Department of Psychology, University of Tennessee-Knoxville.
Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center.
Psychotherapy (Chic). 2021 Mar;58(1):121-132. doi: 10.1037/pst0000350. Epub 2020 Nov 30.
Anxiety disorders in children and adolescents are prevalent and, if left untreated, can lead to comorbid psychological disorders, substance use, poor socioemotional functioning, and academic and occupational underachievement. Subthreshold presentations of anxiety in youth could become problematic if overlooked, resulting in the aforementioned negative outcomes. Thus, it is important to treat such presentations, including with evidence-based treatments such as cognitive-behavioral therapy (CBT). However, because of not meeting the diagnostic criteria for which many CBT protocols were developed, subthreshold presentations of emotional problems could be an especially good match for transdiagnostic treatments like the Unified Protocol for Children (UP-C). Few studies have addressed this application of the UP-C to subthreshold emotion disorders; thus, this study aimed to preliminarily examine in a systemic case analysis (a) the efficacy of the UP-C for a preadolescent patient with mild anxiety/depression, and (b) the clinical utility of assessing both nomothetic and idiographic outcomes. Pre-post and time series outcome data demonstrated significant decreases in symptoms of depression, irritability, and negative reactions to events and significant increases in emotion identification and ownership of emotions. A network analysis of time series data described dynamics between parent and child ratings as well as the importance of child-rated anxiety and parent ratings of child's ownership of emotions. This case study provides evidence for the efficacy of the UP-C with a preadolescent who displayed subclinical symptoms of an emotional disorder. Furthermore, this case study demonstrates the usefulness of nomothetic and idiographic assessments for treating psychological disorders in youth. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
儿童和青少年的焦虑障碍普遍存在,如果不加以治疗,可能会导致共病心理障碍、物质使用、社会情感功能不良以及学业和职业成就低下。如果忽视青年亚临床焦虑的表现,可能会导致上述负面后果。因此,治疗这些表现很重要,包括使用认知行为疗法 (CBT) 等基于证据的治疗方法。然而,由于不符合许多 CBT 方案开发的诊断标准,情绪问题的亚临床表现可能特别适合跨诊断治疗,如儿童统一方案 (UP-C)。很少有研究探讨 UP-C 在亚临床情绪障碍中的应用;因此,本研究旨在通过系统案例分析(a)评估 UP-C 对轻度焦虑/抑郁的青春期前患者的疗效,以及 (b)评估典型和个体结果的临床效用。前后和时间序列结果数据表明,抑郁、易怒和对事件的负面反应症状显著减轻,情绪识别和情绪归属显著增加。时间序列数据的网络分析描述了父母和孩子评分之间的动态关系,以及孩子焦虑评分和父母对孩子情绪归属评分的重要性。这项案例研究为 UP-C 治疗表现出情绪障碍亚临床症状的青春期前患者提供了疗效证据。此外,这项案例研究还证明了典型和个体评估在治疗青少年心理障碍方面的有用性。