The role of attachment style in interpersonal psychotherapy for depressed adolescents
The role of attachment style in interpersonal psychotherapy for depressed adolescents
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DOI：
10.1080/10503307.2017.1315465
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发表时间：
2019-01-02
影响因子：
3.9
通讯作者：
Lee, Susanne
中科院分区：
文献类型：
--
作者：
Gunlicks-Stoessel, Meredith;Westervelt, Ana;Lee, Susanne
目的：采用人际心理治疗(IPT-A)研究抑郁青少年依恋焦虑和回避的变化，以及依恋方式与抑郁变化的关系。方法：40名12-17岁的青少年参加了一项为期16周的随机临床试验，该试验从IPT-A开始，并通过增加IPT-A疗程(n=11)或抗抑郁药物氟西汀(n=11)来加强对反应不足的青少年抑郁症的治疗(n=22)。青少年女性占77.5%，男性占22.5%(平均年龄14.8岁，SD=1.8)。10%的青少年是拉丁裔。亚裔占7.5%，美洲印第安人/阿拉斯加原住民占7.5%，白人占80.0%，混血族占5.0%。在基线、第8周和第16周分别测量依恋风格(亲密关系体验量表[ECR-R])和抑郁(儿童抑郁评定量表[CDRS-R])。结果：从基线到第16周，依恋焦虑和回避(ECR-R)显著降低。基线回避积极预测抑郁(CDRS-R)的更大下降，控制氟西汀。焦虑和回避的减少也与控制氟西汀的CDRS-R的减少显著相关。结论：青少年依恋焦虑和回避的报告可以接受IPT-A的干预。IPT-A可能对报告高水平回避性依恋的青少年特别有益。
Objective(s): This study examined changes in depressed adolescents' reports of attachment anxiety and avoidance with interpersonal psychotherapy (IPT-A), and the relationship between attachment style and change in depression with IPT-A. Method: Forty adolescents (aged 12-17) participated in a 16-week randomized clinical trial of 4 adaptive treatment strategies for adolescent depression that began with IPT-A and augmented treatment for insufficient responders (n = 22) by adding additional IPT-A sessions (n = 11) or the antidepressant medication, fluoxetine (n = 11). Adolescents were 77.5% female and 22.5% male (mean age = 14.8, SD = 1.8). Ten percent of adolescents were Latino. Racial composition was 7.5% Asian, 7.5% American Indian/Alaska Native, 80.0% white, and 5.0% biracial. Measures of attachment style (Experience in Close Relationships Scale-Revised [ECR-R]) and depression (Children's Depression Rating Scale-Revised [CDRS-R]) were administered at baseline and Weeks 8 and 16. Results: Attachment Anxiety and Avoidance (ECR-R) decreased significantly from baseline to Week 16. Baseline Avoidance positively predicted greater reductions in depression (CDRS-R), controlling for fluoxetine. Reductions in Anxiety and Avoidance were also significantly associated with reductions in CDRS-R, controlling for fluoxetine. Conclusions: Adolescents' reports of attachment anxiety and avoidance are amenable to intervention with IPT-A. IPT-A may be particularly beneficial for adolescents who report a high level of avoidant attachment.