Efficacy of a transdiagnostic, prevention-focused program for at-risk young adults: a waitlist-controlled trial.
Efficacy of a transdiagnostic, prevention-focused program for at-risk young adults: a waitlist-controlled trial.
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DOI：
10.1017/s0033291722000046
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发表时间：
2023-06
影响因子：
6.9
通讯作者：
Holt, Daphne J.
中科院分区：
文献类型：
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作者：
DeTore, Nicole R.;Luther, Lauren;Deng, Wisteria;Zimmerman, Jordan;Leathem, Logan;Burke, Anne S.;Nyer, Maren B.;Holt, Daphne J.
关键词：
就降低普通人群的精神病理学水平而言，“跨诊断”的预防计划可能比针对特定疾病的预防计划更具成本效益和益处。这项随机对照研究评估了一种称为弹性训练（RT）的干预计划的功效。报告轻度升高的抑郁或亚临床精神病症状（“精神病经历”（PE））的大学生（n = 107）被随机分配接受 RT（n = 54）或候补对照条件（n = 53）。 RT 包括四次干预，重点是通过获得正念、自我慈悲和心智化技能来提高复原力。在 4 周 RT/候补期之前和之后收集症状测量值和这些增强复原能力的技能，并在 12 个月后进行后续评估。与候补对照组相比，在 4 周的 RT/候补期后，RT 参与者的 PE、与 PE 相关的痛苦、抑郁和焦虑显着减少，并且弹性、正念、自我同情和积极情绪显着改善（所有 p < 0.03）。此外，恢复力促进技能的提高与症状减轻显着相关（所有 p < 0.05）。最后，在 12 个月的随访评估中，与放疗相关的 PE 和相关痛苦的减少得以维持。 RT 是一种简短的、基于团体的干预措施，可提高跨诊断高危年轻人的心理弹性和减少精神病理学症状，并对 PE 产生持续影响。后续研究可以进一步评估放疗相对于其他干预措施的功效，并测试它是否可以降低患严重精神疾病的可能性。
Prevention programs that are ‘transdiagnostic’ may be more cost-effective and beneficial, in terms of reducing levels of psychopathology in the general population, than those focused on a specific disorder. This randomized controlled study evaluated the efficacy of one such intervention program called Resilience Training (RT). College students who reported mildly elevated depressive or subclinical psychotic symptoms (‘psychotic experiences' (PEs)) (n = 107) were randomized to receiving RT (n = 54) or to a waitlist control condition (n = 53). RT consists of a four-session intervention focused on improving resilience through the acquisition of mindfulness, self-compassion, and mentalization skills. Measures of symptoms and these resilience-enhancing skills were collected before and after the 4-week RT/waitlist period, with a follow-up assessment 12-months later. Compared to the waitlist control group, RT participants reported significantly greater reductions in PEs, distress associated with PEs, depression, and anxiety, as well as significantly greater improvements in resilience, mindfulness, self-compassion, and positive affect, following the 4-week RT/waitlist period (all p < 0.03). Moreover, improvements in resilience-promoting skills were significantly correlated with symptom reductions (all p < 0.05). Lastly, the RT-related reductions in PEs and associated distress were maintained at the 12-month follow-up assessment. RT is a brief, group-based intervention associated with improved resilience and reduced symptoms of psychopathology, with sustained effects on PEs, in transdiagnostically at-risk young adults. Follow-up studies can further assess the efficacy of RT relative to other interventions and test whether it can reduce the likelihood of developing a serious mental illness.