Miller Leslie, Hlastala Stefanie A, Mufson Laura, Leibenluft Ellen, Riddle Mark
Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Psychiatry and Behavioral Science, University of Washington, Seattle, WA, USA.
Evid Based Pract Child Adolesc Ment Health. 2016;1(4):159-175. doi: 10.1080/23794925.2016.1247679. Epub 2016 Nov 14.
Interpersonal psychotherapy for depressed adolescents, an evidence-based psychotherapy, has been adapted for youth with chronic irritability and excessive reactivity (i.e., temper outbursts), to create Interpersonal Psychotherapy for Mood and Behavior Dysregulation (IPT-MBD). Youth with chronic irritability and excessive reactivity were originally conceptualized as severe mood dysregulation (SMD) and in the (5th ed.) as disruptive mood dysregulation disorder. Because outbursts are the most prominent symptom, behavioral management strategies are typically a common focus of treatment. These outbursts, along with other mood symptoms, result in significant impairment in multiple domains, with a particularly adverse impact on interpersonal functioning. For this reason improving relationships is an important target for treatment. We present an evidence-based case study of an adolescent who met research criteria for SMD and who received the IPT-MBD intervention as part of a research study. Monthly ratings assessing severity and improvement of SMD symptoms were conducted by an independent evaluator. This adolescent had an overall improvement in SMD symptoms, attended all scheduled therapy sessions, and parent and teen reported satisfaction with the treatment. We discuss factors that may influence the effectiveness of this treatment.
人际心理治疗是一种循证心理治疗方法,最初用于治疗抑郁青少年,现经调整后用于治疗患有慢性易激惹和过度反应(即情绪爆发)的青少年,从而形成了情绪和行为失调的人际心理治疗(IPT-MBD)。患有慢性易激惹和过度反应的青少年最初被概念化为严重情绪失调(SMD),在《精神疾病诊断与统计手册》(第5版)中被定义为破坏性行为障碍。由于情绪爆发是最突出的症状,行为管理策略通常是治疗的常见重点。这些情绪爆发以及其他情绪症状会在多个领域导致严重损害,对人际关系功能产生特别不利的影响。因此,改善人际关系是治疗的一个重要目标。我们介绍一个基于证据的案例研究,该青少年符合SMD的研究标准,并作为一项研究的一部分接受了IPT-MBD干预。由一名独立评估员每月对SMD症状的严重程度和改善情况进行评分。该青少年的SMD症状总体有所改善,参加了所有预定的治疗课程,家长和青少年均对治疗表示满意。我们讨论了可能影响这种治疗效果的因素。