Thøgersen Dagfinn Mørkrid, Bjørnebekk Gunnar, Scavenius Christoffer, Elmose Mette
Department of Psychology, University of Southern Denmark, Odense, Denmark.
Norwegian Center for Child Behavioral Development, Oslo, Norway.
Front Psychol. 2021 Jan 18;11:537706. doi: 10.3389/fpsyg.2020.537706. eCollection 2020.
Despite the availability of evidence-based treatment models for adolescent behavior problems, little is known about the effectiveness of these programs for adolescents with callous-unemotional (CU) traits. Defined by lack of empathy, lack of guilt, flattened affect and lack of caring, CU traits have been linked to long-term anti-social behavior and unfavorable treatment outcomes and might be negatively related to outcomes in evidence-based programs such as Functional Family Therapy (FFT). This study used a single-group pre-post evaluation design with a sample of 407 adolescents (49.1% female, mean age = 14.4 years, = 1.9) receiving FFT to investigate whether outcomes in FFT are predicted by CU traits and to what extent reliable changes in CU traits can be observed. The results showed that although CU traits are related to increased problem severity at baseline, they predicted neither treatment dropout nor post-treatment externalizing behavior and family functioning. CU traits were related to diminished improvement ratings, in particular with respect to parental supervision. Reductions in CU traits were observed across the time of treatment, and these were most profound among adolescents with elevated levels of CU traits at baseline. Further research should investigate whether certain evidence-based treatment components are more suited for adolescents with CU, and if the addition of specific intervention elements for reducing CU-traits could further improve outcomes for this high-risk population.
尽管有针对青少年行为问题的循证治疗模式，但对于这些项目对具有冷酷无情（CU）特质的青少年的有效性知之甚少。CU特质的定义是缺乏同理心、缺乏内疚感、情感平淡和缺乏关爱，它与长期的反社会行为及不良治疗结果有关，并且可能与诸如功能家庭治疗（FFT）等循证项目的结果呈负相关。本研究采用单组前后评估设计，对407名接受FFT治疗的青少年（49.1%为女性，平均年龄 = 14.4岁，标准差 = 1.9）进行抽样，以调查FFT的治疗结果是否由CU特质预测，以及在何种程度上可以观察到CU特质的可靠变化。结果表明，尽管CU特质与基线时问题严重程度的增加有关，但它们既不能预测治疗中断情况，也不能预测治疗后外化行为和家庭功能。CU特质与改善评分降低有关，尤其是在父母监督方面。在整个治疗期间观察到CU特质有所减少，且在基线时CU特质水平较高的青少年中减少最为显著。进一步的研究应调查某些循证治疗成分是否更适合具有CU特质的青少年，以及增加减少CU特质的特定干预要素是否能进一步改善这一高危人群的治疗效果。
