2017.08.007. Epub 2017 Sep 1.
Previous studies have demonstrated the efficacy of early intervention for anxiety in preschoolers through parent-education. The current study evaluated a six-session early intervention program for preschoolers at high risk of anxiety disorders in which a standard educational program for parents was supplemented by direct training of social skills to the children.
Seventy-two children aged 3-5 years were selected based on high behavioural inhibition levels and concurrently having a parent with high emotional distress. Families were randomly assigned to either the intervention group, which consisted of six parent-education group sessions and six child social skills training sessions, or waitlist. After six months, families on waitlist were offered treatment consisting of parent-education only.
Relative to waitlist, children in the combined condition showed significantly fewer clinician-rated anxiety disorders and diagnostic severity and maternal (but not paternal) reported anxiety symptoms and life interference at six months. Mothers also reported less overprotection. These gains were maintained at 12-month follow-up. Parent only education following waitlist produced similar improvements among children. Quasi-experimental comparison between combined and parent-only interventions indicated greater reductions from combined intervention according to clinician reports, but no significant differences on maternal reports.
Results suggest that this brief early intervention program for preschoolers with both parent and child components significantly reduces risk and disorder in vulnerable children. The inclusion of a child component might have the potential to increase effects over parent-only intervention. However, future support for this conclusion through long-term, randomised controlled trials is needed.
先前的研究已经证明，通过家长教育对学龄前儿童进行早期干预可以有效治疗焦虑症。本研究评估了一种针对高焦虑障碍风险学龄前儿童的六节早期干预计划，该计划在为家长提供标准教育计划的基础上，为儿童提供社交技能的直接培训。
根据高行为抑制水平和同时有高情绪困扰的父母，选择了 72 名 3-5 岁的儿童。家庭被随机分配到干预组或候补组。干预组包括六次家长教育组会议和六次儿童社交技能训练会议，候补组则先等待，六个月后，候补组的家庭可以选择接受仅包括家长教育的治疗。
与候补组相比，联合组的儿童在六个月时，临床医生评定的焦虑症障碍和诊断严重程度以及母亲（而非父亲）报告的焦虑症状和生活干扰显著减少。母亲也报告了较少的过度保护。这些改善在 12 个月的随访中得到了维持。候补组接受仅家长教育后，儿童也取得了类似的改善。联合和仅家长干预的准实验比较表明，根据临床医生的报告，联合干预的效果更大，但母亲报告没有显著差异。
研究结果表明，这种针对有父母和儿童参与的学龄前儿童的简短早期干预计划显著降低了弱势儿童的风险和障碍。纳入儿童组成部分可能具有增加超过仅家长干预效果的潜力。然而，需要通过长期、随机对照试验来提供对这一结论的未来支持。
