Center for Children and Families, Florida International University.
Child Study Center, Yale University.
Behav Ther. 2023 Sep;54(5):852-862. doi: 10.1016/j.beth.2023.03.002. Epub 2023 Mar 30.
Research documents that child and adolescent (youth) irritability and anxiety have high co-occurrence, and anxious-irritable presentations are associated with greater impairment than anxious nonirritable presentations. This study examines the association between irritability and youth anxiety treatment outcome and tests a conceptual model of the associations among youth irritability, parent accommodation, and youth anxiety severity following cognitive behavioral treatment (CBT). Participants were N = 128 clinic-referred youths ages 6 to 17 years (M = 9.76 years; 57% female) who met criteria for primary anxiety disorder diagnoses and completed a 12- to 14-week CBT anxiety protocol. Parent- and youth-report on youth irritability, parent accommodation of their child's anxiety, and youth anxiety severity were assessed pretreatment and posttreatment. Using parent-report, youth irritability at pretreatment was associated with high parent accommodation of youth anxiety and high youth anxiety severity at posttreatment. The association between irritability and youth anxiety outcome was mediated contemporaneously by parent accommodation at posttreatment. These findings show that parent accommodation of their anxious-irritable children's anxiety may account for high youth anxiety severity following treatment. Developing strategies to target irritability in anxious youth and/or reduce parent accommodation in the presence of youth irritability represent important directions for future research.
研究文献表明，儿童和青少年（青年）的烦躁和焦虑有很高的共病率，焦虑烦躁型表现与更大的损害相关，而焦虑不烦躁型表现则不相关。本研究考察了烦躁与青年焦虑治疗结果之间的关系，并检验了认知行为治疗（CBT）后青年烦躁、父母顺应与青年焦虑严重程度之间关联的概念模型。参与者为 128 名来自临床的 6 至 17 岁（M=9.76 岁；57%为女性）的青少年，他们符合主要焦虑障碍诊断标准，并完成了为期 12-14 周的 CBT 焦虑方案。在治疗前和治疗后评估了父母和青少年对青少年烦躁、父母对孩子焦虑的顺应以及青少年焦虑严重程度的报告。使用父母报告，青少年在治疗前的烦躁与治疗后父母对青少年焦虑的高度顺应以及青少年焦虑的高度严重程度相关。烦躁与青少年焦虑结果之间的关联在治疗后被父母顺应所即时中介。这些发现表明，父母对焦虑烦躁的孩子的焦虑的顺应可能导致治疗后青少年焦虑的严重程度较高。针对焦虑青少年的烦躁和/或在青少年烦躁时减少父母顺应的策略代表了未来研究的重要方向。
