A Randomized Clinical Trial of an Integrative Group Therapy for Children With Severe Mood Dysregulation.
A Randomized Clinical Trial of an Integrative Group Therapy for Children With Severe Mood Dysregulation.
复制标题
针对严重情绪失调儿童的综合团体治疗的随机临床试验。
DOI：
10.1016/j.jaac.2015.12.011
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发表时间：
2016
影响因子：
13.3
通讯作者：
Pelh
中科院分区：
文献类型：
--
作者：
Waxmonsky,JamesG;Waschbusch,DanielA;Belin,Peter;Li,Tan;Babocsai,Lysett;Humphery,Hugh;Pariseau,MeaghanE;Babinski,DaraE;Hoffman,MartinT;Haak,JeniferL;Mazzant,JessicaR;Fabiano,GregoryA;Pettit,JeremyW;Fallahazad,Negar;Pelh
非发作性易怒是一种常见的损害性问题，导致严重情绪调节障碍（SMD）和破坏性情绪调节障碍（DMDD）的诊断。没有任何心理社会疗法被正式评估，药物是最常见的治疗方法。本研究探讨的可行性和有效性的联合亲子干预SMD.MethodA共68名参与者年龄在7至12岁的注意力缺陷多动障碍（ADHD）和SMD被随机分配到11周的治疗或社区为基础的心理社会治疗。所有参与者首先由研究医生稳定精神兴奋剂药物。在参与者中，56人仍然表现出受损的SMD症状并进入治疗阶段。蒙面评估参与者在基线，中点和终点，治疗参与者重新评估6 weeks later.ResultsAll，但2治疗参与者参加了大多数会议（n = 29），家庭报告的满意度高。使用情绪严重程度指数（MSI）的情绪症状变化的主要结果没有达到显着性，除了在参加大多数会议的子集（效应量= 0.53）。治疗与父母评定的易激惹性显著改善相关（效应量= 0.63）。治疗停止后，对易激惹的治疗效果减弱，但MSI未减弱。对ADHD症状影响不大。结果可能无法推广到患有SMD和与ADHD儿童样本中所见不同的合并症的青少年，并且由于缺乏测量SMD症状变化的金标准而受到限制。综合治疗被认为是一种可行的和有效的治疗参与者的易怒SMD和ADHD。临床试验注册信息--基于团体的行为疗法结合刺激性药物治疗注意缺陷多动障碍和情绪受损儿童; http：//clinicaltrials.gov/; NCT 00632619。
ObjectiveNonepisodic irritability is a common and impairing problem, leading to the development of the diagnoses severe mood dysregulation (SMD) and disruptive mood dysregulation disorder (DMDD). No psychosocial therapies have been formally evaluated for either, with medication being the most common treatment. This study examined the feasibility and efficacy of a joint parent–child intervention for SMD.MethodA total of 68 participants aged 7 to 12 years with attention-deficit/hyperactivity disorder (ADHD) and SMD were randomly assigned to the 11-week therapy or community-based psychosocial treatment. All participants were first stabilized on psychostimulant medication by study physicians. Of the participants, 56 still manifested impairing SMD symptoms and entered the therapy phase. Masked evaluators assessed participants at baseline, midpoint, and endpoint, with therapy participants reassessed 6 weeks later.ResultsAll but 2 therapy participants attended the majority of sessions (n = 29), with families reporting high levels of satisfaction. The primary outcome of change in mood symptoms using the Mood Severity Index (MSI) did not reach significance except in the subset attending the majority of sessions (effect size = 0.53). Therapy was associated with significantly greater improvement in parent-rated irritability (effect size = 0.63). Treatment effects for irritability but not MSI diminished after therapy stopped. Little impact on ADHD symptoms was seen. Results may not be generalizable to youth with SMD and comorbidities different from those seen in this sample of children with ADHD, and are limited by the lack of a gold standard for measuring change in SMD symptoms.ConclusionWhile failing to significantly improve mood symptoms versus community treatment, the integrative therapy was found to be a feasible and efficacious treatment for irritability in participants with SMD and ADHD.Clinical trial registration information—Group-Based Behavioral Therapy Combined With Stimulant Medication for Treating Children With Attention Deficit Hyperactivity Disorder and Impaired Mood; http://clinicaltrials.gov/; NCT00632619.