Carper Matthew M, Silk Jennifer S, Ladouceur Cecile D, Forbes Erika E, McMakin Dana, Ryan Neal, Kendall Philip C
Child and Adolescent Anxiety Disorders Clinic, Temple University, Philadelphia, PA, USA.
Quantitative Sciences Program, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA.
Child Psychiatry Hum Dev. 2022 Jun;53(3):526-537. doi: 10.1007/s10578-021-01141-6. Epub 2021 Mar 3.
Cognitive behavioral therapy (CBT) has been shown to be an efficacious treatment for youth anxiety, but we need to know more about the process of change. Affective network variability, or the "spread" of positive and negative emotions activated across a given time period, has been found to be positively associated with anxiety disorder symptomatology, but it is not yet known how this construct changes in response to intervention or its association with anxiety-focused treatment outcomes. The present study used a dynamical systems framework to model ecological momentary assessment (EMA) data collected via a cellular telephone from 114 youth aged 9-14 years (M = 10.94, SD = 1.46) who were seeking treatment for a primary anxiety disorder. We examined patterns of affective network variability over time and across (a) CBT and (b) client-centered therapy (CCT) to determine whether affective network changes were specific to CBT or due to nonspecific factors. Associations between treatment outcomes and patterns of affect at pretreatment and over the course of the treatments were also examined. Results revealed significant decreases in affective network variability over the course of treatment for youth who received CBT, but not for youth who received CCT. Changes in affective network variability over the course of treatment did not predict treatment outcomes. Findings provide initial support for the dynamical systems approach to examining changes that occur during treatment. Implications and future research are discussed.
认知行为疗法(CBT)已被证明是治疗青少年焦虑症的有效方法,但我们需要更多地了解其改变过程。情感网络变异性,即在给定时间段内激活的积极和消极情绪的“传播”,已被发现与焦虑症症状呈正相关,但尚不清楚这种结构如何因干预而改变,以及它与以焦虑为重点的治疗结果之间的关联。本研究使用动态系统框架对通过手机收集的114名9至14岁(M = 10.94,SD = 1.46)因原发性焦虑症寻求治疗的青少年的生态瞬时评估(EMA)数据进行建模。我们研究了情感网络变异性随时间以及在(a)认知行为疗法和(b)以客户为中心的疗法(CCT)中的变化模式,以确定情感网络的变化是认知行为疗法特有的,还是由非特定因素导致的。还研究了治疗前和治疗过程中治疗结果与情感模式之间的关联。结果显示,接受认知行为疗法的青少年在治疗过程中情感网络变异性显著降低,但接受以客户为中心的疗法的青少年则没有。治疗过程中情感网络变异性的变化并不能预测治疗结果。研究结果为动态系统方法在研究治疗过程中发生的变化方面提供了初步支持。讨论了研究结果的意义和未来研究方向。