“减轻压力”：一项针对自闭症谱系障碍儿童焦虑症的认知行为治疗项目的试点研究。
"Less stress": a pilot study on a cognitive behavioral treatment program for anxiety in children with autism spectrum disorders.
作者信息
Oerbeck Beate, Overgaard Kristin Romvig, Attwood Tony, Bjaastad Jon Fauskanger
机构信息
Oslo University Hospital, Division of Mental Health and Addiction, Oslo, Norway.
Griffith University, Brisbane, Australia.
出版信息
Scand J Child Adolesc Psychiatr Psychol. 2021 Apr 25;9:30-40. doi: 10.21307/sjcapp-2021-005. eCollection 2021.
BACKGROUND
Comorbid anxiety disorders are prevalent in children with autism spectrum disorders (ASD), but only a minority receives adequate treatment for anxiety. Cognitive behavioral therapy (CBT) has been shown to be effective in treating anxiety disorders. The objectives of the present pilot study were to test the feasibility of the CBT program "Less stress" for comorbid anxiety disorders in children with ASD and explore whether an improvement in diagnostic outcomes for anxiety disorders and symptoms of anxiety was found after treatment.
METHODS
Participants were ten children diagnosed with ASD and anxiety disorders (eight boys, mean age = 9.5 years, range 8 - 12 years). The "Less Stress" program includes three months of weekly treatment sessions followed by three monthly booster sessions. Five therapists participated. A standardized semi-structured diagnostic interview with the mothers was used to assess comorbid disorders. Child anxiety symptoms were measured with the Revised Child Anxiety and Depression Scale (RCADS).
RESULTS
The therapists found the manual easy to use but adaptations were necessary, particularly shorter sessions due to frequent (n = 7) comorbid Attention-Deficit/Hyperactivity Disorder. The participants found the program useful and the parents noted that they had learned methods they could continue using after the end of the program.Eight of ten children completed the treatment. Seven of the eight completers benefited from the program. Five of those seven children were free from all anxiety disorders, while two had fewer anxiety disorders. On a group level, a significant mean reduction of anxiety symptoms (RCADS) was found after treatment.
CONCLUSION
The therapists found the "Less stress" program to be a feasible intervention in a sample of children with ASD and comorbid anxiety. The significant reduction of anxiety after treatment is promising, but a replication in a larger and more rigorous study is needed to investigate the effectiveness of the intervention.
背景
共病焦虑障碍在自闭症谱系障碍（ASD）儿童中很常见，但只有少数人得到了充分的焦虑治疗。认知行为疗法（CBT）已被证明对治疗焦虑障碍有效。本试点研究的目的是测试CBT项目“减轻压力”对ASD儿童共病焦虑障碍的可行性，并探讨治疗后焦虑障碍的诊断结果和焦虑症状是否有所改善。
方法
参与者为10名被诊断患有ASD和焦虑障碍的儿童（8名男孩，平均年龄=9.5岁，范围8 - 12岁）。“减轻压力”项目包括为期三个月的每周治疗课程，随后是三个月一次的强化课程。有五名治疗师参与。对母亲进行标准化的半结构化诊断访谈以评估共病障碍。使用修订后的儿童焦虑和抑郁量表（RCADS）测量儿童焦虑症状。
结果
治疗师发现手册易于使用，但需要进行调整，特别是由于频繁（n = 7）共病注意力缺陷/多动障碍而缩短疗程。参与者认为该项目有用，家长们指出他们学到了可以在项目结束后继续使用的方法。十名儿童中有八名完成了治疗。八名完成治疗的儿童中有七名从该项目中受益。这七名儿童中有五名不再患有所有焦虑障碍，而两名儿童的焦虑障碍有所减少。在组水平上，治疗后发现焦虑症状（RCADS）有显著的平均减轻。
结论
治疗师发现“减轻压力”项目对ASD和共病焦虑儿童样本是一种可行的干预措施。治疗后焦虑的显著减轻很有前景，但需要在更大、更严格的研究中进行重复，以调查该干预措施的有效性。
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