Community Study of Outcome Monitoring for Emotional Disorders in Teens (COMET): A comparative effectiveness trial of a transdiagnostic treatment and a measurement feedback system
Community Study of Outcome Monitoring for Emotional Disorders in Teens (COMET): A comparative effectiveness trial of a transdiagnostic treatment and a measurement feedback system
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DOI：
10.1016/j.cct.2018.09.011
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发表时间：
2018-11-01
影响因子：
2.2
通讯作者：
Ginsburg, Golda S.
中科院分区：
文献类型：
--
作者：
Jensen-Doss, Amanda;Ehrenreich-May, Jill;Ginsburg, Golda S.
情绪障碍，包括一系列焦虑和抑郁障碍，是青少年中最普遍和共病的精神疾病。不幸的是，循证心理社会疗法通常集中在单一疾病，很少被社区精神卫生中心的临床医生采用，效果也很有限。本文介绍了两种新的干预措施，旨在解决这些挑战的比较有效性研究的协议。第一种干预措施是跨诊断治疗（青少年情绪障碍跨诊断治疗统一协议，UP-A），这是一种很有前途的新方法，使用少量的共同策略来治疗广泛的情绪障碍及其潜在的共同情绪脆弱性。第二个干预措施是一个标准化的测量反馈系统，青年结果问卷（YOQ），旨在改善临床决策使用每周症状和相关数据。三个研究组是常规治疗（TAU）、TAU + YOQ（TAU+）和UP-A（与YOQ联合使用）。本研究的主要目的是[1]比较UP-A和TAU +与TAU在社区精神卫生诊所的效果，[2]通过比较UP-A和TAU+条件来分离测量和反馈的效果，[3]检查两种干预措施的作用机制。设计考虑和研究方法提供了通知未来的有效性研究。
Emotional disorders, encompassing a range of anxiety and depressive disorders, are the most prevalent and comorbid psychiatric disorders in adolescence. Unfortunately, evidence-based psychosocial therapies typically focus on single disorders, are rarely adopted by community mental health center clinicians, and effect sizes are modest. This article describes the protocol for a comparative effectiveness study of two novel interventions designed to address these challenges. The first intervention is a transdiagnostic treatment (the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents, UP-A), a promising new approach that uses a small number of common strategies to treat a broad range of emotional disorders, and their underlying shared emotional vulnerabilities. The second intervention is a standardized measurement feedback system, the Youth Outcomes Questionnaire (YOQ), designed to improve clinical decision making using weekly symptom and relational data. The three study arms are treatment as usual (TAU), TAU plus the YOQ (TAU+), and UP-A (used in combination with the YOQ). The primary aims of the study are to [1] compare the effects of the UP-A and TAU + to TAU in community mental health clinics, [2] to isolate the effects of measurement and feedback by comparing the UP-A and TAU+ condition, and [3] to examine the mechanisms of action of both interventions. Design considerations and study methods are provided to inform future effectiveness research.