Does Training Parents in Reinforcement Skills or Relationship Skills Enhance Individual Youths' Cognitive Behavioral Therapy for Anxiety? Outcome, Specificity, and Mediation.
Does Training Parents in Reinforcement Skills or Relationship Skills Enhance Individual Youths' Cognitive Behavioral Therapy for Anxiety? Outcome, Specificity, and Mediation.
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DOI：
10.1177/21677026211016402
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发表时间：
2022-03
影响因子：
4.8
通讯作者：
Pettit, Jeremy W.
中科院分区：
文献类型：
--
作者：
Silverman, Wendy K.;Rey, Yasmin;Marin, Carla E.;Jaccard, James;Pettit, Jeremy W.
关键词：
我们在341名患有原发性焦虑症的青少年中进行了一项拆解设计治疗研究，比较了个体CBT，CBT针对父母的强化技能（CBT+Reinf）和CBT针对父母的关系技能（CBT+ Relat）。在治疗后，青少年在CBT与家长参与有较低的焦虑比青少年在CBT。在12个月的随访中，CBT+Relat的青少年相对于CBT保持较低的焦虑。在治疗后，CBT+Reinf中的负强化显著低于CBT+Relat和CBT;负强化部分介导了青年焦虑的减轻。CBT+Reinf中减少父母负强化与较低的父母心理控制有关，这也部分介导了青少年焦虑的减少。其中一些调解活动在后续行动中继续进行。针对具体的行为养育技能，特别是负强化，产生治疗特异性和部分调解相对于不太具体的目标，并增强CBT。研究结果强调了识别机制的复杂性，通过这种机制，针对父母的技能产生青年焦虑减少，并为未来的研究提出了途径。
We conducted a dismantling design treatment study comparing individual CBT, CBT targeting parents’ reinforcement skills (CBT+Reinf), and CBT targeting parents’ relationship skills (CBT+ Relat) in 341 youths with primary anxiety diagnoses. At posttreatment, youths in CBTs with parent involvement had lower anxiety than youths in CBT. At 12-month follow-up, youths in CBT+Relat maintained lower anxiety relative to CBT. At posttreatment, negative reinforcement was significantly lower in CBT+Reinf than CBT+Relat and CBT; negative reinforcement partially mediated youth anxiety reduction. Reducing parental negative reinforcement in CBT+Reinf was associated with lower parental psychological control which also partially mediated youth anxiety reduction. Some of these mediational dynamics continued through follow-up. Targeting concrete behavioral parenting skills, especially negative reinforcement, produced treatment specificity and partial mediation relative to less concrete targeting, and enhanced CBT. Findings highlight complexities in identifying mechanisms through which targeting of parenting skills produces youth anxiety reduction and suggest avenues for future research.
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