Anxiety Symptom Trajectories Predict Depression Symptom Trajectories up to Four Years After CBT for Youth Anxiety Disorders.

IF 2.9 2区 心理学 Q1 PSYCHOLOGY, CLINICAL Research on Child and Adolescent Psychopathology Pub Date : 2024-10-01 Epub Date: 2024-06-15 DOI:10.1007/s10802-024-01214-9
Krister W Fjermestad, Fredrik Ø Norum, Helene S Brask, Arne Kodal, Wendy K Silverman, Einar R Heiervang, Gro Janne Wergeland
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Abstract

Long-term data on depression symptoms after cognitive behavioral therapy (CBT) for youth anxiety disorders are scant. We examined depression symptoms up to four years post CBT for anxiety addressing youth age and gender, family social class, and parent mental health as predictors. The sample comprised 179 youth (M age at pre-treatment = 11.5 years; SD = 2.1) in a randomized controlled trial. Clinically assessed anxiety diagnoses and youth and parent-reported anxiety and depression symptoms were measured before, after, and one and four years after CBT. Parent self-reported mental health was measured before CBT. We used regression analyses to determine whether full diagnostic recovery at post-CBT predicted depression trajectories across the four-year assessment period. We used growth curve models to determine whether anxiety trajectories predicted depression trajectories across the four-year assessment period. Youth who lost their anxiety diagnoses after CBT had significantly lower parent-reported depression levels over time, but not lower youth self-reported depression levels. The anxiety symptom trajectory predicted the depression symptom trajectory up to four years post-treatment. There was more explained variance for within-informant (youth-youth; parent-parent) than cross-informants. Being older, female, having lower socio-economic status and parents with poorer mental health were associated with more youth-rated depression over time. However, these demographic predictors were not significant when anxiety symptoms trajectories were added to the models. Successful CBT for anxiety in children is associated with less depression symptoms for as long as four years. Anxiety symptom improvement appears to be a stronger predictor that demographic variables and parent mental health.

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焦虑症状轨迹预测青少年焦虑症 CBT 治疗四年后的抑郁症状轨迹。
有关青少年焦虑症认知行为疗法(CBT)后抑郁症状的长期数据很少。我们以青少年的年龄和性别、家庭社会阶层和父母的心理健康为预测因素,研究了认知行为疗法治疗焦虑症后四年内的抑郁症状。在一项随机对照试验中,样本包括 179 名青少年(治疗前平均年龄 = 11.5 岁;标准差 = 2.1)。临床评估的焦虑诊断以及青少年和家长报告的焦虑和抑郁症状在 CBT 治疗前、治疗后以及治疗后 1 年和 4 年进行了测量。家长自我报告的心理健康状况在 CBT 前进行了测量。我们使用回归分析来确定,CBT 后诊断的完全恢复是否能预测四年评估期间的抑郁轨迹。我们使用成长曲线模型来确定焦虑轨迹是否能预测四年评估期内的抑郁轨迹。在接受 CBT 治疗后焦虑诊断消失的青少年,其父母报告的抑郁水平随着时间的推移会明显降低,但青少年自我报告的抑郁水平不会降低。焦虑症状轨迹可预测治疗后四年内的抑郁症状轨迹。与跨受试者相比,受试者内部(青少年-青少年;家长-家长)的解释方差更大。随着时间的推移,年龄越大、女性、社会经济地位越低以及父母的心理健康状况越差,青少年的抑郁程度就越高。然而,当焦虑症状轨迹被添加到模型中时,这些人口统计学预测因素并不显著。长达四年的时间里,成功的儿童焦虑症 CBT 治疗与抑郁症状的减少有关。焦虑症状的改善似乎比人口统计学变量和父母的心理健康状况更能预测焦虑症状的改善。
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来源期刊
Research on Child and Adolescent Psychopathology
Research on Child and Adolescent Psychopathology Psychology-Developmental and Educational Psychology
CiteScore
5.00
自引率
4.00%
发文量
107
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