Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA.
Bradley Hospital, East Providence, Rhode Island, USA.
J Child Adolesc Psychopharmacol. 2020 May;30(4):205-214. doi: 10.1089/cap.2019.0130. Epub 2020 Mar 11.
Despite the advances in the field of neuroscience, many questions remain regarding the mechanisms of anxiety, as well as moderators of treatment outcome. Long-term adverse outcomes for anxious youth may relate to pathophysiologically based information processing patterns and self-referential beliefs, such as self-efficacy. In fact, there are no studies highlighting the relationship between self-efficacy and neurocircuitry in youth. The purpose of this study was to explore the relationships between self-efficacy, brain morphometry, and youth anxiety. Parent, child, and clinician ratings of anxiety symptoms and child-reported self-efficacy were analyzed in a sample of 8- to 17-year-old youth ( = 51). Measures were collected from all youth at baseline and during and after treatment for the patients. Anxious patients ( = 26) received 12 sessions of cognitive behavioral therapy (CBT). Moreover, imaging data obtained from all participants before treatment were utilized in analyses. Patients reported lower self-efficacy than healthy volunteers. Across the entire sample, anxiety was negatively related to total, social, and emotional efficacy. Both social and emotional efficacy predicted anxiety posttreatment. In addition, social efficacy predicted social anxiety symptoms posttreatment and social efficacy increased across treatment. There were no significant relations between self-efficacy and neurocircuitry. Self-efficacy is an important treatment target for anxious youth. Although self-efficacy was not related to brain morphometry, self-efficacy beliefs may constitute an important mechanism through which CBT and psychopharmacological interventions decrease fear and anxiety symptoms in youth.
尽管神经科学领域取得了进步,但对于焦虑的机制以及治疗效果的调节因素,仍有许多问题尚未解决。焦虑青少年的长期不良后果可能与基于病理生理学的信息处理模式和自我参照信念有关,如自我效能感。事实上,目前尚无研究强调自我效能感与年轻人神经回路之间的关系。本研究旨在探讨自我效能感、大脑形态计量学与青少年焦虑之间的关系。对 8 至 17 岁青少年(n=51)的焦虑症状、父母、儿童和临床医生的评定以及儿童自我效能感进行了分析。所有青少年在基线、治疗期间和治疗后都接受了测量。焦虑患者(n=26)接受了 12 次认知行为疗法(CBT)。此外,所有参与者在治疗前都获得了影像学数据,并在分析中加以利用。患者报告的自我效能感低于健康志愿者。在整个样本中,焦虑与总体、社交和情绪效能呈负相关。社交和情绪效能都可以预测治疗后的焦虑。此外,社交效能可以预测治疗后的社交焦虑症状,并且社交效能在治疗过程中增加。自我效能感与神经回路之间没有显著的关系。自我效能感是焦虑青少年的一个重要治疗目标。尽管自我效能感与大脑形态计量学无关,但自我效能感信念可能是认知行为疗法和精神药理学干预降低青少年恐惧和焦虑症状的一个重要机制。