Seeley John R, Small Jason W, Feil Edward G, Frey Andy J, Walker Hill M, Golly Annemieke, Forness Steven R
Oregon Research Institute.
University of Oregon.
School Ment Health. 2018 Sep;10(3):243-253. doi: 10.1007/s12310-017-9226-3. Epub 2017 Aug 30.
Preschoolers with elevated anxiety symptoms are at high risk not only for developing more severe mental health disorders in later life but are also apt to respond more poorly to intervention if they present with comorbid disruptive behavior. Because early signs of anxiety disorders may not be recognized as such in preschool settings, many children selected for Tier 2 interventions that target externalizing problem behaviors may also have co-occurring anxiety symptoms and disorders. The First Step to Success intervention has recently been adapted for preschoolers with externalizing behaviors and was found to be efficacious in a randomized controlled trial. The current report examines effects of the First Step intervention on a subsample of 38 preschoolers with comorbid anxiety symptoms. Compared to usual-care controls, preschoolers who were assigned to the First Step intervention demonstrated medium to large effects in reducing externalizing behavior and improving social functioning outcomes, but had small effects for reductions in internalizing behaviors. Implications for intervening with preschoolers at risk for comorbid disruptive and anxiety behaviors are discussed.
有焦虑症状的学龄前儿童不仅在日后生活中出现更严重心理健康障碍的风险很高，而且如果同时出现破坏性行为，他们对干预的反应也往往更差。由于焦虑症的早期迹象在学前环境中可能未被识别出来，许多被选入针对外化问题行为的二级干预的儿童也可能同时存在焦虑症状和障碍。“成功第一步”干预措施最近已针对有外化行为的学龄前儿童进行了调整，并在一项随机对照试验中被证明是有效的。本报告研究了“第一步”干预措施对38名有共病焦虑症状的学龄前儿童子样本的影响。与常规护理对照组相比，被分配到“第一步”干预措施的学龄前儿童在减少外化行为和改善社会功能结果方面显示出中等至较大的效果，但在内化行为减少方面效果较小。文中讨论了对有共病破坏性行为和焦虑行为风险的学龄前儿童进行干预的意义。
