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注视相关音乐奖励疗法对 7 至 10 岁临床焦虑儿童的疗效:一项开放性多点基线可行性研究。

Gaze-Contingent Music Reward Therapy for Clinically Anxious 7- to 10-Year-Olds: An Open Multiple Baseline Feasibility Study.

机构信息

School of Psychological Sciences, Tel Aviv University.

Section on Developmental Affective Neuroscience, National Institute of Mental Health.

出版信息

J Clin Child Adolesc Psychol. 2020 Sep-Oct;49(5):618-625. doi: 10.1080/15374416.2019.1573685. Epub 2019 Mar 25.

Abstract

This multiple-baseline open pilot trial examined feasibility, compliance, acceptability, and preliminary indices of efficacy of Gaze-Contingent Music Reward Therapy (GC-MRT) for anxious 7- to 10-year-old children. GC-MRT is a novel therapy for anxiety disorders that relies on eye-tracking technology and operant conditioning principles to divert attention toward neutral over threat stimuli, with music serving as a reward. Using a multiple-baseline design, 12 children (  = 8.3 years, = .72, range = 7-10; 4 girls) with social anxiety disorder, generalized anxiety disorder, or separation anxiety disorder received 8 therapy sessions. Clinical status was determined via semistructured interviews and questionnaires. Patients were randomized to wait 1, 3, or 5 weeks between initial assessment and beginning of therapy. Self-reported anxiety was recorded weekly, and comprehensive clinical assessments were obtained pre- and posttreatment. All 12 patients completed the full course of GC-MRT within the allocated therapy period. Therapy credibility rates were moderate to high as reported by both children and parents. Clinician-rated anxiety levels remained consistent during baseline measurement and decreased significantly following treatment. Parent-reports also yielded significant reductions in child anxiety symptoms from pre- to posttreatment. However, child-reported anxiety did not change significantly. The results provide preliminary evidence for feasibility, acceptability, and efficacy of GC-MRT for young children with anxiety disorders. Efficacy should now be tested in randomized controlled trials.

摘要

本多基线开放式先导试验旨在考察注视相关音乐奖励疗法(GC-MRT)治疗 7-10 岁焦虑儿童的可行性、依从性、可接受性和初步疗效指标。GC-MRT 是一种新颖的焦虑障碍治疗方法,它依赖于眼动跟踪技术和操作性条件反射原理,将注意力从威胁刺激转移到中性刺激上,而音乐则作为奖励。采用多基线设计,12 名患有社交焦虑症、广泛性焦虑症或分离焦虑症的儿童(n=8.3 岁,M=0.72,范围=7-10;4 名女孩)接受了 8 次治疗。临床状况通过半结构化访谈和问卷调查来确定。患者被随机分配到初始评估后等待 1、3 或 5 周开始治疗。每周记录自我报告的焦虑程度,在治疗前后进行全面的临床评估。所有 12 名患者都在规定的治疗期内完成了 GC-MRT 的全部疗程。儿童和家长报告的治疗可信度评分均为中等至高度。临床医生评定的焦虑水平在基线测量期间保持一致,治疗后显著降低。父母报告的儿童焦虑症状也从治疗前到治疗后显著减轻。然而,儿童自我报告的焦虑程度没有显著变化。结果为 GC-MRT 治疗儿童焦虑障碍的可行性、可接受性和疗效提供了初步证据。现在应该在随机对照试验中检验其疗效。

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