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一种针对高危年轻成年人的跨诊断、预防为重点的方案的疗效:一项等待名单对照试验。

Efficacy of a transdiagnostic, prevention-focused program for at-risk young adults: a waitlist-controlled trial.

机构信息

Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.

Harvard Medical School, Boston, MA, USA.

出版信息

Psychol Med. 2023 Jun;53(8):3490-3499. doi: 10.1017/S0033291722000046. Epub 2022 Mar 1.

Abstract

BACKGROUND

Prevention programs that are 'transdiagnostic' may be more cost-effective and beneficial, in terms of reducing levels of psychopathology in the general population, than those focused on a specific disorder. This randomized controlled study evaluated the efficacy of one such intervention program called Resilience Training (RT).

METHODS

College students who reported mildly elevated depressive or subclinical psychotic symptoms ('psychotic experiences' (PEs)) ( = 107) were randomized to receiving RT ( = 54) or to a waitlist control condition ( = 53). RT consists of a four-session intervention focused on improving resilience through the acquisition of mindfulness, self-compassion, and mentalization skills. Measures of symptoms and these resilience-enhancing skills were collected before and after the 4-week RT/waitlist period, with a follow-up assessment 12-months later.

RESULTS

Compared to the waitlist control group, RT participants reported significantly greater reductions in PEs, distress associated with PEs, depression, and anxiety, as well as significantly greater improvements in resilience, mindfulness, self-compassion, and positive affect, following the 4-week RT/waitlist period (all < 0.03). Moreover, improvements in resilience-promoting skills were significantly correlated with symptom reductions (all < 0.05). Lastly, the RT-related reductions in PEs and associated distress were maintained at the 12-month follow-up assessment.

CONCLUSIONS

RT is a brief, group-based intervention associated with improved resilience and reduced symptoms of psychopathology, with sustained effects on PEs, in transdiagnostically at-risk young adults. Follow-up studies can further assess the efficacy of RT relative to other interventions and test whether it can reduce the likelihood of developing a serious mental illness.

摘要

背景

预防计划“跨诊断”可能更具成本效益,并且从减少普通人群中精神病理学水平的角度来看,比针对特定疾病的预防计划更有益。本随机对照研究评估了一种名为韧性训练(RT)的干预计划的效果。

方法

报告轻度升高的抑郁或亚临床精神病症状(“精神病体验”(PEs))的大学生(n=107)被随机分配接受 RT(n=54)或等待名单对照条件(n=53)。RT 由一个四节的干预组成,侧重于通过获得正念、自我同情和心理化技能来提高韧性。在 4 周的 RT/等待名单期间之前和之后收集症状和这些增强韧性的技能的测量值,并在 12 个月后进行随访评估。

结果

与等待名单对照组相比,RT 参与者报告 PEs、PEs 相关的痛苦、抑郁和焦虑显著减少,以及韧性、正念、自我同情和积极情绪显著提高,在 4 周的 RT/等待名单期后(均 <0.03)。此外,增强韧性的技能的提高与症状的减少显著相关(均 <0.05)。最后,在 12 个月的随访评估中,RT 相关的 PEs 减少和相关的痛苦得以维持。

结论

RT 是一种简短的、基于小组的干预措施,与增强韧性和减少精神病理学症状相关,对跨诊断风险的年轻成年人的 PEs 有持续的影响。后续研究可以进一步评估 RT 相对于其他干预措施的效果,并测试它是否可以降低患上严重精神疾病的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9feb/10277773/ecd3572b8fa5/S0033291722000046_fig1.jpg

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