Jakobsen Sarah, Tølbøll Katrine B, Thastum Mikael, Lomholt Johanne J
Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark.
TrygFonden's Centre for Child Research, Aarhus University, Aarhus, Denmark.
Child Psychiatry Hum Dev. 2025 May 8. doi: 10.1007/s10578-025-01847-x.
This pre-registered (#CRD42024509947) systematic review synthesized evidence on cognitive behavioral interventions (CBTs) for youths with school attendance problems (SAPs). The PsycINFO, PubMed, ERIC, and Scopus databases were searched through 1985-2024 for randomized controlled trials (RCTs), non-RCTs, and open trials (OTs) evaluating SAP-focused CBT. Data were synthesized narratively and through meta-analysis. Four RCTs and eleven OTs met eligibility criteria, including 932 youths. Meta-analyses revealed small to large uncontrolled pre- to post-intervention effects for school attendance (g = 1.02), anxiety (g = - 0.57), depression (g = - 0.66), and behavioral problems (g = - 0.40), which were maintained at follow-up. When compared to a control, CBT had a medium effect on school attendance (g = 0.44) but non-significant effects on anxiety (g = - 0.09) and depression (g = - 0.14). While the results hold promise for SAP-focused CBTs, evidence was limited by study heterogeneity, bias risks, methodological limitations, and inconsistent outcome measures, highlighting the needed for further RCTs.
这项预先注册（#CRD42024509947）的系统评价综合了关于针对有上学出勤问题（SAP）的青少年的认知行为干预（CBT）的证据。通过检索1985年至2024年的PsycINFO、PubMed、ERIC和Scopus数据库，查找评估以SAP为重点的CBT的随机对照试验（RCT）、非随机对照试验和开放试验（OT）。数据通过叙述性综合和荟萃分析进行综合。四项RCT和十一项OT符合纳入标准，包括932名青少年。荟萃分析显示，干预前到干预后在上学出勤（g = 1.02）、焦虑（g = -0.57）、抑郁（g = -0.66）和行为问题（g = -0.40）方面有小到中等程度的未控制效应，这些效应在随访时得以维持。与对照组相比，CBT对上学出勤有中等效应（g = 0.44），但对焦虑（g = -0.09）和抑郁（g = -0.14）的效应不显著。虽然结果显示以SAP为重点的CBT有前景，但证据受到研究异质性、偏倚风险、方法学局限性和不一致的结局测量的限制，突出了进一步进行RCT的必要性。
