Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at University of California, Los Angeles, California, USA.
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Bipolar Disord. 2024 Nov;26(7):733-743. doi: 10.1111/bdi.13466. Epub 2024 Jul 25.
Behavioral interventions require considerable practice of treatment skills in between therapy sessions. The effects of these treatments may vary with the degree to which patients are able to implement these practices. In offspring of parents with bipolar and major depressive disorders, we examined whether youth who frequently practiced communication and problem-solving skills between family-focused therapy (FFT) sessions had less severe mood symptoms and better psychosocial functioning over 6 months than youth who practiced less frequently.
We randomly assigned offspring (ages 12-19) of parents with mood disorders to 12 sessions of FFT plus a mobile app that encouraged the practice of communication, problem-solving and mood management skills (FFT-MyCoachConnect [MCC] condition) or 12 sessions of FFT with an app that only allowed for tracking of symptoms and stress (FFT-Track condition). Independent evaluators assessed youths' mood and psychosocial functioning at 9-week intervals over 27 weeks. Clinicians rated participants' between-session skill practice at each FFT session.
FFT-MCC was associated with more frequent skill practice than FFT-Track over 18 weeks of treatment. Skill practice was associated with reductions in youths' mood instability and perceptions of family conflict over 27 weeks in both app conditions. Skill practice mediated the effects of app condition on youths' mood instability and family functioning.
Mobile applications as adjuncts to family therapy for youth with mood disorders can help increase skill practice. These findings provide preliminary causal evidence for behavioral skill practice improving mood symptoms and family functioning among youth with mood disorders.
行为干预需要在治疗疗程之间大量练习治疗技能。这些治疗的效果可能因患者实施这些实践的程度而有所不同。在父母患有双相情感障碍和重度抑郁症的子女中，我们研究了在家庭为中心的治疗（FFT）疗程之间，经常练习沟通和解决问题技巧的年轻人与较少练习的年轻人相比，是否在 6 个月后具有更轻的情绪症状和更好的社会心理功能。
我们将患有心境障碍的父母的子女（年龄在 12-19 岁之间）随机分配到 12 节 FFT 加一个鼓励练习沟通、解决问题和情绪管理技巧的移动应用程序（FFT-MyCoachConnect [MCC]条件）或 12 节 FFT 加一个仅允许跟踪症状和压力的应用程序（FFT-Track 条件）。独立评估者在 27 周内每隔 9 周评估年轻人的情绪和社会心理功能。临床医生在每次 FFT 疗程中评估参与者的疗程间技能练习情况。
在 18 周的治疗过程中，FFT-MCC 比 FFT-Track 更频繁地进行技能练习。在两个应用程序条件下，技能练习与年轻人情绪不稳定和对家庭冲突的感知减少有关，持续 27 周。技能练习在应用程序条件对年轻人的情绪不稳定和家庭功能的影响中起中介作用。
作为对患有心境障碍的年轻人的家庭治疗的辅助手段，移动应用程序可以帮助增加技能练习。这些发现为行为技能练习改善患有心境障碍的年轻人的情绪症状和家庭功能提供了初步的因果证据。
