Sousa Rúben, Ribeiro da Silva Diana, Petrocchi Nicola, Gilbert Paul, Rijo Daniel
Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
Department of Economics and Social Sciences, John Cabot University, Rome, Italy.
Front Psychiatry. 2023 Jan 10;13:1032011. doi: 10.3389/fpsyt.2022.1032011. eCollection 2022.
Literature has pointed the need for intervention programs specifically tailored to target the treatment needs of young offenders, as well as the need to test the efficacy of such programs through physiological indexes of emotion regulation (e.g., heart rate variability; HRV), complementing self-reports typically used as outcome measures. The PSYCHOPATHY.COMP is a 20-session individual intervention program based on Compassion Focused Therapy aiming to reduce psychopathic traits and disruptive behavior among young offenders through the development of a compassionate motivation, while stimulating the soothing system as a strategy to improve emotion regulation. Previous research with young offenders has shown decreases in vagally mediated HRV (vmHRV) when the soothing system is activated. This physiological pattern seems to mirror threat-like responses that contrast with relaxed states.
To test the efficacy of the PSYCHOPATHY.COMP, a clinical trial was implemented encompassing a treatment ( = 56) and a control group ( = 53). Treatment participants attended the PSYCHOPATHY.COMP, while controls received the Treatment As Usual (TAU) delivered in Portuguese juvenile detention facilities. HRV data was collected throughout a standardized procedure (encompassing resting, reactivity and recovery phases) specifically designed to trigger the soothing system. Participants were assessed at pre-treatment, post-treatment and 6-months follow-up.
Although treatment participants continued to process the soothing system as unpleasant (with decreased vmHRV), they seem to become able to adaptively recover from the stimuli without avoiding it or resorting to maladaptive coping strategies. The physiological pattern was in line with participants' decreases in difficulties in emotion regulation across the assessment periods. In contrast, controls seemed to have actively employed coping strategies associated with increases in vmHRV not only when the soothing system was triggered, but also when recovering from the stimuli. Congruently, for controls, increases in difficulties in emotion regulation were found, with increases in the lack of emotional clarity across the assessment periods.
Findings offer new evidence for the efficacy of the PSYCHOPATHY.COMP program in improving emotion regulation in young offenders, assessed through both self-report and physiological measures. Additionally, findings support the assessment of the autonomic balance as a treatment efficacy index in future research, targeting the rehabilitation of these youth.
ClinicalTrials.gov, identifier NCT03971682.
文献指出需要制定专门针对年轻罪犯治疗需求的干预计划，以及通过情绪调节的生理指标（如心率变异性；HRV）来测试此类计划的疗效，以此补充通常用作结果指标的自我报告。PSYCHOPATHY.COMP是一个为期20节的个体干预计划，基于同情聚焦疗法，旨在通过培养同情动机来减少年轻罪犯的精神病态特征和破坏性行为，同时刺激舒缓系统作为改善情绪调节的一种策略。先前针对年轻罪犯的研究表明，当舒缓系统被激活时，迷走神经介导的HRV（vmHRV）会降低。这种生理模式似乎反映了与放松状态形成对比的类似威胁的反应。
为了测试PSYCHOPATHY.COMP的疗效，实施了一项临床试验，包括一个治疗组（n = 56）和一个对照组（n = 53）。治疗组参与者参加PSYCHOPATHY.COMP，而对照组接受葡萄牙青少年拘留设施提供的常规治疗（TAU）。HRV数据通过专门设计的标准化程序（包括静息、反应性和恢复阶段）收集，以触发舒缓系统。在治疗前、治疗后和6个月随访时对参与者进行评估。
尽管治疗组参与者继续将舒缓系统视为不愉快的（vmHRV降低），但他们似乎能够从刺激中适应性恢复，而不会回避刺激或采取适应不良的应对策略。生理模式与参与者在评估期间情绪调节困难的减少一致。相比之下，对照组似乎不仅在舒缓系统被触发时，而且在从刺激中恢复时，都积极采用与vmHRV增加相关的应对策略。相应地，对于对照组，发现情绪调节困难增加，在评估期间情绪清晰度缺乏增加。
研究结果为PSYCHOPATHY.COMP计划在改善年轻罪犯情绪调节方面的疗效提供了新证据，这是通过自我报告和生理测量评估得出的。此外，研究结果支持在未来研究中评估自主神经平衡作为治疗疗效指标，以针对这些青少年的康复。
ClinicalTrials.gov，标识符NCT03971682。
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