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预防焦虑父母子女焦虑障碍的发生:一项为期六年的随访研究。

Preventing the Onset of Anxiety Disorders in Offspring of Anxious Parents: A Six-Year Follow-up.

机构信息

Department of Psychiatry, University of Connecticut School of Medicine, 65 Kane Street Room 2033, West Hartford, CT, 06119, USA.

Department of Psychology, Arizona State University, Tempe, USA.

出版信息

Child Psychiatry Hum Dev. 2021 Aug;52(4):751-760. doi: 10.1007/s10578-020-01080-8. Epub 2020 Oct 18.

Abstract

This study examined the effects of a family-based intervention Coping and Promoting Strength (CAPS) relative to a control condition, information-monitoring (IM), to prevent the onset of anxiety disorders in offspring of anxious parents six years after their initial assessment. One hundred thirty six families participated in the original randomized trial; 113 (83%) completed the one time follow-up assessment. Presence of anxiety disorders and severity of symptoms in offspring were assessed by masked evaluators using the Anxiety Disorders Interview Schedule; parents and offspring also completed questionnaires assessing offspring anxiety. Using the intention to treat sample from the original trial, Cox regression models showed significant intervention main effects in the rate of onset of anxiety disorders from baseline to follow-up (anxiety disorder: hazard ratio (HR) = 2.55, 95% CI: 1.54, 4.21) but growth curves suggest effects occurred within the first year after program completion. No group differences were found in the cumulative incidence of anxiety disorders at the six-year follow-up. Additional intervention appears needed to maintain the initial positive effects long-term to reduce the risk for downstream disability.Clinical Trials Registration: NCT00847561.

摘要

这项研究考察了一种基于家庭的干预措施——应对和增强力量(CAPS)相对于对照条件(信息监测,IM)对预防焦虑父母的子女在最初评估后六年出现焦虑障碍的效果。136 个家庭参加了最初的随机试验;113 个家庭(83%)完成了一次随访评估。通过使用焦虑障碍访谈量表由盲法评估者评估子女的焦虑障碍和症状严重程度;父母和子女也完成了评估子女焦虑的问卷。使用原始试验的意向治疗样本,Cox 回归模型显示出干预措施在从基线到随访期间焦虑障碍发病速度上的显著主要效果(焦虑障碍:风险比(HR)=2.55,95%置信区间:1.54,4.21),但生长曲线表明效应发生在计划完成后的第一年。在六年随访时,两组在焦虑障碍的累积发生率上没有差异。需要进一步的干预措施来维持最初的积极效果,以降低下游残疾的风险。临床试验注册:NCT00847561。

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