Mohammadi Abolfazl, Soleimani Mehdi, Mohammadi Mohammad Reza, Abasi Imaneh, Foroughi Ali Akbar
Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Iran J Psychiatry. 2019 Apr;14(2):171-178.
Cognitive-behavioral interventions have been used as effective approaches for the treatment and prevention of depression and anxiety. However, to date, no anxiety and depression prevention guidelines package has been developed for Iranian adolescents. Thus, the purpose of this study was to develop transdiagnostic prevention program of anxiety and depression for Iranian adolescents and to assess the effectiveness of this program in a sample of adolescents. Based on evidence-based literatures on CBT interventions, transdiagnostic prevention program was developed and its content and face validity was assessed and established by three clinical psychologies (Ph.D.) and a psychiatrist (child and adolescent postdoctoral). Then, in a semi-experimental design, 62 students were recruited from a school in Tehran by purposive sampling method and were randomly assigned in to experimental (n = 40) and control (n = 22) groups. They participated in 8 sessions of intervention based on the developed program. Revised Child Anxiety and Depression Scale (RCADS)- Child Version and Parent Version- were used to gather the data before, after, and 3 months after intervention. Results of ANCOVA, controlling for the effect of pretest score, showed no significant differences (P>0.05) between experimental and control groups in SAD, panic, MDD, separation anxiety, GAD, OCD, total anxiety, and total anxiety-depression for parent and child in pretest and posttest. Transdiagnostic prevention package for anxiety and depression had no significant effect on reducing anxiety and depression of adolescents. Using an inappropriate measure, difficulties with timing of assessment, and lower severity of pre-intervention anxiety and depression due to universal prevention and sample recruited, might have affected the present findings. Discussion would be clearer and more complete by analyzing follow-up results and education performance in the future.
认知行为干预已被用作治疗和预防抑郁与焦虑的有效方法。然而，迄今为止，尚未为伊朗青少年制定焦虑和抑郁预防指南包。因此，本研究的目的是为伊朗青少年制定焦虑和抑郁的跨诊断预防计划，并在青少年样本中评估该计划的有效性。基于关于认知行为疗法干预的循证文献，制定了跨诊断预防计划，并由三位临床心理学家（博士）和一位儿童及青少年博士后精神病医生评估并确定了其内容和表面效度。然后，采用半实验设计，通过目的抽样法从德黑兰的一所学校招募了62名学生，并将他们随机分为实验组（n = 40）和对照组（n = 22）。他们参加了基于所制定计划的8次干预课程。使用修订后的儿童焦虑和抑郁量表（RCADS）儿童版和家长版在干预前、干预后以及干预后3个月收集数据。协方差分析结果在控制了预测试分数的影响后显示，实验组和对照组在预测试和后测试中，家长和孩子在社交焦虑障碍、惊恐障碍、重度抑郁症、分离焦虑、广泛性焦虑障碍、强迫症、总焦虑以及总焦虑抑郁方面均无显著差异（P>0.05）。焦虑和抑郁的跨诊断预防包对减轻青少年的焦虑和抑郁没有显著效果。由于采用了不恰当的测量方法、评估时间安排上的困难以及因普遍预防和所招募样本导致的干预前焦虑和抑郁严重程度较低，可能影响了当前的研究结果。通过分析未来的随访结果和教育表现，讨论将会更加清晰和完整。
