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Evidence-based practice in child and adolescent mental health最新文献

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Building a Summer Treatment Program in the Real World 在现实世界中建立暑期治疗项目
Pub Date : 2022-12-22 DOI: 10.1080/23794925.2022.2151527
S. Tannenbaum, Katie C. Hart, S. Moody, Vasco M. Lopes, Carla C. Allan
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引用次数: 0
Cultivating Strength-Based Assessment: Psychometric Evaluation of the Social-Emotional, Evidence-Based Developmental Strengths (SEEDS) Youth Self-Report with Ethnically Diverse Grade School Youth 培养基于力量的评估:社会情感、基于证据的发展力量(SEEDS)青少年自我报告的心理测量评估
Pub Date : 2022-12-01 DOI: 10.1080/23794925.2022.2148309
Marina M. Matsui, Brad J. Nakamura
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引用次数: 0
A Self-Efficacy Measure for Use During Exposure in CBT Therapy for Childhood Anxiety Disorders CBT治疗儿童焦虑症暴露期间使用的自我效能测量
Pub Date : 2022-11-22 DOI: 10.1080/23794925.2022.2148380
M. K. Cancilliere, Aleksandra M. Fryc, E. Flannery-Schroeder
ABSTRACT Cognitive-behavioral therapy (CBT) with exposure is an effective treatment for childhood anxiety disorders; however, by nature it may involve much discomfort, often rendering engagement during exposure a challenge. An examination of factors related to engagement during exposure in CBT for anxiety is needed; yet, a search of the extant literature found few appropriate assessment tools. Thus, the current study focuses on developing and testing a measure of self-efficacy specific to exposure tasks, a construct likely to contribute to engagement during exposures. Twenty-four parent-child dyads were recruited, and parent, child, and clinician assessments were completed. Analyses revealed significant increases in self-efficacy in tandem with reductions in anxiety symptoms and increases in social and family functioning. Internal consistency was acceptable to excellent across time. Observed effect sizes were promising, warranting greater investigation of the self-efficacy measure. Further investigation into factors contributing to child engagement during exposure in CBT for anxiety is needed.
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引用次数: 0
Adaptation of a Transdiagnostic Cognitive-Behavioral Treatment for Adolescents with Comorbid Mental Health Conditions and High Risk Behavior 跨诊断认知行为治疗对青少年共病心理健康状况和高危行为的适应性
Pub Date : 2022-10-06 DOI: 10.1080/23794925.2022.2124556
Christianne Esposito-Smythers, Sarah F. Fischer, Emma D. Whitmyre, Annamarie B. Defayette, Katherine D. Maultsby, Keith D. Renshaw
Millions of adolescents seek treatment for mental health concerns and high-risk behaviors (e.g., suicidality, non-suicidal self-injury, substance use) each year. Use of services for mental health crises have only increased since the onset of the COVID-19 pandemic. Evidence-based treatments that can be readily employed in community settings are sorely needed to address the growing adolescent mental health crisis. To be most effective, they must be able to accommodate the common comorbidity and high-risk behaviors present among the treatment-seeking adolescent population, and be designed in a manner that can be readily adopted by clinicians that serve these youth within community-based organizations. Following the Replicating Effective Programs (REP) framework, we describe the adaptation and pre-implementation process of a transdiagnostic and modular cognitive-behavioral treatment, which integrates motivational interviewing and dialectical behavior therapy techniques, to address multiple adolescent mental health conditions and high-risk behaviors. Using a mixed-methods design, we collected data from community clinicians and/or other stakeholders on perceptions of the training protocol and treatment manual, self-efficacy and knowledge in manual use, use of modules with clients, and treatment adherence, to inform our REP efforts around modifications to the training and treatment manual. We present these data and describe modifications made using the Framework for Reporting Adaptations and Modifications (FRAME) to evidence-based interventions. Overall, data support our intensive training model and transdiagnostic treatment for use by clinicians in community settings. Stakeholder engagement, adaptations to the training and treatment materials, and participation in post-training consultation, appeared to facilitate successful pre-implementation efforts. Copyright © 2022 SCCAP.
每年有数百万青少年因心理健康问题和高风险行为(如自杀、非自杀性自残、药物使用)寻求治疗。自2019冠状病毒病大流行爆发以来,对精神卫生危机服务的使用只增不减。为了解决日益严重的青少年心理健康危机,迫切需要在社区环境中易于采用的循证治疗方法。为了达到最有效的效果,它们必须能够适应寻求治疗的青少年人群中常见的合并症和高风险行为,并以一种易于被社区组织中为这些青少年服务的临床医生采用的方式进行设计。在复制有效程序(REP)框架下,我们描述了一种跨诊断和模块化认知行为治疗的适应和实施前过程,该治疗结合了动机访谈和辩证行为治疗技术,以解决多种青少年心理健康状况和高危行为。采用混合方法设计,我们从社区临床医生和/或其他利益相关者那里收集了关于培训方案和治疗手册、自我效能感和手册使用知识、客户使用模块和治疗依从性的数据,以告知我们在培训和治疗手册修改方面的REP工作。我们展示了这些数据,并描述了使用报告适应和修改框架(FRAME)对循证干预措施所做的修改。总的来说,数据支持我们的强化培训模式和跨诊断治疗,供临床医生在社区环境中使用。利益相关者的参与、对培训和治疗材料的适应以及参与培训后咨询,似乎有助于成功的实施前工作。版权所有©2022 SCCAP。
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引用次数: 0
Harnessing Parent–Child Interaction Therapy for the Behavioral Treatment of a Child with Tuberous Sclerosis Complex and Autism Spectrum Disorder 利用亲子互动疗法对患有结节性硬化症和自闭症谱系障碍儿童的行为治疗
Pub Date : 2022-10-03 DOI: 10.1080/23794925.2022.2127134
Abigail Peskin, W. Rothenberg, Jason F. Jent
ABSTRACT Tuberous sclerosis complex (TSC) is a complex, rare genetic disorder often comorbid with severe autism spectrum disorder (ASD) with language and cognitive deficits. Despite the combination of TSC and ASD often leading to significant disruptive child behaviors, studies to treat ASD caused by TSC have thus far focused on pharmacological rather than behavioral interventions. This single-case study presents a 7-year-old Hispanic male “Michael,” diagnosed with TSC and ASD, and treated using Parent–Child Interaction Therapy (PCIT) adapted to his language and developmental level. Upon graduation from PCIT, Michael’s aggression and disruptive behavior decreased across clinic, home, and school settings (per parent report), and several social communication behaviors had emerged and increased including functional play, looking toward others, and directing smiles and other emotions. This case study highlights the promise of PCIT for children with lower cognitive and language functioning, demonstrates the potential of naturalistic parent-coaching interventions for older children with ASD, and provides a detailed clinical strategy for the behavioral treatment of TSC and ASD.
摘要结节性硬化综合征(TSC)是一种复杂、罕见的遗传性疾病,常与语言和认知缺陷的严重自闭症谱系障碍(ASD)合并。尽管TSC和ASD的结合通常会导致显著的破坏性儿童行为,但迄今为止,治疗TSC引起的ASD的研究主要集中在药理学而非行为干预上。这项单一病例研究介绍了一名7岁的西班牙裔男性“Michael”,他被诊断为TSC和ASD,并使用适应其语言和发育水平的亲子互动疗法(PCIT)进行治疗。从PCIT毕业后,Michael的攻击性和破坏性行为在诊所、家庭和学校环境中都有所减少(根据家长报告),一些社交行为出现并增加,包括功能性游戏、看向他人、引导微笑和其他情绪。该案例研究强调了PCIT对认知和语言功能较低儿童的前景,证明了自然主义父母指导干预对年龄较大的ASD儿童的潜力,并为TSC和ASD的行为治疗提供了详细的临床策略。
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引用次数: 0
Factors Associated with Readmissions to a Child Psychiatric Inpatient Unit 儿童精神科住院病人再入院的相关因素
Pub Date : 2022-10-02 DOI: 10.1080/23794925.2022.2127135
Melody English, Shannon McCullough, Mackenzie S. Sommerhalder, D. Day, Miranda Lingenfelter, S. Edwards, Kristin Scardamalia
ABSTRACT Readmission of youth to psychiatric inpatient care has several negative consequences, including increased risk of suicide and need for more frequent hospitalizations, disruption of education, and high cost of care for families as well as hospitals. Previously identified factors predicting readmission to psychiatric inpatient care for youth have included a wide variety of clinical diagnoses, indicating inconsistency in the association between diagnoses and risk of readmission. Instead, the current study focuses on behavioral definitions derived from chief complaints for psychiatric inpatient readmissions. The present study explores the relationship between chief complaint and readmission for patients ages 5–12 who were readmitted within 30 days post-discharge and over 30 days post-discharge from an inpatient psychiatric unit. Results demonstrated that when compared to patients without aggression as their identified chief complaint, patients whose chief complaint was identified as aggression-only and aggression-plus-other-factors were more likely to be readmitted within 30 days post-discharge and to have significantly more 30-day readmissions. Additionally, compared to patients without SI as their identified chief complaint, patients with SI-only as their identified chief complaint were found to be less likely to be readmitted within 30 days and have significantly fewer 30-day readmissions. These results suggest that physical aggression is a unique factor that may increase the risk of readmission for patients 5–12 years old. The results may be particularly useful in identifying crucial treatment components when establishing standards of care for inpatient psychiatric units, though further investigation is needed.
青少年再入院接受精神科住院治疗有几个负面后果,包括自杀风险增加、需要更频繁的住院治疗、教育中断以及家庭和医院的高护理成本。先前确定的预测青少年再入院精神科住院治疗的因素包括各种临床诊断,表明诊断与再入院风险之间的关联不一致。相反,目前的研究集中在精神科住院病人再入院主诉的行为定义上。本研究探讨5-12岁住院精神科出院后30天内及出院后30天以上再入院患者主诉与再入院的关系。结果表明,与不以攻击为主诉的患者相比,主诉为单纯攻击和攻击加其他因素的患者在出院后30天内再入院的可能性更大,且在30天内再入院的可能性更大。此外,与不以SI为主诉的患者相比,仅以SI为主诉的患者在30天内再入院的可能性更小,30天再入院的次数也明显减少。这些结果表明,身体攻击是可能增加5-12岁患者再入院风险的一个独特因素。虽然还需要进一步的研究,但研究结果可能对确定精神科住院病人护理标准时的关键治疗成分特别有用。
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引用次数: 1
Inpatient Psychiatric Care for Children and Adolescents: Increasing the Integration of Service and Science 儿童和青少年住院精神病护理:加强服务与科学的结合
Pub Date : 2022-10-02 DOI: 10.1080/23794925.2022.2127132
M. Patriquin, Alysha D. Thompson, Kelly Walker Lowry, J. Leffler, Elizabeth K. Reynolds
ABSTRACT The past decade has seen a significant increase in rates of mental illness for youth, including a dramatic increase in rates of suicide. This rise in youth mental illness coincides with a growing utilization of inpatient psychiatric care for children and adolescents. Now, more than ever, evidence-based interventions – and the science to develop these treatments – is needed for youth inpatient psychiatric care. Herein, we outline the strengths, weaknesses, opportunities, and threats (SWOT) for increasing the science in youth inpatient psychiatric settings to develop new evidence-based services.
摘要在过去的十年里,年轻人的精神疾病发病率显著上升,其中自杀率急剧上升。青少年精神疾病的增加与儿童和青少年住院精神病护理的日益利用相吻合。现在,比以往任何时候都更需要循证干预——以及开发这些治疗方法的科学——来进行青少年住院精神病护理。在此,我们概述了在青年住院精神病环境中增加科学以开发新的循证服务的优势、劣势、机会和威胁(SWOT)。
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引用次数: 0
Introduction to the Second Special Issue: Acute, Intensive, and Residential Services 第二期特刊导言:急性、密集和住宿服务
Pub Date : 2022-10-02 DOI: 10.1080/23794925.2022.2127136
Alysha D. Thompson, J. Leffler, Aaron J. Vaughn
ABSTRACT This second special issue of Evidence Based Practice in Child and Adolescent Mental Health will focus on Acute, Intensive, and Residential Services (AIRS) for youth. Despite recent increases in AIRS research, there remains a shortage of applying, evaluating, and developing evidence-based treatments (EBTs) in these settings. In addition, since the publication of our first special issue, the American Academy of Pediatrics (AAP), Children’s Hospital Alliance (CHA), and American Academy of Child and Adolescent Psychiatry (AACAP) have issued a joint statement declaring the state of youth mental illness to be a national crisis, worsened by the COVID-19 pandemic (American Academy of Pediatrics, Children’s Hospital Association, & American Academy of Child and Adolescent Psychiatrists [AAP, CHA, & AACAP], 2021). The introduction to the special issue will highlight work being done in AIRS settings for youth around the country.
这是儿童和青少年心理健康循证实践的第二期特刊,将重点关注青少年的急性、强化和住宿服务(AIRS)。尽管最近air研究有所增加,但在这些环境中仍然缺乏应用、评估和开发循证治疗(ebt)。此外,自我们的第一期特刊出版以来,美国儿科学会(AAP)、儿童医院联盟(CHA)和美国儿童和青少年精神病学学会(AACAP)发表了一份联合声明,宣布青少年精神疾病状况是一场全国性的危机,并因COVID-19大流行而恶化(美国儿科学会、儿童医院协会和美国儿童和青少年精神病学家学会[AAP, CHA, & AACAP], 2021)。特刊的介绍将重点介绍为全国各地的青年在空气环境中所做的工作。
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引用次数: 0
Exploring Agreement Between Adolescent Self-Reported PTSD Symptoms and Clinical Diagnoses on a Psychiatric Inpatient Unit 探讨青少年自我报告的PTSD症状与精神科住院病人临床诊断的一致性
Pub Date : 2022-09-30 DOI: 10.1080/23794925.2022.2127133
C. White, A. Ugueto
ABSTRACT A significant number of adolescents in the U.S. experience traumatic events, putting them at risk for developing Posttraumatic Stress Disorder (PTSD). Despite this risk, PTSD is not a commonly assigned diagnosis in psychiatric settings. The current study examined rates of psychiatrist-reported PTSD (PR-PTSD) diagnoses compared to probable PTSD diagnoses based on adolescent self-reported PTSD (SR-PTSD) symptoms on a psychiatric inpatient unit (n = 151, age 13–17). Self-report measures included questions on exposure to trauma and The Child PTSD Symptom Scale for DSM-5 (CPSS-5). Approximately 60% of participants met criteria for a “probable PTSD diagnosis” on the CPSS-5; however, only 10 out of 151 (6.6%) and 58 out of 151 (38.4%) were given PR-PTSD at admission and at discharge, respectively. Chi-square analyses indicated adolescents with SR-PTSD were more likely to have previous psychiatric admissions, χ2(1, N = 149) = 3.87, p = .049. There was also a significant association between SR-PTSD and suicide risk, χ2(3, N = 148) = 9.93, p = .019. Both the null and low suicide risk groups contributed the most to predicting SR-PTSD based on the standardized residuals being ±1.96. Additionally, SR-PTSD and insurance status were significantly associated, χ2(1, N = 147) = 4.48, p = .034. All of the cells equally contributed to the significance. When comparing diagnosis given at admission to SR-PTSD, agreement was poor (κ=.070, p = .043), and there was no agreement between diagnosis given at discharge and SR-PTSD (κ=.116, p = .074). Findings from the study highlight a discrepancy in SR-PTSD and PR-PTSD in adolescent psychiatric settings.
摘要:在美国,有相当多的青少年经历过创伤事件,这使他们面临患创伤后应激障碍(PTSD)的风险。尽管有这种风险,创伤后应激障碍并不是精神疾病中常见的诊断。目前的研究检查了精神科医生报告的PTSD(PR-PTSD)诊断率,与基于精神科住院病房青少年自我报告的创伤后应激障碍(SR-PTSD = 151岁,13-17岁)。自我报告测量包括创伤暴露问题和DSM-5儿童创伤后应激障碍症状量表(CPSS-5)。大约60%的参与者符合CPSS-5“可能的PTSD诊断”标准;然而,151人中只有10人(6.6%)和151人中有58人(38.4%)在入院和出院时分别服用了PR-PTSD。卡方分析表明,患有SR-PTSD的青少年更有可能有精神病史,χ2(1,N = 149) = 3.87,p = .SR-PTSD与自杀风险之间也存在显著相关性,χ2(3,N = 148) = 9.93,p = .根据标准化残差为±1.96,零自杀风险组和低自杀风险组对预测SR-PTSD的贡献最大。此外,SR-PTSD与保险状态显著相关,χ2(1,N = 147) = 4.48,p = .034.所有细胞对显著性的贡献相同。当比较SR-PTSD入院时的诊断时,一致性较差(κ=0.070,p = .043),出院时的诊断与SR-PTSD之间没有一致性(κ=.116,p = .074)。研究结果强调了青少年精神病环境中SR-PTSD和PR-PTSD的差异。
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引用次数: 2
Evaluation of the Virtual Youth Mental Health First Aid Training for Asian Americans During COVID-19 新冠肺炎期间亚裔美国人虚拟青少年心理健康急救培训评估
Pub Date : 2022-09-08 DOI: 10.1080/23794925.2022.2111727
Mazneen Havewala, Cixin Wang, Diksha Bali, A. Chronis-Tuscano
ABSTRACT Asian American youth experience high rates of racism and mental health difficulties, yet are less likely to seek mental health services compared to their non-Asian peers. Due to restrictions on in-person interactions imposed by the COVID-19 pandemic, many mental health services have been delivered virtually since March 2020. Youth Mental Health First Aid (YMHFA) virtual training is a manualized program designed to educate adults on recognizing signs and symptoms of common adolescent mental health challenges, and how they could effectively intervene. However, there is no published research on the effectiveness of the YMHFA-virtual version. Also, there is limited research on the effectiveness of YMHFA among Asian Americans, a vulnerable population. Utilizing a pre-post design, we evaluated the effects of the virtual YMHFA that we adapted for Asian Americans. Thirty-five Asian/American adults (Mage = 47.0, SDage = 8.98) participated in the YMHFA-virtual training and completed pre- and post- surveys. Significant increases were found in participants’ mental health literacy (MHL), mental health knowledge, confidence in using the mental health first aid skills, help-seeking intentions, and help-seeking attitudes, while a significant decrease was found in their stigma toward mental illnesses. The effect sizes varied from small (e.g., attitudes) to large (MHL and confidence in using MHFA skills). These promising findings have several implications. The culturally adapted YMHFA-virtual version may be an effective way to reach Asian Americans and promote mental health awareness, helpful attitudes, and confidence in supporting youth with mental health challenges in a culturally sensitive and non-threatening manner among this population.
亚裔美国青年经历种族主义和心理健康问题的高比例,但与非亚裔同龄人相比,他们寻求心理健康服务的可能性较低。由于COVID-19大流行对面对面互动施加了限制,自2020年3月以来,许多精神卫生服务都是以虚拟方式提供的。青少年心理健康急救(YMHFA)虚拟培训是一个人工程序,旨在教育成年人识别常见的青少年心理健康挑战的体征和症状,以及如何有效地进行干预。然而,目前还没有关于YMHFA-virtual版本有效性的公开研究。此外,在弱势群体亚裔美国人中,关于YMHFA有效性的研究也很有限。利用前后设计,我们评估了我们为亚裔美国人改编的虚拟YMHFA的效果。35名亚洲/美国成年人(年龄= 47.0,年龄= 8.98)参加了ymhfa虚拟训练并完成了前后调查。心理健康素养(MHL)、心理健康知识、使用心理健康急救技能的信心、求助意向和求助态度显著提高,对精神疾病的污名化显著降低。效应大小从小(如态度)到大(MHL和使用MHFA技能的信心)不等。这些有希望的发现有几个含义。文化适应的ymhfa -虚拟版本可能是接触亚裔美国人的有效途径,并促进心理健康意识,帮助态度和信心,以文化敏感和无威胁的方式支持该人群中面临心理健康挑战的青少年。
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引用次数: 0
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Evidence-based practice in child and adolescent mental health
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