Wolke D, Gray P, Meyer R
Behavioural Science Unit, University of London Institute of Child Health, UK.
Pediatrics. 1994 Sep;94(3):322-32.
To determine the efficacy of behavioral management counseling in the treatment of persistent, excessive infant crying (> 3 hours per day).
Two treatments, one no treatment control group. Infants were group-matched according to baseline fuss/cry levels, sociodemographic, and infant variables. Treatments were carried out sequentially by the same counselors.
Telephone counseling by volunteers (mothers) of CRY-SIS, a national support group for the parents of crying infants.
Sequential sample of 27 mother-infant pairs receiving treatment 1 (Tr1, empathy: talking through the problem), 21 receiving treatment 2 (Tr2, behavioral management: specific care taking suggestions) and 44 receiving no treatment (C, controls). Infants were between 1 to 5 months of age.
Mother-infant pairs had a pretreatment baseline assessment and a posttreatment follow-up (3 months after baseline) using 1-week diaries. Total fuss/cry duration reduced significantly more in the behavioral management group (by 51%) than the empathy group (37%) or the control group (35%). This was mainly due to significantly reduced evening fussing/crying in Tr2 (67%) compared with Tr1 (45%) and C (42%). No differences in total number of fuss/cry bouts/day were found. However, the number of fuss/cry bouts reduced significantly more in the evening in Tr2 (by 55%) compared with Tr1 (27%) and C (32%). Behavioral management mothers evaluated the same counselors as more sympathetic, knowledgeable, and understanding. Tr2 was also perceived by mothers to have helped them more in reducing the crying problem, coping with the infant, and improving the relationship with their infant than Tr1. No effects of treatment on infant difficult temperament were found.
Behavioral management was more effective in reducing fussing/crying than spending time with the mother talking through the problem or just waiting for spontaneous remission. Treatment by suitably but briefly trained lay counselors is an inexpensive and successful treatment option.
确定行为管理咨询在治疗持续性过度婴儿哭闹（每天>3小时）中的疗效。
两种治疗方法，一个不治疗对照组。婴儿根据基线烦躁/哭闹水平、社会人口统计学和婴儿变量进行组间匹配。治疗由同一名咨询师依次进行。
由CRY-SIS的志愿者（母亲）进行电话咨询，CRY-SIS是一个为哭闹婴儿的父母提供全国性支持的组织。
27对母婴接受治疗1（Tr1，共情：通过讨论问题），21对接受治疗2（Tr2，行为管理：具体的护理建议），44对不接受治疗（C，对照组），构成顺序样本。婴儿年龄在1至5个月之间。
母婴对在基线前进行一次评估，并在基线后3个月使用1周日记进行治疗后随访。行为管理组的总烦躁/哭闹时长显著减少更多（减少51%），高于共情组（37%）和对照组（35%）。这主要是因为与Tr1（45%）和C组（42%）相比，Tr2组晚上的烦躁/哭闹显著减少（67%）。未发现每天烦躁/哭闹发作总数有差异。然而，与Tr1组（27%）和C组（32%）相比，Tr2组晚上的烦躁/哭闹发作次数减少更多（55%）。接受行为管理的母亲认为同一名咨询师更有同情心、知识更丰富且善解人意。母亲们还认为，与Tr1相比，Tr2在减少哭闹问题、应对婴儿以及改善与婴儿的关系方面对她们的帮助更大。未发现治疗对婴儿难养型气质有影响。
行为管理在减少烦躁/哭闹方面比花时间与母亲讨论问题或只是等待自然缓解更有效。由经过适当但简短培训的非专业咨询师进行治疗是一种廉价且成功的治疗选择。
