预防和治疗儿童和青少年焦虑症的认知和行为疗法的调节因素:一项系统回顾和荟萃分析。

IF 13.7 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Clinical Psychology Review Pub Date : 2025-01-09 DOI:10.1016/j.cpr.2025.102548
Siyu Zhou, Cathy Creswell, Urška Košir, Tessa Reardon
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引用次数: 0

摘要

先前的研究表明,认知和行为疗法(cbt)在预防和治疗儿童和青少年焦虑症方面的有效性存在很大差异,这表明存在影响结果的调节因子。本荟萃分析调查了样本特征(儿童年龄、儿童基线焦虑水平、父母基线焦虑水平)和干预特征(干预持续时间、调解人接触时间、调解人背景、分娩形式、父母参与)是否调节了cbt在儿童和青少年焦虑症的普遍预防、针对性预防和治疗中的有效性。我们确定了86项符合条件的随机对照试验(rct),评估了98项cbt与非主动对照的有效性。效应量是CBT与非主动对照组之间儿童广义焦虑症状的干预后标准化平均差异。采用meta回归和亚组分析分别对儿童和父母报告的结果进行适度分析。我们发现了一些证据:(1)儿童年龄、调解人背景和父母参与对cbt普遍预防效果的调节作用;(2)儿童年龄和干预时间对cbt针对性预防效果的调节作用;(3)儿童年龄、调解人接触时间和递送形式对cbt治疗效果有调节作用。没有证据表明儿童基线焦虑水平对cbt在普遍/有针对性的预防或治疗中的有效性有调节作用。由于现有数据有限,没有测试父母基线焦虑水平的调节作用及其与父母参与的潜在相互作用。尽管这些发现为“什么对谁有效”的问题提供了见解,但考虑到可用数据有限、结果差异大、潜在的混杂因素以及儿童和父母报告的结果之间的差异,应该谨慎解释这些发现。
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Moderators of cognitive and behaviour therapies for prevention and treatment of anxiety disorders in children and adolescents: A systematic review and meta-analysis.

Previous studies have indicated wide variation in the effectiveness of cognitive and behaviour therapies (CBTs) for preventing and treating anxiety disorders in children and adolescents, indicating the presence of moderators influencing outcomes. This meta-analysis investigated whether sample characteristics (child age, child baseline anxiety levels, parental baseline anxiety levels) and intervention characteristics (intervention duration, facilitator contact time, facilitator background, delivery formats, parental involvement) moderate the effectiveness of CBTs for universal prevention, targeted prevention, and treatment of anxiety disorders in children and adolescents. We identified 86 eligible randomized controlled trials (RCTs) assessing the effectiveness of 98 CBTs versus non-active controls. Effect sizes were the post-intervention standardized mean difference of children's broad anxiety symptoms between CBT and non-active controls. Moderation analyses were conducted separately on child- and parent-reported outcomes using meta-regression and subgroup analyses. We found some evidence for (1) a moderating role of child age, facilitator background, and parental involvement on the effectiveness of CBTs for universal prevention; (2) a moderating role of child age and intervention duration on the effectiveness of CBTs for targeted prevention; (3) a moderating role of child age, facilitator contact time, and delivery formats on the effectiveness of CBTs for treatment. There was no evidence for a moderating role of child baseline anxiety levels on the effectiveness of CBTs for universal/targeted prevention or treatment. The moderating role of parental baseline anxiety levels and its potential interaction with parental involvement was not tested given the limited available data. Although these findings provide insights into the question of what works for whom, they should be interpreted cautiously given the limited available data, wide variation in outcomes, potential confounders, and discrepancies between child- and parent-reported outcomes.

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来源期刊
Clinical Psychology Review
Clinical Psychology Review PSYCHOLOGY, CLINICAL-
CiteScore
23.10
自引率
1.60%
发文量
65
期刊介绍: Clinical Psychology Review serves as a platform for substantial reviews addressing pertinent topics in clinical psychology. Encompassing a spectrum of issues, from psychopathology to behavior therapy, cognition to cognitive therapies, behavioral medicine to community mental health, assessment, and child development, the journal seeks cutting-edge papers that significantly contribute to advancing the science and/or practice of clinical psychology. While maintaining a primary focus on topics directly related to clinical psychology, the journal occasionally features reviews on psychophysiology, learning therapy, experimental psychopathology, and social psychology, provided they demonstrate a clear connection to research or practice in clinical psychology. Integrative literature reviews and summaries of innovative ongoing clinical research programs find a place within its pages. However, reports on individual research studies and theoretical treatises or clinical guides lacking an empirical base are deemed inappropriate for publication.
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