Effects of a Cognitive Behavioral Therapy Intervention Trial to Improve Disease Outcomes in Children with Inflammatory Bowel Disease
Effects of a Cognitive Behavioral Therapy Intervention Trial to Improve Disease Outcomes in Children with Inflammatory Bowel Disease
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DOI：
10.1097/mib.0000000000000881
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发表时间：
2016-09-01
影响因子：
4.9
通讯作者：
Whitehead, William E.
中科院分区：
文献类型：
--
作者：
Levy, Rona L.;van Tilburg, Miranda A. L.;Whitehead, William E.
背景资料：测试行为干预对改善儿童炎症性肠病的心理社会后遗症的有效性的研究是有限的。本报告介绍了一项大型随机对照试验的结果，通过6个月的随访，测试了认知行为干预对炎症性肠病儿童及其父母的疗效。方法：185名年龄在8至17岁之间的克罗恩病或溃疡性结肠炎诊断儿童及其父母被随机分为两个3期条件之一：（1）社会学习和认知行为治疗条件或（2）旨在控制时间和注意力的教育支持条件。结果：治疗后6个月，克罗恩病或溃疡性结肠炎所致缺课的总体治疗效果显著（P < 0.05）。治疗后，儿童报告的生活质量（P < 0.05），父母报告的适应性儿童应对方式的增加（P < 0.001），以及父母对儿童症状的适应不良反应的减少（P < 0.05）也有显着的整体效果。最后，探索性分析表明，对于耀斑水平较高的儿童，（2个或更多）基线前，那些在社会学习和认知行为治疗条件下经历了更大的减少耀斑治疗后。这项试验表明，对患有炎症性肠病的儿童及其父母进行简短的认知行为干预可以改善儿童的功能和生活质量，对某些儿童来说，这可能会降低疾病的活动性。
Background: Studies testing the efficacy of behavioral interventions to modify psychosocial sequelae of inflammatory bowel disease in children are limited. This report presents outcomes through a 6-month follow-up from a large randomized controlled trial testing the efficacy of a cognitive behavioral intervention for children with inflammatory bowel disease and their parents.Methods: One hundred eighty-five children aged 8 to 17 years with a diagnosis of Crohn's disease or ulcerative colitis and their parents were randomized to one of two 3-session conditions: (1) a social learning and cognitive behavioral therapy condition or (2) an education support condition designed to control for time and attention.Results: There was a significant overall treatment effect for school absences due to Crohn's disease or ulcerative colitis (P < 0.05) at 6 months after treatment. There was also a significant overall effect after treatment for child-reported quality of life (P < 0.05), parent-reported increases in adaptive child coping (P < 0.001), and reductions in parents' maladaptive responses to children's symptoms (P < 0.05). Finally, exploratory analyses indicated that for children with a higher level of flares (2 or more) prebaseline, those in social learning and cognitive behavioral therapy condition experienced a greater reduction in flares after treatment.Conclusions: This trial suggests that a brief cognitive behavioral intervention for children with inflammatory bowel disease and their parents can result in improved child functioning and quality of life, and for some children may decrease disease activity.