儿童虐待对青少年抑郁症治疗效果的调节作用。

Sheree L Toth, Elizabeth D Handley, Jody Todd Manly, Robin Sturm, Tangeria R Adams, Elizabeth M Demeusy, Dante Cicchetti
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引用次数: 0

摘要

青春期女孩患抑郁症的风险较高,由于青春期抑郁症可能会引发一系列负面的发育问题,因此在青春期早期进行干预有可能会改变负面的发育轨迹。找出影响干预反应的风险因素,可为决定为患有抑郁症的少女提供何种治疗提供依据。了解循证治疗结果的调节因素对于提供及时有效的干预至关重要。将患者与最佳干预措施有效匹配,不仅能加快缓解患者的痛苦,还能减少将不必要的时间和资源花费在不太有利的干预措施上。本次调查研究了针对抑郁青少年的人际心理疗法(IPT-A)的疗效,研究对象是 120 名 13-15 岁低收入少女(有或没有儿童虐待史),样本具有种族和民族多样性。在治疗开始和结束时,对青少年和家长报告的抑郁症状进行评估,并要求诊断出抑郁症或抑郁症的亚症状。结果表明,在经历过两种或两种以上亚型虐待的少女中,IPT-A 比强化社区标准(ECS)治疗更有效。重要的是,当进一步探究虐待的亚型时,在有性虐待史的少女中,我们发现有初步证据表明,IPT-A 在减少抑郁症状方面的效果明显优于 ECS,而且效应大小很大。因此,如果存在虐待史,尤其是包括性虐待在内的虐待史,可能有必要专门解决与抑郁症状相关的人际环境问题。
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The Moderating Role of Child Maltreatment in Treatment Efficacy for Adolescent Depression.

Adolescent girls are at heightened risk of depression, and because adolescent depression may initiate a negative developmental cascade, intervention early in adolescence has potential for altering a negative developmental trajectory. Identifying risk factors that impact response to intervention may inform decisions about the type of treatment to provide for adolescent girls with depression. Understanding moderators of outcomes in evidence-based treatment is critical to the delivery of timely and effective interventions. Matching patients effectively with optimal intervention will not only expedite the alleviation of patients' distress, but will also reduce unnecessary time and resources spent on less advantageous interventions. The current investigation examines the efficacy of Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) in a racially and ethnically diverse sample of 120 low-income adolescent girls age 13-15 with and without histories of child maltreatment. Adolescent and parent report of depressive symptoms were assessed at the beginning and end of treatment and a diagnosis of subsyndromal symptoms of depression or depression were required for purposes of inclusion. Results indicated that among adolescent girls who had experienced two or more subtypes of maltreatment, IPT-A was found to be more efficacious than Enhanced Community Standard (ECS) treatment. Importantly, when the subtype of maltreatment experienced was further probed, among girls with a history of sexual abuse, we found preliminary evidence that IPT-A was significantly more effective than ECS in reducing depressive symptoms, and the effect size was large. Thus, if a history of maltreatment is present, especially including sexual abuse, specifically addressing the interpersonal context associated with depressive symptoms may be necessary.

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期刊介绍: Research on Child and Adolescent Psychopathology brings together the latest innovative research that advances knowledge of psychopathology from infancy through adolescence. The journal publishes studies that have a strong theoretical framework and use a diversity of methods, with an emphasis on empirical studies of the major forms of psychopathology found in childhood disorders (e.g., disruptive behavior disorders, depression, anxiety, and autism spectrum disorder). Studies focus on the epidemiology, etiology, assessment, treatment, prognosis, and developmental course of these forms of psychopathology. Studies highlighting risk and protective factors; the ecology and correlates of children''s emotional, social, and behavior problems; and advances in prevention and treatment are featured. Research on Child and Adolescent Psychopathology is the official journal of the International Society for Research in Child and Adolescent Psychopathology (ISRCAP), a multidisciplinary scientific society.
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