Department of Psychology and Human Development, Vanderbilt University, Peabody College #552, 230 Appleton Place, Nashville, TN, 37203, USA.
Department of Psychology, Vanderbilt University, 301 Wilson Hall, 111 21st Avenue South, Nashville, TN, 37203, USA.
Curr Psychiatry Rep. 2022 Dec;24(12):853-859. doi: 10.1007/s11920-022-01384-7. Epub 2022 Nov 12.
This review integrates recent systematic reviews and meta-analyses on the efficacy of cognitive behavioral therapy (CBT) for the treatment of anxiety disorders in children and adolescents. To inform personalized approaches to intervention, we also review recent research on moderators and predictors of outcomes.
Meta-analyses provide strong support for the efficacy of CBT for youth anxiety disorders, including with preschool-aged children using appropriate modifications. Furthermore, there is evidence that CBT is an effective adjunct treatment to psychopharmacological interventions, and the combination of treatments may be most effective for some youth. There is limited evidence of consistent demographic and clinical moderators of outcomes. Recent work in neuroscience has highlighted novel predictors of treatment outcomes that, with replication, may aid in more personalized approaches to youth anxiety treatment. CBT is efficacious for treating anxiety disorders in youth and lowering recurrence rates. CBT can also be an efficacious adjunct treatment for psychopharmacological interventions. Neuroimaging and psychophysiological measures of threat and motivational processing have shown initial promise in predicting symptom change with CBT, with potential implications for precision medicine.
本综述整合了最近关于认知行为疗法(CBT)治疗儿童和青少年焦虑障碍疗效的系统评价和荟萃分析。为了为干预提供个性化方法,我们还回顾了最近关于结局的调节因素和预测因素的研究。
荟萃分析为 CBT 治疗青少年焦虑障碍提供了强有力的支持,包括对使用适当调整的学龄前儿童。此外,有证据表明 CBT 是精神药理学干预的有效辅助治疗,并且联合治疗可能对某些青少年最有效。结局的一致人口统计学和临床调节因素的证据有限。神经科学的最新研究强调了治疗结局的新预测因素,这些因素经过复制,可能有助于更个性化的青少年焦虑治疗方法。CBT 治疗青少年焦虑症有效,可降低复发率。CBT 也可以作为精神药理学干预的有效辅助治疗。威胁和动机加工的神经影像学和心理生理学测量在预测 CBT 症状改善方面显示出初步的前景,这对精准医疗具有潜在意义。