针对已确诊有破坏性行为问题儿童的基于小组的指示性预防措施的有效性：德国医疗保健系统中的一项实施研究结果
Effectiveness of group-based indicated prevention in children identified with disruptive behavior problems: results of an implementation study in the German health care system.
作者信息
McDonald Maria, Fippel Theresia, Knappe Susanne, Porst Patricia Theresa, Siegmund Cornelia Beate, Zink Julia, Weniger Max, Beesdo-Baum Katja, Roessner Veit
机构信息
Department of Child and Adolescent Psychiatry and Psychotherapy, Faculty of Medicine, TUD Dresden University of Technology, Fetscherstr 74, 01307, Dresden, Germany.
Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Dresden, Germany.
出版信息
Child Adolesc Psychiatry Ment Health. 2025 May 16;19(1):55. doi: 10.1186/s13034-025-00902-8.
BACKGROUND
Subclinical disruptive behavior problems often occur during childhood and are a risk factor for developing a mental disorder later in life. To prevent a manifestation of dysfunctional disruptive behavior, early intervention is critical. This study aimed to examine the effectiveness of an indicated prevention program in children with disruptive behavior problems.
METHODS
Screening for disruptive behavior problems was conducted using the Strength and Difficulties Questionnaire during routine pediatric health check-ups. Depending on their risk status (normal vs. borderline vs. abnormal), children received a recommendation for no intervention, an indicated prevention program (i.a. "Baghira") or further diagnostics. Questionnaires such as the Child Behavior Checklist and the Parent Rating Scale for Conduct Disorder (DISYPS Competence scale) were administered at three time points (T0: pre-intervention, T1: 6 months after screening/ post-intervention, T2: 6 months after T1). Children who participated in "Baghira" (BA n = 171), a cognitive-behavioral group program for children with disruptive behaviors, were compared to children screened as normal (NOR n = 881) or received a recommendation for "Baghira" but refused participation (NO BA n = 46).
RESULTS
Disruptive behavior problems decreased (BA: β = - 3.61, p <.001) and prosocial behavior increased (BA: β = 1.67, p <.001) in the BA compared to the NOR group from T0 to T1. These effects were maintained at T2 follow-up (BA: β = - 1.60; p =.035; β = 1.12; p =.019). However, the NO BA group also improved in prosocial behavior and from T0 to T1.
CONCLUSION
Although an improvement in disruptive behavior symptoms as well as an increase in prosocial behavior were observed, controlled studies using matched or stratified designs are needed to replicate the effectiveness of "Baghira" in a prevention context, apart from the Covid-19 pandemic, to improve children's mental health.
背景
亚临床破坏性行为问题常在儿童期出现，是日后发生精神障碍的一个风险因素。为防止功能失调性破坏性行为的表现，早期干预至关重要。本研究旨在检验一项针对有破坏性行为问题儿童的选择性预防项目的有效性。
方法
在常规儿科健康检查期间，使用长处与困难问卷对破坏性行为问题进行筛查。根据其风险状况（正常、临界或异常），儿童会收到不干预、参加选择性预防项目（如“巴希拉”）或进一步诊断的建议。在三个时间点（T0：干预前，T1：筛查后/干预后6个月，T2：T1后6个月）发放儿童行为清单和品行障碍家长评定量表（DISYPS能力量表）等问卷。将参加针对破坏性行为儿童的认知行为小组项目“巴希拉”（BA组，n = 171）的儿童与筛查为正常的儿童（NOR组，n = 881）或收到“巴希拉”建议但拒绝参加的儿童（未参加BA组，n = 46）进行比较。
结果
与NOR组相比，BA组从T0到T1破坏性行为问题减少（BA组：β = -3.61，p <.001），亲社会行为增加（BA组：β = 1.67，p <.001）。这些效果在T2随访时得以维持（BA组：β = -1.60；p =.035；β = 1.12；p =.019）。然而，未参加BA组的亲社会行为也从T0到T1有所改善。
结论
尽管观察到破坏性行为症状有所改善以及亲社会行为有所增加，但除了新冠疫情期间，还需要使用匹配或分层设计的对照研究来在预防背景下复制“巴希拉”项目的有效性，以改善儿童心理健康。
Zotero 插件