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创伤焦点认知行为疗法治疗因体重而被欺凌的青少年:一项可行性研究。

Trauma-Focused Cognitive-Behavioral Therapy for Adolescents Bullied Because of Weight: A Feasibility Study.

机构信息

Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.

出版信息

Int J Eat Disord. 2024 Oct;57(10):2117-2127. doi: 10.1002/eat.24257. Epub 2024 Jul 15.

Abstract

OBJECTIVE

The objective of this study was to test the feasibility and acceptability of a treatment for weight bullying.

METHOD

Participants who had experienced weight-related bullying and were currently experiencing traumatic stress were recruited and enrolled in a feasibility trial of trauma-focused cognitive behavioral therapy combined with cognitive-behavioral therapy for eating disorders (TF-CBT-WB). Thirty adolescents (aged 11-17) were determined eligible and 28 began treatment (12 weeks).

RESULTS

This study demonstrated the treatment feasibility and acceptability of TF-CBT-WB for adolescents with traumatic stress following weight-bullying experiences. Overall retention and treatment satisfaction were good. Within-subjects improvements were observed for intrusion symptoms of traumatic stress, global eating-disorder severity, overvaluation of weight/shape, dissatisfaction with weight/shape, dietary restraint, and depression. Clinically-meaningful improvements were attained for several patient outcomes. Clinically-meaningful decreases in functional impairment were attained by more than half of the participants.

CONCLUSIONS

Overall, this clinical trial testing TF-CBT-WB for adolescents experiencing traumatic stress following weight-bulling experiences demonstrated therapy feasibility, acceptability, and initial evidence that clinically-meaningful improvements in patient outcomes were feasible. However, some patient outcomes thought to be more central to how the youth viewed the world failed to show improvements, suggesting that additional content related to these constructs might yield greater benefit.

TRIAL REGISTRATION

This pilot study was registered on clinicaltrials.gov: NCT04587752, Cognitive-Behavioral Therapy for Weight-related Bullying.

摘要

目的

本研究旨在测试针对体重欺凌的治疗方法的可行性和可接受性。

方法

招募了经历过与体重相关的欺凌且目前正在经历创伤后应激的参与者,并对其进行了创伤焦点认知行为疗法与饮食障碍认知行为疗法联合治疗(TF-CBT-WB)的可行性试验。确定了 30 名(年龄在 11-17 岁之间)符合条件的青少年,并开始了 28 名(12 周)的治疗。

结果

本研究表明,针对经历过体重欺凌的青少年创伤后应激,TF-CBT-WB 的治疗具有可行性和可接受性。总体保留率和治疗满意度较高。创伤后应激的闯入症状、整体饮食障碍严重程度、对体重/体型的高估、对体重/体型的不满、饮食限制和抑郁等方面均观察到了内隐改善。几个患者结局达到了临床意义上的改善。超过一半的参与者实现了功能性损伤的临床意义上的降低。

结论

总体而言,这项针对经历过体重欺凌的青少年创伤后应激的 TF-CBT-WB 临床试验证明了该疗法的可行性、可接受性,以及患者结局取得临床意义上的改善是可行的。然而,一些被认为是青少年看待世界的核心的患者结局并未显示出改善,这表明可能需要增加与这些结构相关的额外内容,以带来更大的益处。

试验注册

这项初步研究已在 clinicaltrials.gov 上注册:NCT04587752,针对体重相关欺凌的认知行为疗法。

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本文引用的文献

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School absenteeism and impairment associated with weight bullying.与体重欺凌相关的逃学和损伤。
J Adolesc. 2023 Oct;95(7):1478-1487. doi: 10.1002/jad.12220. Epub 2023 Jul 24.

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