Evidence Base Update: 50 Years of Research on Treatment for Child and Adolescent Anxiety
Evidence Base Update: 50 Years of Research on Treatment for Child and Adolescent Anxiety
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DOI：
10.1080/15374416.2015.1046177
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发表时间：
2016-03-03
影响因子：
4.2
通讯作者：
Chorpita, Bruce F.
中科院分区：
文献类型：
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作者：
Higa-McMillan, Charmaine K.;Francis, Sarah E.;Chorpita, Bruce F.
焦虑症是儿童和青少年中最常见的心理健康障碍。我们检查了 1967 年至 2013 年中期发表的 111 项治疗结果研究，测试了 204 种针对儿童和青少年焦虑的治疗条件。使用 PracticeWise 循证服务数据库选择纳入本次综述的研究。使用本杂志确定的指南（Southam-Gerow & Prinstein，），如果研究对象是有焦虑和/或回避问题的儿童和/或青少年（1-19 岁），则纳入研究。除了审查证据的强度外，审查还审查了有效性指标、治疗家庭的常见做法以及治疗结果的中介因素和调节因素。六种治疗方法对儿童和青少年焦虑达到了既定状态，其中 8 种被确定为可能有效，2 种被确定为可能有效，6 种治疗被认为是实验性的，还有 8 种治疗效果可疑。本次综述的结果表明，认知行为疗法（CBT）作为治疗青少年焦虑症的有效且适当的一线疗法得到了大力支持。其他几种可能有效的治疗方法主要不是基于 CBT，这表明对于 CBT 反应不佳的儿童和青少年，从业者可以采用其他基于证据的治疗方法。该综述最后讨论了除了减轻症状之外还可以改善功能的治疗方法、基于证据的治疗的常见做法、治疗结果的调节因素和调节因素、最佳实践的建议以及对未来研究的建议。
Anxiety disorders are the most common mental health disorder among children and adolescents. We examined 111 treatment outcome studies testing 204 treatment conditions for child and adolescent anxiety published between 1967 and mid-2013. Studies were selected for inclusion in this review using the PracticeWise Evidence-Based Services database. Using guidelines identified by this journal (Southam-Gerow & Prinstein, ), studies were included if they were conducted with children and/or adolescents (ages 1–19) with anxiety and/or avoidance problems. In addition to reviewing the strength of the evidence, the review also examined indicators of effectiveness, common practices across treatment families, and mediators and moderators of treatment outcome. Six treatments reached well-established status for child and adolescent anxiety, 8 were identified as probably efficacious, 2 were identified as possibly efficacious, 6 treatments were deemed experimental, and 8 treatments of questionable efficacy emerged. Findings from this review suggest substantial support for cognitive-behavioral therapy (CBT) as an effective and appropriate first-line treatment for youth with anxiety disorders. Several other treatment approaches emerged as probably efficacious that are not primarily CBT based, suggesting that there are alternative evidence-based treatments that practitioners can turn to for children and adolescents who do not respond well to CBT. The review concludes with a discussion of treatments that improve functioning in addition to reducing symptoms, common practices derived from evidence-based treatments, mediators and moderators of treatment outcomes, recommendations for best practice, and suggestions for future research.