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认知行为疗法和元认知疗法:广泛性焦虑障碍儿童治疗效果的调节因素。

Cognitive Behavior Therapy and Metacognitive Therapy: Moderators of Treatment Outcomes for Children with Generalized Anxiety Disorder.

机构信息

Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen, Denmark.

Department of Psychology, Virginia Tech, Blacksburg, VA, USA.

出版信息

Child Psychiatry Hum Dev. 2019 Jun;50(3):449-458. doi: 10.1007/s10578-018-0853-1.

Abstract

Although cognitive behavioral therapy (CBT) is effective for childhood anxiety disorders, approximately 40% of youth remain anxious after treatment. Metacognitive therapy (MCT-c) for children with generalized anxiety disorder (GAD) has shown promising effects. The present study aimed to examine if CBT and MCT-c show differential effects in children with primary GAD based on baseline characteristics, in a quasi-experimental design. To investigate which treatment is most beneficial for whom, three potential moderators: age, symptom severity, and comorbid social anxiety were examined. Sixty-three children aged 7-14 completed CBT or MCT-c. Participants were assessed before and after treatment. Both CBT and MCT-c were highly effective in treatment of childhood GAD. None of the selected variables significantly moderated treatment outcomes. Subgroups of children with high symptom severity and social anxiety comorbidity showed trends of responding better to CBT. Methodologically stronger studies are needed to facilitate a better adaptation of treatment for children with GAD.

摘要

虽然认知行为疗法 (CBT) 对儿童焦虑症有效,但约有 40%的青少年在治疗后仍存在焦虑。针对广泛性焦虑症 (GAD) 儿童的元认知疗法 (MCT-c) 已显示出有希望的效果。本研究旨在在准实验设计中,根据基线特征,检查 CBT 和 MCT-c 在患有原发性 GAD 的儿童中是否具有不同的效果。为了研究哪种治疗对谁最有益,研究检查了三个潜在的调节因素:年龄、症状严重程度和共患社交焦虑。63 名 7-14 岁的儿童完成了 CBT 或 MCT-c。参与者在治疗前后进行了评估。CBT 和 MCT-c 对儿童 GAD 的治疗均非常有效。所选变量均无显著调节治疗效果。症状严重程度高和社交焦虑共病的儿童亚组表现出对 CBT 反应更好的趋势。需要进行方法学更强的研究,以促进为 GAD 儿童更好地调整治疗。

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