Warren Alpert Medical School of Brown University, Providence, RI, USA; Rhode Island Hospital, Providence, RI, USA.
Warren Alpert Medical School of Brown University, Providence, RI, USA; Rhode Island Hospital, Providence, RI, USA.
Behav Res Ther. 2020 Aug;131:103625. doi: 10.1016/j.brat.2020.103625. Epub 2020 Apr 19.
This study examined the feasibility, acceptability, and preliminary efficacy of a decision rule driven treatment for youth with comorbid conduct problems and depression. A randomized, controlled, repeated measures design was used to compare two treatment approaches: Decision-Rule Based Treatment (DR) and Sequential Treatment (SEQ). Participants included 30 children (ages 8-14; 66% female; 80% Caucasian) who met criteria for a depressive disorder (major depressive disorder and/or dysthymia) and a conduct problem disorder (oppositional defiant disorder and/or conduct disorder). Assessments were conducted at baseline, post-treatment, and six-month follow-up. Treatment adherence, attendance, and session evaluations ratings indicate that the treatments were feasible to implement and acceptable to parents and youth in both conditions. Both treatments showed similar remission of internalizing and externalizing diagnoses. Participants in DR showed significantly greater improvements at six-month follow-up in child-reported depressive symptom severity compared to SEQ. Both DR and SEQ conditions showed significantly lower behavior problems at end of treatment and six-month follow-up. DR showed significant reductions in emotion dysregulation at 6-month follow-up, while SEQ did not. Findings suggest that a decision rule based intervention holds promise as a feasible and acceptable treatment with high rates of remittance.
本研究旨在检验一种针对共患品行问题和抑郁的儿童的决策规则驱动治疗的可行性、可接受性和初步疗效。采用随机、对照、重复测量设计比较了两种治疗方法：决策规则治疗（DR）和序贯治疗（SEQ）。参与者包括 30 名符合抑郁障碍（重性抑郁障碍和/或心境恶劣）和品行问题障碍（对立违抗性障碍和/或品行障碍）标准的儿童（年龄 8-14 岁；66%为女性；80%为白种人）。在基线、治疗后和 6 个月随访时进行评估。治疗依从性、出席率和疗程评估评分表明，两种治疗方法在两种条件下对父母和儿童都是可行和可接受的。两种治疗方法都显示出类似的内化和外化诊断的缓解。与 SEQ 相比，DR 组的儿童在 6 个月随访时报告的抑郁症状严重程度有显著改善。DR 和 SEQ 组在治疗结束时和 6 个月随访时的行为问题均显著减少。DR 在 6 个月随访时显示出情绪调节的显著改善，而 SEQ 则没有。研究结果表明，基于决策规则的干预具有作为一种可行且可接受的治疗方法的潜力，具有较高的缓解率。
