Faculty of Health & Medical Sciences, University of Adelaide, Australia.
Research School of Psychology, Australian National University, Australia.
J Behav Ther Exp Psychiatry. 2024 Dec;85:101985. doi: 10.1016/j.jbtep.2024.101985. Epub 2024 Aug 3.
Transdiagnostic approaches have been promoted as a means of maximising preventative effects across multiple problems with depression and anxiety suitable targets as they appear to have highly interconnected systems in pathology development and maintenance. This study investigated long-term effects of two universal school-based programs, Emotion Regulation (ER) and Behavioral Activation (BA), that sought to prevent depression and anxiety by targeting worry (a transdiagnostic feature) to promote resilience.
This follow-up study captured data from 162 of 316 initial students (aged 8-13; 52.2% female), from six Australian schools. The original study design cluster randomised students by school into BA, ER, or a usual class control. Intervention conditions consisted of 8 × 50-min weekly sessions. This study measured the effects of these interventions after 24 months on resilience, worry, depression, and anxiety. Resilience was also examined as a potential mediator.
At 24-month follow-up, there was no significant effect of either intervention on depression, anxiety, worry, or resilience levels. Significantly fewer participants in ER and BA met clinical thresholds for separation anxiety disorder (SAD) and obsessive-compulsive disorder (OCD) in the 24-month follow-up compared with baseline. No mediation effects were found.
Although self-report measures are common in universal, school-based research, this represents a study limitation.
Both interventions may provide limited long-term protective effects on SAD and OCD symptoms, which appear to have a shelf-life shorter than 24 months. To maintain program effects, refresher sessions at shorter intervals may be a consideration for future research.
跨诊断方法已被推广为一种在抑郁和焦虑等多个问题上最大化预防效果的手段，因为它们在病理发展和维持方面似乎具有高度互联的系统，所以这些问题是合适的目标。本研究调查了两种普遍的基于学校的计划——情绪调节（ER）和行为激活（BA）的长期效果，这两种计划通过针对担忧（一种跨诊断特征）来促进适应力，从而预防抑郁和焦虑。
这项随访研究从最初的 316 名学生（年龄 8-13 岁；女性占 52.2%）中获取了来自澳大利亚六所学校的 162 名学生的数据。原始研究设计按学校将学生随机分为 BA、ER 或常规课程对照组。干预条件包括 8 次每周 50 分钟的课程。本研究测量了这些干预措施在 24 个月后对适应力、担忧、抑郁和焦虑的影响。还检查了适应力作为潜在中介的作用。
在 24 个月的随访中，干预措施对抑郁、焦虑、担忧或适应力水平均无显著影响。与基线相比，在 24 个月的随访中，ER 和 BA 组中分别有较少的参与者符合分离焦虑障碍（SAD）和强迫症（OCD）的临床诊断标准。未发现中介效应。
尽管在普遍的基于学校的研究中使用自我报告的测量方法很常见，但这是研究的一个局限性。
这两种干预措施可能对 SAD 和 OCD 症状提供有限的长期保护作用，这些作用的有效期似乎短于 24 个月。为了保持项目效果，可能需要考虑在更短的时间间隔内进行复习课程，这是未来研究的一个考虑因素。
