Do specific modules of cognitive behavioral therapy for depression have measurable effects on youth internalizing symptoms? An idiographic analysis.
Do specific modules of cognitive behavioral therapy for depression have measurable effects on youth internalizing symptoms? An idiographic analysis.
复制标题
抑郁症认知行为疗法的特定模块对青少年内化症状是否有可测量的影响？
DOI：
10.1080/10503307.2022.2131475
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Weisz,JohnR
中科院分区：
文献类型：
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作者：
Frederick,Jennifer;Ng,MeiYi;Valente,MatthewJ;Chorpita,BruceF;Weisz,JohnR
目的了解认知行为疗法（CBT）每个模块的功效可能有助于改善青少年抑郁症的结果，但特定模块的效果很难检查。具体的中断时间序列模型提供了一种稳健的方法来估计模块对个体症状的影响。这项研究探讨了抑郁症的特定 CBT 模块与在随机试验中接受模块化 CBT 的抑郁青少年的内化症状之间的关联。方法为三名符合研究标准的青少年创建了个体模型。青少年完成每周症状报告，临床医生完成交付模块的记录。一阶自回归模型量化了模块交付前后平均内化症状严重程度的变化。结果所有青少年都有 1-3 个与症状减轻显着相关的模块和 1-3 个与症状恶化相关的模块。与至少一名青少年的改善相关的 5 个模块也缺乏关联（参与、放松、认知重构），或者与其他青少年的恶化（活动选择、父母心理教育）相关。七个模块对任何青少年都没有显示出可测量的益处或损害。结论这项研究表明，特定模块具有可测量的效果，但需要做更多的工作来建立特定模块效果的证据基础，为青少年抑郁症的个性化治疗提供信息。
ObjectiveUnderstanding the efficacy of each module of cognitive behavioral therapy (CBT) may inform efforts to improve outcomes for youth depression, but effects of specific modules have been difficult to examine. Idiographic interrupted time series models offer a robust way to estimate module effects on an individual’s symptoms. This study examined the association of specific CBT modules for depression on internalizing symptoms among depressed youths who received modular CBT in a randomized trial.MethodsIndividual models were created for three youths who met study criteria. Youths completed weekly symptom reports, and clinicians completed records of modules delivered. First order auto-regressive models quantified the change in average internalizing symptom severity between pre- and post-module delivery.ResultsAll youths had 1–3 modules that were significantly associated with symptom reduction and 1–3 modules associated with deterioration. The 5 modules associated with improvement in at least one youth also lacked association (engagement, relaxation, cognitive reframing), or were associated with worsening (activity selection, parent psychoeducation) in others. Seven modules showed no measurable benefit, or detriment to any youth.ConclusionThis study demonstrated that specific modules have measurable effects, but more work is needed to build an evidence base of specific module effects to inform treatment personalization for youth depression.