a Mental Health Interventions and Technology (MINT) Program, Center for Children and Families , Florida International University.
J Clin Child Adolesc Psychol. 2019 Jan-Feb;48(1):1-15. doi: 10.1080/15374416.2018.1534208. Epub 2019 Jan 14.
The controlled evaluation of treatments for early childhood anxiety and related problems has been a relatively recent area of investigation, and accordingly, trials examining early childhood anxiety treatment have not been well represented in existing systematic reviews of youth anxiety treatments. This Evidence Base Update provides the first systematic review of evidence supporting interventions specifically for the treatment of early childhood anxiety and related problems. Thirty articles testing 38 treatments in samples with mean age < 7.9 years (N = 2,228 children) met inclusion criteria. We applied Southam-Gerow and Prinstein's (2014) review criteria, which classifies families of treatments according to one of five levels of empirical support-Well-Established, Probably Efficacious, Possibly Efficacious, Experimental, and of Questionable Efficacy. We found family-based cognitive-behavioral therapy (CBT) to be a Well-Established treatment, and Group Parent CBT and Group Parent CBT + Group Child CBT to both be Probably Efficacious treatments. In contrast, play therapy and attachment-based therapy are still only Experimental treatments for early childhood anxiety, relaxation training has Questionable Efficacy, and there is no evidence to date to speak to the efficacy of individual child CBT and/or medication in younger anxious children. All 3 currently supported interventions for early childhood anxiety entail exposure-based CBT with significant parental involvement. This conclusion meaningfully differs from conclusions for treating anxiety in older childhood that highlight the well-established efficacy of individual child CBT and/or medication and that question whether parental involvement in treatment enhances outcomes.
对儿童早期焦虑及相关问题的治疗进行对照评估是一个相对较新的研究领域，因此，在现有的青少年焦虑症治疗系统评价中，并未很好地体现出针对儿童早期焦虑症治疗的试验。本证据更新提供了首个专门针对儿童早期焦虑及相关问题治疗干预措施的证据的系统评价。有 30 篇文章在平均年龄<7.9 岁的样本中（N=2228 名儿童）测试了 38 种治疗方法，符合纳入标准。我们应用了 Southam-Gerow 和 Prinstein（2014）的评价标准，该标准根据实证支持的五个级别之一对治疗方法进行分类，即：已确立、可能有效、可能有效、实验性和疗效存疑。我们发现，家庭为基础的认知行为疗法（CBT）是一种已确立的治疗方法，团体父母 CBT 和团体父母 CBT+团体儿童 CBT 都是可能有效的治疗方法。相比之下，游戏疗法和依恋疗法仍然只是儿童早期焦虑症的实验性治疗方法，放松训练疗效存疑，目前尚无证据表明单独的儿童 CBT 和/或药物治疗对年幼的焦虑儿童有效。目前所有 3 种支持的儿童早期焦虑症干预措施都需要进行基于暴露的 CBT，同时需要父母的大量参与。这一结论与治疗较大儿童焦虑症的结论大相径庭，后者强调了单独的儿童 CBT 和/或药物治疗的有效性，并质疑父母参与治疗是否能提高疗效。
