Milgram Lauren, Tonarely Niza A, Ehrenreich-May Jill
Department of Psychology, University of Miami, Coral Gables, FL, USA.
Child Psychiatry Hum Dev. 2022 Jun;53(3):582-598. doi: 10.1007/s10578-021-01151-4. Epub 2021 Mar 17.
The Top Problems assessment is an idiographic measure of client concerns that may allow clinicians to identify early treatment response. Few studies have examined early response to evidence-based therapies using Top Problems. We collected weekly Top Problems ratings from 95 youth with emotional disorders who received treatment using the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/UP-A). We assessed Top Problems rating change from session 1 to session 4, the role of pre-treatment variables in early Top Problems rating change, and the role of early Top Problems rating change in post-treatment symptom outcomes. Top Problems ratings decreased significantly from session 1 to session 4. Younger child age and higher parent cognitive flexibility were associated with early Top Problems improvement. Controlling for pre-treatment, early Top Problems rating change did not explain the variance in post-treatment outcomes. Future research should examine Top Problems trajectories over treatment course.
“首要问题”评估是一种针对来访者所关注问题的个性化测量方法，它可能有助于临床医生识别早期治疗反应。很少有研究使用“首要问题”来检验对循证疗法的早期反应。我们收集了95名患有情绪障碍的青少年的每周“首要问题”评分，这些青少年接受了针对儿童和青少年情绪障碍的跨诊断治疗统一方案（UP-C/UP-A）。我们评估了从第1次治疗到第4次治疗期间“首要问题”评分的变化、治疗前变量在早期“首要问题”评分变化中的作用，以及早期“首要问题”评分变化在治疗后症状结果中的作用。从第1次治疗到第4次治疗，“首要问题”评分显著下降。年龄较小的儿童以及父母较高的认知灵活性与早期“首要问题”的改善有关。在控制了治疗前因素后，早期“首要问题”评分变化并不能解释治疗后结果的差异。未来的研究应该考察整个治疗过程中“首要问题”的变化轨迹。
