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CBT 模块对谁最有效?通过特定模块的差异化反应识别抑郁青少年的亚组。

What CBT Modules Work Best for Whom? Identifying Subgroups of Depressed Youths by Their Differential Response to Specific Modules.

机构信息

Florida International University.

Florida International University.

出版信息

Behav Ther. 2024 Jul;55(4):898-911. doi: 10.1016/j.beth.2024.01.004. Epub 2024 Feb 12.

Abstract

Prior research suggests that the effects of specific cognitive-behavioral therapy (CBT) modules on symptom outcomes can be estimated. We conducted a study utilizing idiographic and nomothetic methods to clarify which CBT modules are most effective for youth depression, and for whom they are most effective. Thirty-five youths received modular CBT for depression. Interrupted time series models estimated whether the introduction of each module was associated with changes in internalizing symptoms, whereby significant symptom reduction would suggest a therapeutic response to the module. Regression models were used to explore whether participant characteristics predicted subgroups of youths based on their estimated response to certain types (e.g., cognitive) of modules, and whether group membership was associated with posttreatment outcomes. Thirty youths (86%) had at least one module associated with a significant change in internalizing symptoms from premodule delivery to postmodule delivery. The specific modules associated with these changes varied across youths. Behavioral activation was most frequently associated with symptom decreases (34% of youths). No participant characteristics predicted estimated response to module type, and group membership was not significantly associated with posttreatment outcomes. Youths display highly heterogeneous responses to treatment modules, indicating multiple pathways to symptom improvement for depressed youths.

摘要

先前的研究表明,可以估计特定认知行为疗法 (CBT) 模块对症状结果的影响。我们采用个体化和定量化方法进行了一项研究,以阐明哪些 CBT 模块对青少年抑郁最有效,以及对哪些人最有效。35 名青少年接受了针对抑郁的模块化 CBT。中断时间序列模型估计了引入每个模块是否与内化症状的变化相关,其中症状显著减轻表明对该模块有治疗反应。回归模型用于探索参与者特征是否基于他们对特定类型(例如认知)模块的估计反应来预测青少年亚组,以及团体成员资格是否与治疗后结果相关。30 名青少年(86%)中有至少一个模块与内化症状从模块交付前到模块交付后的显著变化相关。与这些变化相关的特定模块在青少年中各不相同。行为激活最常与症状减轻相关(34%的青少年)。没有参与者特征预测对模块类型的估计反应,团体成员资格与治疗后结果无显著相关性。青少年对治疗模块的反应高度异质,表明抑郁青少年有多种改善症状的途径。

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