The impact of treatment delivery format on response to cognitive behaviour therapy for preadolescent children with anxiety disorders

被引:25
作者
McKinnon, Anna [1 ]
Keers, Robert [2 ]
Coleman, Jonathan R. I. [3 ,4 ]
Lester, Kathryn J. [5 ]
Roberts, Susanna [3 ]
Arendt, Kristian [6 ]
Bogels, Susan M. [7 ]
Cooper, Peter [8 ,9 ,10 ]
Creswell, Cathy [8 ]
Hartman, Catharina A. [11 ]
Fjermestad, Krister W. [12 ,13 ]
In-Albon, Tina [14 ]
Lavallee, Kristen [15 ]
Lyneham, Heidi J. [1 ]
Smith, Patrick [16 ]
Meiser-Stedman, Richard [17 ]
Nauta, Maaike H. [18 ]
Rapee, Ronald M. [1 ]
Rey, Yasmin [19 ]
Schneider, Silvia [15 ]
Silverman, Wendy K. [20 ]
Thastum, Mikael [6 ]
Thirlwall, Kerstin [8 ]
Wergeland, Gro Janne [13 ]
Eley, Thalia C. [3 ,4 ]
Hudson, Jennifer L. [1 ]
机构
[1] Macquarie Univ, Dept Psychol, Ctr Emot Hlth, Sydney, NSW 2109, Australia
[2] Queen Mary Univ London, Sch Biol & Chem Sci, Dept Biol & Expt Psychol, London, England
[3] Kings Coll London, Inst Psychiat Psychol & Neurosci, Social Genet & Dev Psychiat Ctr, London, England
[4] South London & Maudsley NHS Trust, NIHR Biomed Res Ctr Mental Hlth, London, England
[5] Univ Sussex, Sch Psychol, Brighton, E Sussex, England
[6] Aarhus Univ, Dept Psychol & Behav Sci, Aarhus, Denmark
[7] Univ Amsterdam, Res Inst Child Dev & Educ, Amsterdam, Netherlands
[8] Univ Reading, Sch Psychol & Clin Language Sci, Reading, Berks, England
[9] Stellenbosch Univ, Dept Psychol, Stellenbosch, South Africa
[10] Univ Cape Town, Dept Psychol, Cape Town, South Africa
[11] Univ Groningen, Univ Med Ctr Groningen, Dept Psychiat, Groningen, Netherlands
[12] Univ Bergen, Fac Psychol, Dept Clin Psychol, Bergen, Norway
[13] Haukeland Hosp, Dept Child & Adolescent Psychiat, Anxiety Disorders Res Network, Bergen, Norway
[14] Univ Landau Koblenz, Dept Psychol, Landau, Germany
[15] Ruhr Univ Bochum, Dept Psychol, Bochum, Germany
[16] Kings Coll London, Inst Psychiat, Dept Psychol, London, England
[17] Univ East Anglia, Dept Psychol, Norwich, Norfolk, England
[18] Univ Groningen, Dept Clin Psychol & Expt Psychopathol, Groningen, Netherlands
[19] Florida Int Univ, Child Anxiety & Phobia Program, Dept Psychol, Miami, FL 33199 USA
[20] Yale Univ, Sch Med, Ctr Child Study, New Haven, CT 06510 USA
基金
澳大利亚研究理事会; 瑞士国家科学基金会; 英国医学研究理事会;
关键词
Anxiety; treatment trials; cognitive therapy; ADOLESCENTS; TRIAL; GENES;
D O I
10.1111/jcpp.12872
中图分类号
B844 [发展心理学(人类心理学)];
学科分类号
040202 ;
摘要
Background: Several delivery formats of cognitive behaviour therapy (CBT) for child anxiety have been proposed, however, there is little consensus on the optimal delivery format. The primary goal of this study was to investigate the impact of the child's primary anxiety diagnosis on changes in clinical severity (of the primary problem) during individual CBT, group CBT and guided parent-led CBT. The secondary goal was to investigate the impact of the child's primary anxiety diagnosis on rates of remission for the three treatment formats. Methods: A sample of 1,253 children (5-12 years; Mage = 9.3, SD = 1.7) was pooled from CBT trials carried out at 10 sites. Children had a primary diagnosis of generalised anxiety disorder (GAD), social anxiety disorder (SoAD), specific phobia (SP) or separation anxiety disorder (SAD). Children and parents completed a semistructured clinical interview to assess the presence and severity of DSM-IV psychiatric disorders at preintervention, postintervention and follow-up. Linear mixture modelling was used to evaluate the primary research question and logistic modelling was used to investigate the secondary research question. Results: In children with primary GAD, SAD or SoAD, there were no significant differences between delivery formats. However, children with primary SP showed significantly larger reductions in clinical severity following individual CBT compared to group CBT and guided parent-led CBT. The results were mirrored in the analysis of remission responses with the exception that individual CBT was no longer superior to group CBT for children with a primary SP. The difference between individual and group was not significant when follow-up data were examined separately. Conclusions: Data show there may be greater clinical benefit by allocating children with a primary SP to individual CBT, although future research on cost-effectiveness is needed to determine whether the additional clinical benefits justify the additional resources required.
引用
收藏
页码:763 / 772
页数:10
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