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一项针对患有自闭症和焦虑症青少年的短期团体远程健康认知行为疗法干预:一项试点研究。

A Short-Term Group Telehealth Cognitive Behavioral Therapy Intervention for Youth with Autism and Anxiety: A Pilot Study.

作者信息

Rivelis Erin, Valicenti-McDermott Maria

机构信息

Developmental and Behavioral Pediatrics, Montefiore Hospital and Medical Center, Bronx, New York, USA.

出版信息

J Child Adolesc Psychopharmacol. 2024 Dec;34(10):470-475. doi: 10.1089/cap.2024.0034. Epub 2024 Oct 11.

Abstract

Children with autism often present with comorbid anxiety disorders. Cognitive behavioral therapy (CBT) is an effective, evidence-based approach to treating anxiety, but information on youth with autism and anxiety is limited. Coping Cat is a 16-week CBT intervention for children with anxiety but its use in a group telehealth format in an urban, predominantly Hispanic population is limited. (a) To examine the feasibility and preliminary effectiveness of a short-term CBT telehealth group for youth with autism and anxiety disorders in an urban, predominantly Hispanic population and (b) to examine satisfaction with the intervention. Single-arm pilot study that consisted of a 16-week telehealth CBT group therapy was based on a modified Coping Cat curriculum. Youth with autism and anxiety disorders who were on a waitlist for psychotherapy at an urban developmental center were invited to participate. Anxiety was assessed pre- and posttreatment using the Screen for Child Anxiety Related Emotional Disorders, parent and self-report. Eighteen children were enrolled; 16 children completed the program. Mean age was 11 ± 2.5 years (8-15 years); 89% males, 61% Hispanic. There was a significant reduction in pre-post intervention in symptoms of overall anxiety (parent: 41.0 ± 18.5 to 31.0 ± 16.3 ≤ 0.003, self: 25.9 ± 12.8 to 14.1 ± 7.8 ≤ 0.001), panic disorder (parent: 8.1 ± 7.0 to 4.1 ± 4.2 = 0.013, self: 5.1 ± 4.8 to 0.8 ± 0.9 = 0.004), and separation anxiety disorder (parent: 7.5 ± 4.8 to 5.7 ± 4.4 = 0.041, self: 5.8 ± 3.3 to 3.8 ± 2.4 = 0.018) as per parent and self-reports. Self-report data also revealed a significant reduction in symptoms of social anxiety disorder (6.5 ± 3.5 to 3.9 ± 2.7 ≤ 0.001). Parents and children reported satisfaction with the group. In this small, predominantly Hispanic population of youth with autism and anxiety disorder, 89% of families were compliant with a group telehealth CBT intervention. Parents and youth reported a significant reduction in anxiety symptoms and program satisfaction. A modified group CBT program via telehealth represents a feasible intervention for youth with autism and anxiety disorders.

摘要

患有自闭症的儿童常常伴有焦虑症。认知行为疗法(CBT)是一种治疗焦虑症的有效且有循证依据的方法,但关于患有自闭症和焦虑症的青少年的信息有限。应对猫疗法是一种针对焦虑症儿童的为期16周的认知行为疗法干预,但在城市中以西班牙裔为主的人群中采用远程医疗小组形式使用该疗法的情况有限。(a)在城市中以西班牙裔为主的人群中,研究针对患有自闭症和焦虑症的青少年的短期认知行为疗法远程医疗小组的可行性和初步有效性,以及(b)研究对该干预措施的满意度。单臂试点研究包括一个基于改良的应对猫疗法课程的为期16周的远程医疗认知行为疗法小组治疗。邀请了在城市发展中心等待心理治疗的患有自闭症和焦虑症的青少年参与。在治疗前和治疗后,使用儿童焦虑相关情绪障碍筛查量表,通过家长和自我报告来评估焦虑情况。18名儿童登记参加;16名儿童完成了该项目。平均年龄为11±2.5岁(8 - 15岁);89%为男性,61%为西班牙裔。根据家长和自我报告,干预前后总体焦虑症状(家长:41.0±18.5降至31.0±16.3≤0.003,自我:25.9±12.8降至14.1±7.8≤0.001)、恐慌症(家长:8.1±7.0降至4.1±4.2 = 0.013,自我:5.1±4.8降至0.8±0.9 = 0.004)和分离焦虑症(家长:当7.5±4.8降至5.7±4.4 = 0.041,自我:5.8±3.3降至3.8±2.4 = 0.018)有显著降低。自我报告数据还显示社交焦虑症症状有显著降低(6.5±3.5降至3.9±2.7≤当0.001)。家长和孩子对该小组表示满意。在这个以西班牙裔为主的患有自闭症和焦虑症的青少年小群体中,89%的家庭遵守了远程医疗认知行为疗法小组干预。家长和青少年报告焦虑症状显著减轻且对项目满意。通过远程医疗实施的改良小组认知行为疗法项目对患有自闭症和焦虑症的青少年来说是一种可行的干预措施。

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