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针对儿童基于影像的自传体记忆以预防情绪障碍:干预措施的制定和一项可行性随机对照试验。

Targeting image-based autobiographical memory in childhood to prevent emotional disorders: Intervention development and a feasibility randomised controlled trial.

机构信息

Department of Psychology, Institute of Psychiatry, King's College London, London, UK.

Cultural Institute, King's College London, Artist, Illustrator and Arts and Wellbeing Project Producer, Lewes, East Sussex, UK.

出版信息

Behav Res Ther. 2021 Sep;144:103913. doi: 10.1016/j.brat.2021.103913. Epub 2021 Jun 24.

Abstract

Maladaptive cognitive styles confer vulnerability for emotional disorders and may emerge in childhood. In three phases, we developed and evaluated a novel parent-led intervention (My Memory Forest) to target overgeneral memory and avoidance of negative memories. In phase 1, the intervention was co-designed using two focus groups (n = 30 children) and consultation with teachers and parents. The acceptability, feasibility, and clinical potential of My Memory Forest was initially evaluated in phase two (n = 12 children aged 6 to 9) and then in a feasibility randomised controlled trial in phase three, against an active control (n = 56 aged 6 to 9). Acceptability and engagement were good, and no harm was reported by parents or participants. Phase 2 identified decreases in self-reported anxiety (d = 1.08), depression (d = 0.51) and vividness of negative events (d = 0.53). There was little change in parent-reported symptoms. In phase 3, recruitment was highly feasible and participant retention excellent (100%) but parent retention poor (55%). Descriptive statistics indicated similar changes in anxiety and depression for both groups. Changes between Phases 2 and 3 (e.g. methods of recruitment) could explain the discrepancy between results. Further development is necessary before proceeding to another trial. TRIAL REGISTRATION: ISRCTN13142918.

摘要

适应不良的认知风格易导致情绪障碍,并可能在儿童时期出现。我们分三个阶段开发并评估了一种新的家长主导的干预措施(My Memory Forest),以针对过度概括记忆和回避负面记忆。在第一阶段,我们使用两个焦点小组(n=30 名儿童)和与教师和家长的协商共同设计了干预措施。在第二阶段(n=12 名 6 至 9 岁的儿童),以及在第三阶段(n=56 名 6 至 9 岁的儿童)的可行性随机对照试验中,初步评估了 My Memory Forest 的可接受性、可行性和临床潜力,该试验与积极对照组(n=56 名 6 至 9 岁的儿童)相对照。父母和参与者均报告接受性和参与度良好,且无任何伤害。第二阶段发现自我报告的焦虑(d=1.08)、抑郁(d=0.51)和负性事件生动性(d=0.53)降低。父母报告的症状变化不大。在第三阶段,招募工作非常可行,参与者保留率极高(100%),但父母保留率较低(55%)。描述性统计数据表明,两组的焦虑和抑郁均有类似的变化。第二阶段和第三阶段之间的变化(例如招募方法)可能解释了结果的差异。在进行另一项试验之前,需要进一步开发。试验注册:ISRCTN84623352。

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