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基于共病认知行为疗法的方案对青少年焦虑症状自然病程的影响。

Effects of a transdiagnostic cognitive behaviour therapy-based programme on the natural course of anxiety symptoms in adolescence.

机构信息

Department of Psychiatry. Autonomous University of Madrid, Spain Centre for Biomedical Research in Mental Health. CIBERSAM, Spain.

Research Institute of Health Sciences. University of the Balearic Islands, Spain.

出版信息

J Affect Disord. 2020 Mar 1;264:474-482. doi: 10.1016/j.jad.2019.11.078. Epub 2019 Nov 14.

Abstract

BACKGROUND

Anxiety disorders frequently have an onset during adolescence, which when left untreated could lead to a chronic course and outcome. This study aimed to examine the way in which a cognitive behaviour therapy-based programme (Super Skills for Life - adolescent version; SSL-A) could change the course of anxiety symptoms through adolescent's behavioural performance and cardiac function.

METHOD

Sixty-one adolescents at risk of developing an anxiety disorder (45.30% boys; M = 13.76 years, SD = 0.32) were randomly assigned to either an intervention (IG), placebo (PG), or a waitlist group (WG). Adolescents in the IG participated in SSL-A over an 8-week period. Adolescents in the PG participated in an 8-session school-work programme. Adolescents in the WG did not receive any intervention. Anxiety symptoms were assessed every six months, twice before the intervention, as well as at the post-intervention and six months after the intervention. Participants in the IG additionally underwent a stressful task to assess behavioural performance and cardiac adjustment.

RESULTS

Adolescents in the IG significantly reported lower levels of social phobia and generalised anxiety symptoms at the follow-up assessment compared to the adolescents in the PG and the WG. They also showed a significant improvement in vocal quality and lower discomfort during a stressful task at post-intervention, and showed attenuated cardiac recovery indexes, in terms of sample entropy.

LIMITATIONS

The study has a small sample size.

CONCLUSION

SSL-A changed the natural course of anxiety symptoms, as shown by a significant reduction in social phobia and generalised anxiety symptoms, and a significant improvement in behaviour and physiological (cardiac) function during a stressful situation.

摘要

背景

焦虑障碍常于青少年期起病,如果未予治疗,可能导致疾病慢性化和结局不佳。本研究旨在探讨基于认知行为疗法的方案(生命技能强化课程-青少年版;SSL-A)如何通过青少年的行为表现和心脏功能改变焦虑症状的进程。

方法

61 名有发展为焦虑障碍风险的青少年(45.30%为男性;M=13.76 岁,SD=0.32)被随机分配至干预组(IG)、安慰剂组(PG)或等待组(WG)。IG 组青少年接受为期 8 周的 SSL-A 治疗。PG 组青少年参加 8 次学校工作课程。WG 组青少年不接受任何干预。在干预前每 6 个月评估一次焦虑症状,共评估两次,以及在干预后和干预后 6 个月评估。IG 组参与者还接受了一项应激任务以评估行为表现和心脏调节。

结果

与 PG 组和 WG 组相比,IG 组青少年在随访评估时报告的社交恐惧症和广泛性焦虑症状水平显著降低。他们在干预后还表现出嗓音质量显著改善和应激任务时不适感降低,以及在样本熵方面心脏恢复指数的衰减。

局限性

该研究样本量较小。

结论

SSL-A 改变了焦虑症状的自然进程,表现为社交恐惧症和广泛性焦虑症状显著减轻,以及在应激情况下行为和生理(心脏)功能显著改善。

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